IV Cardiac Meds

[Lylesmom]

Just wandering about something. I work on a Physical Rehab Unit, and a couple times now they have tried to admit someone who is getting prn IV cardiac medications. We don't have telemetry and would have no way of monitoring them if we had to give it. the second person, came from med/surg where they do not have telemetry either. They are suppose to be stable and able to endure 3 hours of therapy a day. What can we as nurses do about this, and what could we say to the doctor that wants to go ahead and admit these patients? Thanks for your help everyone! I love knowing there are nurses out there that you can ask questions without feeling like I am nothing but a dumb new LPN, or a student nurse.

[Larry77, RN]

"Cardiac meds" is very broad...what specific meds are you talking about? Some meds that would fall into this category I would not be afraid of administering without a monitor others I would refuse so I'm curious to know what they are asking you to give.

[UM Review RN, ASN, RN]

On my unit we have an IV Protocol reference written up by Pharmacy that states which meds can be given on what unit.

For instance, on my Telemetry unit, I cannot IV Push Labetolol, yet we have gotten patients with an order for it. In that instance we call the doc and inform them that we cannot give the med and ask for a substitute. If the patient must have that form of the med, then the patient cannot be transferred.

I suggest you check around for something in writing and call Pharmacy for backup on this one.

[danielleRN76]

Most hospitals have a list of what types of meds require cardiac monitoring, and it is usually broken down by units. For example, my current tele unit can give some meds like cardizem as a "push" but if they are on a drip, they need to go to ICU. Talk to the nursing supervisor, or the head pharmacist. They should be able to help you.

[danielleRN76]

One other thing, if it's something like metoprolol that they were getting IV due to an NPO status, it may have been overlooked. See if the MD would change it to PO. That happened to me before.

[Lylesmom]

the order was for Apresoline 50mg. They are suppose to be stable and without IV in place, due to working with therapy, that way it does not potentially get dislodged or such from the various things they do with therapy. more and more we seem to be getting patients that aren't stable that we end up having to transfer back out because of not being stable. There is a lot more issues in regards to that than i can go into though. but thanks for lettting me know what route to take!