which med do I give first

[kbkbajs]

I'm in my first year of school so I don't have a lot of experience with medications.Anyways our class was given a take home quiz (we can use any notes, people ect.) and many of us are stumped with this question because we feel we could rationalize each medication. The question goes like this- a patient who was admitted to the hospital with pneumococcal pneumonia has a temperature of 101.6 F with a frequent cough and is complaining of chest pain rated a 7 on a 10 point scale with deep inspiration. which of these ordered medications should the nurse give first?

A. Azithromycin (Zithromax)

B. Acetaminophen (Tylenol)

C. Codeine phosphate (Codeine)

I would appreciate anybody's input!! I'm really stumped, like I said I feel I could give a good rational for each.

[leslie :-D]

Giving the pain med will reduce the pain from deep inspiration. Once the pain is reduced the pt will then be able to cough and deep breath which is important to mobilize the fluid in the lungs.

true, but you really wouldn't want an infectious pt to be coughing.

once the zithro starts working, then coughing would be encouraged.

leslie

[ayla2004, ASN, RN]

wouldn't it be easy to get the codeine tyenol

and then hang the iv?

[UM Review RN, ASN, RN]

wouldn't it be easy to get the codeine tyenol

and then hang the iv?

In the real world, you're going to pull all 3 of those meds from the same Pyxis. It'd be silly to go back and forth three times. I always hang the IV first because I was taught to actually watch patients take their pills and swallow them.

But nowadays, who knows. The rules are always changing.

[hypocaffeinemia, BSN, RN]

I'm in my first year of school so I don't have a lot of experience with medications.Anyways our class was given a take home quiz (we can use any notes, people ect.) and many of us are stumped with this question because we feel we could rationalize each medication. The question goes like this- a patient who was admitted to the hospital with pneumococcal pneumonia has a temperature of 101.6 F with a frequent cough and is complaining of chest pain rated a 7 on a 10 point scale with deep inspiration. which of these ordered medications should the nurse give first?

A. Azithromycin (Zithromax)

B. Acetaminophen (Tylenol)

C. Codeine phosphate (Codeine)

I would appreciate anybody's input!! I'm really stumped, like I said I feel I could give a good rational for each.

Codeine will help stop the coughing and reduce the chest pain associated with frequent coughing and pneumonia. It would be my first choice. I'd give the zithro next because it is essential to fight his infection. His fever isn't high, persay, and I would hold off on the tylenol at least initially as a moderate fever helps to fight his infection and is not dangerous.

[ALS1023]

so what was the correct answer..have you received this info from your instructor yet with the rationales?

[aednurse]

My husband is an MD

he said zithromax 1st always. I as the nurse want to give the codeine 1st but I try to always do as taught do as the doc says:argue:

[beth66335, BSN, RN]

Just my:twocents:. I have not seen in clinicals orders written for Tylenol if pain is 7/10. Tylenol is usually for lower pain levels. I would give the pt a box of tissue with instructions to cover when coughing and hang the Zithromax. Then, if the Codeine is for pain I would give it, most pt coming into the hospital start with consolidations and don't have a productive cough at first, fluids and antibiotics will start breaking things up so the gunk can move. Then break out the Incentive Spirometer and go to town! If the pain can be managed I wouldn't suppress the cough at all, just encourage fluid intake to break things up.

Long story short...I agree with Daytonite

[aednurse]

That's what my husband said zithromax 1st

[AtomicWoman]

I love questions like this! I am learning so much just reading all your replies. Of course, I wouldn't love it so much if it were MY assignment to complete. :)

[leslie :-D]

i have a feeling that it's one of those nsg questions that no one will agree with...

even when provided w/the "correct" answer.

leslie

[coolvibesRN]

Pain takes first priority.Ill give the codeine,which will help with the pain and cough tgether.Then head for the zithromax.The codeine also has tylenol which might help with the fever too.

[Chrizzle]

I just had this question on a test. The answer is Zithromax.

Review of the choices:

A. Azithromycin (Zithromax)

B. Acetaminophen (Tylenol)

C. Codeine phosphate (Codeine)

I would appreciate anybody's input!! I'm really stumped, like I said I feel I could give a good rational for each.

Answer B - tylenol is not going to be effective. The pain stated is a 7 out of 10. It does not state a dose so it is assumed it is 325mg and is only one. The nurse should be calling the Dr. and asking what they can give that is stronger considering the pain level in real life.

Answer C - coedine is an opiate. You don't want to suppress the coughing you want it to come up.

That leaves Zithromax. rationale is it is quick acting and you want the dose in them as quick as possible because it will need be followed up by a second dose in the same day.

HTH