Med-Surg IV Meds

[Gyh]

I am starting a Med-Surg job soon and I have never worked in the hospital. Nurses who work Med-Surg what are the common IV push and IV medications? I want to review most common IV meds so that it's not too overwhelming when I start the job.

[Gyh]

1 minute ago, justjRN said:

Hi there! CONGRATS on the new position!

I’ve worked med surg about 6 years now and these are my most common iv push meds

reglan, Pepcid, toradol, morphine,dilaudid,Lasix, solumedrol at times, protonix and zofran (lots of zofran!!)

IV meds are usually antibiotics flagyl,ancef,rocephin,vancomycin and zosyn are the most common.

Good luck to you!!

Thank you for the info!

Thank you everyone for all of your replies! I have made a solid list of IV meds and now studying them.

[caffeinatednurse, BSN, RN]

Pretty much anything. Lots of pain meds (toradol, dilaudid, morphine, IV Tylenol are the big ones). GI meds (IV Pepcid, protonix, octreotide, zofran, reglan, phenergan). IV antibiotics galore. IV hydralazine, decadron, solumedrol, Lasix, bumex, Ativan, and phenobarbital are common. A few uncommon ones I’ve given are Synthroid and vitamin B by IV.

We also administer lots of blood transfusions, platelets, albumin, etc. And electrolyte replacements (calcium gluconate, potassium chloride, mag infusions to name a few).

Find Lexi-comp on your computer and bookmark it. Also be friendly with your pharmacists. I can’t count on both hands how many times I’ve called them with questions about a weird infusion I’ve never given before.

[MJJFan1, BSN, RN]

You’re better off knowing your common diagnosis admitted to the unit and then the treatments/labs/tests/meds that go along with that

[Eurobreakstar]

Hydromorphone, morphine, furosemide, methocarbamol, insulin, abx, metoprolol, metoclopramide, Heparin, pantoprazol, lorazepam, hydralazine, famotadine, ondansetron.

[jobellestarr]

On 8/3/2020 at 8:32 PM, Hoshio said:

In my setting, which is not an ICU, we do not allow Iv insulin per our policy by nursing. I’ve had some MDs that try to pressure nurses to do it here, but I simply tell them per policy I cannot administer that med, so either we do subq or I tel them they can come up and administer it themselves and stay with the patient to monitor them.

I had one moonlighter tell me after explaining our policy to them “it’s just insulin I don’t get the big deal”. The big deal that this isn’t an ICU, an IV insulin might kill my patient if done incorrectly ?.

Only different step meds I’ve done are either blood or tpn. Any high risk medication infusion will have a policy. Just lookup, and READ it.

For example, on the unit next to mine I remember a new nurses started a heparin drip on a patient and “looked up” the policy, but doubt she read it because the provider never ordered initial labs prior to initiating the drip which per our policy MUST be done before heparin is hung.

If you’re unsure about a policy, go up your chain of command to make sure you’re doing everything per your facility.

Also, depending on your facility providers may not need to specify rates for medications IV in their order. If you’re running things that don’t exist on a smart pump , always always always - verify the rate is acceptable for that medication with the pharmacist , and have them check your math and do a double check with another nurse. Basic mode is a scary mode on pumps, because the pump will do whatever you plug into it.

We used to have insulin drips on the m/s floor but it requires more monitoring with frequent glucose checks and insulin titration than is safe especially since we have so many patients and not 1-2 as in ICU.

[MiladyMalarkey, ASN, BSN]

Tons of antibiotics to hang & NS, many, various push meds. When I don't know something I read up on the med reference before administering. Remember a quick call to pharmacy is always a option when in doubt or you have questions. They are very helpful & have given me info at times I was able to pass on to MD's when having to call them.

[londonflo]

I have always found the Gahart app to be the best resource to have on my phone. Right up front of each medication entry, it tells you if you have to dilute, and how long to push a med. Some meds really require dilution; some it depends where you work. And you have to know the difference. Gahart comes our every year but you can buy an older spiral bound copy on Amazon for $5. Just nothing over 5 years old.

