IV question

[mcknis]

So, the other day at work I was to give scheduled IV Protonix to a pt with a maintance IV with 10mEq of K. In school i had a pt with K added and thought that those two meds (K and Protonix) were incompatible. In our med rooms we don't have an IV drug book but only a standard nurses drug book so i was not able to confirm my suspicions. I feel bad calling pharm for trivial questions that I could easily find the answer to in drug guide. Maybe I am barking up the wrong tree, but have you ever given an IVP med that you weren't sure of its compatibilities? I got my suspicions confirmed through pharmacy and instead of giving the med in the line, i pushed it into the actual heplock.

Do you all have a cheat card/book with push rates, compatibilities, etc. or do you just call pharmacy for those things? I choose to look things up myself and call them for uncertainties because i am well aware that they have their busy jobs as well. just curious...

[Becster]

That's great that you are so considerate of pharmacy. You should speak with your manager about getting an IV drug book for your med room.

I have seen nurses draw some med from the line and test it with a dose for the IVP for precipitate, but there are some drugs that do not cause an precipitate but rather act as an antagonist or increase the effects of the other so I don't think that this is a very safe way to be sure that you are delivering drugs appropriately. We have the same access that our pharmacists do to Micromedex where we can check compatability. We also have 2 updated IV med books in our pharmacy as well as a poster of frequently used meds. Most units have access to the internet where there are a number of reliable sources. But, if your unit is unwilling to shell out the money to provide safe patient care, then the only choice that you have is to call the pharmacist. Maybe their manager will get tired of the interruptions and force the powers-that-be to spend $50 on a good IV drug book.

On a side note, I am a bit of fanatic about checking compatability and am surpised at how many things that I see piggy-backed that have either questionable compatability or a not compatable. Sad.

[embarrasingfield]

You should never, never feel bad about calling pharmacy or any other resource to confirm safety.

I usually use a software product that gives compatibilities.

But in the past or in the future, I will call whoever I feel like to get answers.

No question is a stupid question. The pharmacy is being paid to provide medications and information about them.

[iluvivt, BSN, RN]

You need to purchase the BIBLE of Intravenous medications. This book has been around for ages and comes out with a new addition every year. It is titled Intravenous Medications. By Betty Gahart and Adrienne Naxareno and there is a 2008 24th edition. This is by far the best IV drug book I have ever used. It is lightweight and comes in aspiral format. As a matter of fact,your hospital should purchase it for your medication room.

[marilynmom, LPN, NP]

Do you not have any type of online access to check compatibilities for IV drugs? I work in an ICU and as a new RN I check everything through Clinical Pharmacology online or UpToDate online.....it literally only takes me a minute and then if that doesn't answer my question I have will call pharmacy....that is what they are there for and they have always been happy to answer my questions.

I would think that with something like an IV push drug like protonix if you unclamp the main line that is giving them their maintenance fluids and flush it well, give your protonix (or whatever) and then flush again before re hooking the line, you should be fine. I usually try not to inject any IV push meds (this is just me personally) into an infusion if it's something I can just unclamp for a couple minutes. Something like dopamine, milrinone, epi etc gtts I would go so far as to start another IV site just for IV push meds/code meds/blood draws, etc Or consult your charge RN if your not sure how to handle something (I do that a lot too since I'm pretty new RN).

BUt no, I have always check IV meds and compatibilities.

[BriBriRN]

You should never, never feel bad about calling pharmacy or any other resource to confirm safety.

I usually use a software product that gives compatibilities.

But in the past or in the future, I will call whoever I feel like to get answers.

No question is a stupid question. The pharmacy is being paid to provide medications and information about them.

I totally agree....I never hesitate to call pharmacy, or ask someone else. These reactions and incompatablities could be really serious. It's up to us make sure it dosn't happen.

[Babs0512]

I would never hesitate to call pharm if I had a question about compatibility, and to answer your question, no, I would never give an IVP med unless I was sure of the compatibility with whatever their baseline IV is.

[mcknis]

thanks babs!