Ondansetron.... iv or im ..... doctor's prescription....

Rod, Male Nurse · Jan 31, 2015

What does the doctors order state? If it only states to give IV then IM shouldn't be a consideration for a low risk medication like this. You push over the preferred 2-5 minutes to lower the risk of side effects. Patient comfort should be considered as well. Why stick him/her with a needle when you can give it IV.

I'm looking at my patients order for zofran right now and it states "IV push" with no mention of IM. IM wouldn't even be considered.

TheNGTKingRN · Jan 31, 2015

You can call the provider and question and suggest, you cannot change the route yourself. Never ever decide you want to change the route on your own without an order because if something goes wrong your butt is on the line.

poppycat, ADN, BSN · Jan 31, 2015

I guess I'm confused. Why give it at all if the patient isn't vomitting or nauseated?

As the others have stated, you can't change the route without an order.

nrsang97, BSN, RN · Jan 31, 2015

I guess I'm confused. Why give it at all if the patient isn't vomitting or nauseated?
As the others have stated, you can't change the route without an order.

This was my thought as well. If not nauseated or vomiting why would you give zofran? Was it a premedication for something? I would give the dose as prescribed IV.

Rod, Male Nurse · Jan 31, 2015

I guess I'm confused. Why give it at all if the patient isn't vomitting or nauseated?
As the others have stated, you can't change the route without an order.

Right. If the patient is being given other medications that are likely to cause nausea then it would be indicated but otherwise why give? I'm of the mindset that I wouldn't want medications in me that I don't need and I treat my patients as such.

@nurse_kinjal...This sounds like your instructor is testing your critical thinking skills.

NICUmiiki, DNP, NP · Jan 31, 2015

The prescribed parameters probably mentioned to give for nausea/vomiting. No n/v = no zofran.

If not, you can't just change the route of a drug. And if you could, why choose the more painful option if an IV is already in place.

And IF you really REALLY want to call the doc and get the route changed to something less immediate acting, I would go with PO.

JWG223 · Jan 31, 2015

Zofran? This is a PRN medication, typically, unless you are giving it with a narcotic to prevent immanent NV. Do what the MD ordered regarding route, I have NEVER given Zofran IM. NEVER.

Let the Dr. be the Dr. unless you see something unsafe. IV Zofran is not unsafe.

registerednutrn, BSN, RN · Jan 31, 2015

I give zodran scheduled to all patients with a pca (the docs order it that way) to prevent nausea. I have never given it IM and I can not find anything saying it can be given IM. Never just change a route on a med with talking to the doc that prescribed it.

dream'n, BSN, RN · Jan 31, 2015

I also have never seen Zofran ordered as an IM injection. Never, ever. And an IM is more painful for the patient anyway. Is the professor giving you a trick question maybe? IMs have side effects too and causes a break in the skin, therefore increasing infection risk. If a slower route is preferred, then I'd ask the Dr. for the SL route but in the hospital I've only used the SL route if there is no IV access at the moment. Don't know why you would want a slower route though, it's used for N/V so even without vomiting being present, nausea is certainly not comfortable for the patient.

SierraBravo · Jan 31, 2015

In oncology it is not uncommon to see ondansetron scheduled q6h for delayed onset CINV with additional anti-emetics with different MOA's prn.

EDIT: Like the other posters have already said, you CANNOT change the route of a medication without an order to do so.

psu_213, BSN, RN · Jan 31, 2015

I guess I'm confused. Why give it at all if the patient isn't vomitting or nauseated?

Not sure of the setting/clinical situation of the OP, but In the ED, for example, we give it quite a bit as a "premedication" for someone getting IV opioidsâ€¦even if they are not nauseated at the time of administration.