HemOnc RN resident and posterior fossa syndrome

[margaritaw78]

Hi,

I'm a new RN, towards end of residency. I work on a HemOnc unit. My kiddo has been dealing w/posterior fossa syndrome, lots of head pain, tantrums, etc. He had prn meds of Benadryl and Reglan. I didn't administer them together, and the prn order didn't specifically state to give Benadryl, followed by Reglan. When my kiddo began to itch from his prior 4 day chemo, I gave Benadryl,but no Reglan. However, later (3 hrs) on Reglan was given by my preceptor, and I was told by on coming RN that's unsafe.....to give Reglan without Benadryl being within an hour of the Reglan. Can anyone clarify? My preceptor had to leave, change of shift was hectic, so it was not clarified for me. I'd like to know, practice safely, thanks!

[sergel02, BSN]

Hmm I wonder if it has anything to do with the diagnosis. I'm a new oncology nurse as well and I've given reglan without benadryl before.

[KelRN215, BSN, RN]

Posterior fossa syndrome is related to the child's craniotomy. The reglan/benadryl issue is unrelated to the posterior fossa syndrome. In peds oncology, benadryl is routinely given with reglan, especially if the dose is on the higher side, to decrease the risk of dystonic reactions. When I worked in the hospital, benadryl was continued q 6hr x 24 hrs following the last dose of reglan. That said, benadryl is typically dosed q 6hrs so if the patient already had it in board, I don't see the problem with giving reglan 3 hours later. We did always give them together when I worked in the hospital- mixed in the same syringe sometimes.

[margaritaw78]

KelRN215

I appreciate your knowledge on the issue. I was not initially concerned about how either had been administered, until it was pointed out it could be unsafe. That being said, the dose of Reglan was very small. I do understand that reactions can occur anyway, however the Benadryl was being given q6 ATC as well. Thanks for your insight.