New grad-still wondering when to hold certain meds!

[RockinNurse]

I'm a new grad working on a med-surg/telemetry unit. I've been taken off orientation and have been working on my own for about a month. When a new patient is admitted, a formal med sheet is not printed out for them and there is generally a hand written one by the unit clerk. I am always a little bit iffy on when to hold certain meds and when to give them. The other day, a bunch of the nurses were picking on another new nurse for holding lisinopril for a pulse less than 60. I know that generally you would only hold that drug for a low BP (less than 100 systolic) rather than a pulse. But it made me think! The other day, another nurse was giving Procardia. She gave it to a patient with a heart rate of 50. I thought that you should hold this drug for a HR of less than 60 and systolic BP less than 100, but I'm really not sure! What about Cardizem? Hold for a low BP, low pulse, or both? Just wondering if anyone has any info on BP/pulse affecting drugs! Wish I had one of those drug books for nurses to tell you when to hold and when not to!

Also, insulins...I know everyone's blood sugar differs and insulins affect people differently. But at what blood sugar would you typically hold Regular Insulin or other types of insulin? I just started working nights, if a patient has dialysis in the morning, do you hold ALL of their meds or just certain ones? That's a lot of questions for one night...thanks!! :)

[cleback]

They were talking about the nurse holding Lisinopril for a pulse of

As for other meds, if you don't want to ask toooo many questions, look it up in a drug book to see what the side effects are...it will tell you lowers pulse, etc. If it still isn't clear after looking it up, then ask!! Don't let others intimidate you into not asking because it is your responsibility to know and it is better to suck it up and ask then give something that may cause more problems.

Good luck! It does get better!

This. Also your pharmacist is your best friend for med questions.

[Sour Lemon]

The OP has seven years of experience now and may be less confused.