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.

[skimpstah]

I'd be ****** if i got a question like this on a test.

[jnick31]

I think Textbook answer is Zithromax first. Real world answer is you would give all at the same time. I think of it this way... if the person were going to go to emergency surgery and I had 30 seconds to give one of those 3 meds before they left... which one would I give?

[CaptainHook]

Weren't we taught that severe pain is treated 1st?

All of the meds were ordered...so: the client will be getting all the listed meds. I was thinking codeine to help the pain which is at a level 7.

It's hard to keep from reading into the question but -which is going to help patient comfort quickest- is how I would look at it.

[~Mi Vida Loca~RN, ASN, RN]

Weren't we taught that severe pain is treated 1st?

All of the meds were ordered...so: the client will be getting all the listed meds. I was thinking codeine to help the pain which is at a level 7.

It's hard to keep from reading into the question but -which is going to help patient comfort quickest- is how I would look at it.

While we are taught that pain is a priority, it is not always the case, sometimes pain meds can mask other things going on so we have to deal with the problem first before giving the meds. I am just saying that in general though, something for you to remember and think about, not necessarily in this case. But I have had a lot of test questions that we didn't give pain meds first because we needed to figure out what was going on and pain meds would mask that. Often neuro symptoms. Patient comfort doesn't override ABC's and safety.

For the question the way I see it, this patient is needing the Abs right away, it's a quick acting antibiotic. Tylenol also isn't going to do anything for a this kind of pain IMO. But I think Chrizzle post summed it up good with the order and rationales.

[NicuGal, MSN, RN]

I'd be inclined to go the Zithro, Tylenol and then codeine route. They always want the antibiotics on board first.