Home health med admin

[britmansf18]

Ok, right now I am not working as a nurse but i was recently sent to a client who just returned home from a nursing home with a new med list and a visiting nurse is monitoring his situation. I was concerned as a caregiver because we are supposed to "assist" the client to take scheduled meds. I was curious as to WHICH meds id be helping him take and only to find out that he was taking lisinopril, lasix, and metoprolol all at night at the same time. No one was monitoring his blood pressure beforehand. In my mind i was panicking thinking that its not ok to give a bp med like that without knowing a pressure... One nurse told me thats crazy unsafe ..but another tells me homecare is a different world and most people are non-compliant and do not monitor their pressures on BP meds. I guess it sort of makes sense if they've been taking them and I guess im used to the hospital setting.. Can someone comment on my thought process? Am I too paranoid? I literally feel embarrassed for even asking and just plain old DUMB.. like i should have known better.

[realnursealso/LPN, LPN]

The first thing you have to remember is that this is a person's home, not a facility. It is true that you are only supposed to remind them to take their meds. No one takes their BP every day at home before taking their meds. You stated that you are not working as a nurse at this case. What would you do with the BP after you took it? You have no parameters to follow, and where on your paper work does it ask what your patient's BP was. Reminding someone to take their meds vs. actually giving someone their meds are two different things. The visiting nurse will be the one pouring and managing the meds.

[britmansf18]

I understand theres a huge difference between a licensed person and nonlicensed and reminding them about meds vs managing i get it.. but regardless of parameters.. what about one knowing what a low blood pressure looks like? What any sensible person would do with a significantly low blood pressure? I sure as hell wouldnt give bp meds. Idk i guess i just thought if its low for whatever reason and then someone gives that and he bottoms out then what? Still gonna have some kind of accountability to the situation because u helped him take his meds. Im just sharing my thoughts and now i realize that people who take them for a long time dont need to..sorry

[CodeteamB]

I don't think you need to worry about it too much. This patient is stabilized on these medications. Many people living at home take more and stronger BP meds all together, and as someone else pointed out not many people are monitoring at home. If anything I'd say that the bedtime dose of lasix is concerning due to sleep interruption/ fall risk, however the patient may not find it troublesome, depending on the dose/ his reaction.

[NightNurseRN13]

I have a patient that is a walking pharmacy. I never touch his medications, I just ask him if he took them.

There was one time where he had acute onset of bilateral pitting edema in his lower extremities, weakness, loss of appetite, low BP, tachycardia and O2 sats that were on their own little roller coaster ride dipping into low 70's that wouldn't increase with ETS or duoneb. I sent him to the ED that night.

You aren't there morning, noon, and night to monitor his/her BP, so you work off what you find and act accordingly.

[T-Bird78]

Why is the lasix given at night? They'll be up all night peeing!