Hello.....I am VERY curious what others will say about this....!!!
I went to put a new 75mcg Fentanyl patch on a new admit who was LETHARGIC, (ordered Q 3 days) but realized the one she already had on from her previous facility wasn't due to be changed for another day.... so, to me it was OBVIOUS not to put the new one on....
A nurse practitioner, pharmacist , AND my supervisor said it would have been FINE to put the new one on a day early, which surprized me! And I have to add that they ALL told me "as long as you had removed the old one"....okay, I KNEW that already!!!
(**ALL my coworkers agreed they would NOT have put the new one on!!!**)
I still CANNOT believe that the pharmacist even seemed mad at the MONEY it cost when I wasted the patch.....(like it comes out of HIS paycheck??) Yes, it DID bother me to waste this lovely new patch I'd just opened....KNOWING it was probably expensive, but hellllooooo----the patient is more important!!!!!!!!!!!!)
She was ALSO on prn Norco, which I had recently given....ANOTHER reason I was NOT putting that Fentanyl patch on a DAY early!!!
Thank you for all the feedback....I guess I could have just put the new patch on!
I should've explained that she had just been through her first day of PT and OT, (she is post laminectomy) ---she was perfectly alert and chatty before she left for therapies, so the ONLY thing I can come up with is that she was just plain TIRED!!!?
She is diabetic; (glucose was 132).....vitals were fine, 02 sats 98% on room air.....skin color fine.....I can't possibly recall ALL the other PO scheduled meds she was on, but there are tons, so perhaps that was part of it.
To clarify, I had given the prn Norco *before* she left for PT and OT......(when she was NOT lethargic!) ..... Oh, I should add that the doc changed her to Oxy-IR, and has tweaked her prn pain meds several times( so, those are obviously the "culprit" and not the patch, I guess?) ......You are all thorough nurses, and I appreciate your questions. Sorry I did NOT give more detailed info in my original post!
Specializes in icu, er, transplant, case management, ps.
Back in the mid1990's I was on a fentanyl patch. I suffered no lethargy, so I think hers may be due to something else. Second, one gets a measured dose. Putting on a new patch does not give a patient a boost of medication. I would have removed the old one, cleaned the area and applied a new patch.
nervousnurse, ASN
291 Posts
Thank you for all the feedback....I guess I could have just put the new patch on!
I should've explained that she had just been through her first day of PT and OT, (she is post laminectomy) ---she was perfectly alert and chatty before she left for therapies, so the ONLY thing I can come up with is that she was just plain TIRED!!!?
She is diabetic; (glucose was 132).....vitals were fine, 02 sats 98% on room air.....skin color fine.....I can't possibly recall ALL the other PO scheduled meds she was on, but there are tons, so perhaps that was part of it.
To clarify, I had given the prn Norco *before* she left for PT and OT......(when she was NOT lethargic!) ..... Oh, I should add that the doc changed her to Oxy-IR, and has tweaked her prn pain meds several times( so, those are obviously the "culprit" and not the patch, I guess?) ......You are all thorough nurses, and I appreciate your questions. Sorry I did NOT give more detailed info in my original post!