[BrendaH84, BSN]

I too had this question on graduating, as I wanted to study more in depth on freq used meds, bcuz the more you know about something, the more confident you feel=less freaking out or emotional stress.

no one ever really gave me any good answers, and during my 1st week my preceptor asked me to get something, I can't remember what, but it sounded like something else, I brought the something else and she really let me have it, she went overboard, but it is exactly the reason I should have been familiar with common med/surg meds.

you should know the brand name & the med. people & the dispensing machine will use them interchangeably

my med/surg most freq , if not daily are:

IV= vancomycin, meropenem, Zosyn, cefepime , cefazolin , ceftriaxone , ciprofloxacin and levofloxacin , immunoglobulin

IV push: dilaudid, morphine, lasix, ativan, pantoprazol, zofran, metoprolol, , hydralazine, and famotadine, and methylprednisolone

also understand tylenol how much you may give in a day, etc, because you will see that almost daily.

[Newishnurse1995]

You’ll see when you get on the floor. Don’t worry about that. They will teach you. I will say, my unit had a book and access to an online resource that went into detail about what we can and can’t push on certain floors.

[Mrs.D., BSN]

On 8/3/2020 at 11:01 PM, Gyh said:

LOL I bet! Amy IV medications that needed to be titrated following a protocol in your experience? Any IV push or IV medications that are cardiac related?

I work medical cardiology, so medsurg plus cardiac patients. It’s really going to depend where you work because medsurg has so many specialties like oncology, neuro, ortho too. I’m sure they regularly use stuff I’ve never heard of or would need to look up.

Some IV push & drips are amiodarone, sotalol, diltiazem, labetalol, metoprolol (lopressor), nitroglycerin, and electrolytes like potassium and magnesium. I feel like I push the lopressor and diltiazem the most, and hang the electrolytes erryday. I feel like it depends on the doctor’s preferences that you work with often. These meds are for things like atrial fibrillation with RVR, severe hypertension, SVT, chest pain with rising troponins—those are all very common on my floor. We recently did a bedside adenosine cardiovert, that was interesting...

Never be afraid to call the pharmacy. Ask for advice from your coworkers, for sure—even just to come with you the first time, but just remember that it’s your *** if you don’t follow hospital policy and something goes wrong. So print it out if you need to. I generally like to look up the guidelines myself, if I can’t remember. Know where your IV drug administration guidelines are (the DAG) for push times, dilutions, common dosages, etc. Know which meds require a BEDSIDE cardiac monitor and WHY.

Wherever you work will train you. If the floor has a patient going on a dilt drip, nitro drip, heparin drip, etc., chances are they will find you to teach you. If not, mention to the charge to spread the word that you haven’t done X, Y, Z, and if there’s time you’d love someone to show you if they get it. And ALWAYS mention if you haven’t done something and you’re nervous. There’s no shame and even if you think you’ve got it on your own with the policy (which is cool too), we can keep an eye out for questions.

Good luck, don’t stress, it’ll all come in time. ?

[kkbb, BSN, RN]

Learn where your resources are AND USE THEM. I use micromedex a lot at work to look up IV compatibility (not everything plays nice in the lines). Never assume things will be compatible...NS and 1/2 NS are not the same thing and things may work in NS but not 1/2 NS.

Your question is a great one to ask your preceptor, as they will know what is most common on your unit. For example, I work hem/onc med/surg, and there are times we use ativan or haldol for nausea, which isn't common on the other med/surg units, except for palliative. My unit can have certain cardiac drips, but the catch is that we cannot titrate them. If titration is needed then off to the cardiac unit or PCU they go.

[Toya2xcel, BSN, RN]

On 8/3/2020 at 1:10 AM, Gyh said:

I am starting a Med-Surg job soon and I have never worked in the hospital. Nurses who work Med-Surg what are the common IV push and IV medications? I want to review most common IV meds so that it's not too overwhelming when I start the job.

Zofran, compazine, opioids such as morphine/dilaudid, protonix, Pepcid, ABx like vancomycin, cefepime, flagyl, levaquin, zosyn, lasix, vasotec, we started also giving IV hydralazine too, Ativan, methylprednisone and dexamethasone