Med questions

[clearblue3]

Hi all!

I am new to private duty and had a couple questions about meds...my client only takes a variety of vitamins and has an albuterol neb. The POC doesn't have a dose for the neb...just says "one ampule." There is a box of them in the med cabinet that are used but the problem is that it actually has the client's sisters name on the box...apparently they have the same prescription and will share them for cost reasons or something. What do I do about that? I have only been in the hospital environment so I am not how big of a deal this is but it makes me uncomfortable. The nurse I mentioned it to says it doesn't matter?

My my second question is how it works with vitamin supplements. One of the vitamins is a different dose than what is on the MAR and POC. Does this matter or can a client take whatever OTC things they want? I am just a worrier and I like to do things by the book. I just don't know what things to make a big deal about and what things are really not issues in home care. Meds seem like kind of a big deal. Or am i just too paranoid? I am new on this case and don't want to cause problems right from the get go. Any thoughts?

[clearblue3]

Thanks!! I know the other nurses there are wonderful (and so is the client :-)) so I figured they knew what they were doing...but the worrier in me always has to ask :-) The experience and knowledge on this board is always priceless :-)

[Not_A_Hat_Person, RN]

I work for an agency that requires Nurses to have written orders for anything they give, including OTCs and herbal supplements. Family and other caregivers can give what the want when they want, we just need to document it. The policy came in handy last fall when one of my clients ended up with liver damage from an OTC "muscle building" supplement.

[nursel56]

Clearblue you can call the pharmacy who fills the albuterol prescription. If he doesn't have a current prescription under his own name with the correct dosage the pharmacy will normally call the doctor to get it. Siblings share as they will, but the orders still need to be properly written.

As far as refusing assessments..my experience is that adults with longterm, chronic disabling conditions often hate anything that reminds them of a hospital, and he's right in that their HHAs don't bug them about it.

You can sometimes humor them into it, or if he refuses, don't press the issue so that if he shows some unusual symptom when you really need more info he'll let you assess his breath sounds etc. I found that telling them you need to do it so you can check it off on your flow sheet is the worst strategy.

Sometimes I forget the person has endured countless requests to poke, prod, etc for decades in some cases. Best wishes!

[caliotter3]

You might get him to agree to an assessment every three weeks, or some other time frame, for GP sake, absent symptoms. Has worked for me. They usually are willing to meet you halfway.