going to start in med surg soon

[supaflyz]

Hello guys,

I will hopefully start in med surg floor soon if my physical is clear. I have been working at a rehab/snf for a year. I'm scared, but looking forward to it. I wanted to get some advice on what medications to hold. I know about the blood pressure medications.

Can you guys give me some tips on the (Important medications) and when to hold them.

[alliecatrn10]

I always check BP myself before giving BP meds..even if the CNA did it 10min ago. If it's a beta blocker always watch the HR- don't give if hr below 60.

If pt is hypotensive, Iv pain meds, po opiates and benzos can drop the BP even more so I'm always very careful with that.

For Parkinson's patients, do not give sinemet if experiencing tardive dyskinesia or severe dystonic movements- it will make it worse.

For patients in liver failure make sure there's no Tylenol ordered- I've seen it sneak it's way onto the MAR occasionally

Pharmacy should be paying attention to this but if a patients kidney function is going downhill (creatinine and BUN are trending up), many antibiotics need to be adjusted to renal function so it's good to give pharm a heads up that the dose probably needs to be adjusted

If you have a vanco trough/peak that needs to be drawn, make sure you wait to hang the vanco until it's back.

Hold stool softeners/laxatives for diarrhea (obviously)

I'm sure there's more, but that's what's coming to mind atm! Hope that helps!

[alliecatrn10]

Oh and of course holding any sedatives for lethargy (takes a judgement call- you get a feel

For what patients can and can't handle) this includes phenergan

[ClaraRedheart, BSN, RN]

Good info Allie! Thanks :) I'm a new nurse as well.

[supaflyz]

Thank you Allie!