Oops:(

TazziRN, RN · May 10, 2007

It makes you human. Learn from this and move on. We all make med mistakes, some minor, some serious. We have a lot of responsibility but we are not perfect.

joey323 · May 10, 2007

thanks so much lucky the pt was not harmed. we just took vitals and when we notified the doctor he was like i'm not worried about that but was glad we called. So we just took vitals on the patient. Nursing is a hard profession i never want feel like this again. this was the worst day.

samaletta · May 10, 2007

yes u r right, it is a hard profession. I used to be a waitress, it was hard physically and mentally.....remembering what people ordered, who needed refills etc. (I can somewhat compare the two professions) Now that I am a nurse, I realize I can't slack off, I can't make mistakes. it's so serious. before if I brought the wrong order to the table, it was ok, no biggy, but if I were to bring the wrong med or something to a patient..... whoa!

it's such a big responsibility it's almost scary to me.

hey, tomorrow is my pinning! woo hoo! And congratulations to you with your upcoming graduation!

SouthernBelleinsocal · May 10, 2007

We're all human, and we've all made a mistake somewhere along the line. A few months ago, I gave a pt Xanax after the MD had DC'd it for possible allergic reaction. Nothing came of it and the MD ended up reordering the Xanax when I told him I had given it accidentally and there was no reaction. But for the rest of the night, I was back and forth making sure my pt wasn't hallucinating or having a more severe reaction.

Learn from your mistake, and make it a point to be more careful with double checking your meds. And be thankful your instructor didn't have a hissy fit. My clinical instructor would have made me feel like I had murdered someone intentionally for mispronouncing something....*sigh*

Good luck in your new career :)

Jess :nurse:

fultzymom · May 10, 2007

I know it does not make all better by saying that we all have done this.....but we are human. We, too, make mistakes. You did the right thing by notifying the DOC et watching your patient closely. The thing is to learn from your mistake et watch your times very carefully. Congrats on getting ready to graduate!!

Kyrshamarks, BSN, RN · May 10, 2007

I would not worry about it at all. The dosage that the dady is on is actually less than HALF of the minimum daily suggested effective dose. The normal Daily effective dosage for Lorpessor is 100 - 400 mg DAILY. and many time the at the lower end of the dosage it is divided into Q6 hour administration. I personally would be wondering why such a low dose in the first place.

gr8rnpjt, RN · May 10, 2007

Everyone makes mistakes, and some seasoned nurses just push it under the rug and cover it up. So you owned up to your mistake and you monitored the pt so you did everything right! You will make an excellent nurse!

fultzymom · May 10, 2007

I would not worry about it at all. The dosage that the dady is on is actually less than HALF of the minimum daily suggested effective dose. The normal Daily effective dosage for Lorpessor is 100 - 400 mg DAILY. and many time the at the lower end of the dosage it is divided into Q6 hour administration. I personally would be wondering why such a low dose in the first place.

I do not think this is such great advise. No matter what the recommended dose is, your patients dose is based on what they need. So yes, you need to worry about giving the correct dose at the correct time so that you are not making them go too low. You also need to always worry about giving the correct med at the right time, ect. Probably such a low dose due to their blood pressure runnings. I have patients at my LTC on that low of a dose.

ICU_floater · May 10, 2007

I would not worry about it at all. The dosage that the dady is on is actually less than HALF of the minimum daily suggested effective dose. The normal Daily effective dosage for Lorpessor is 100 - 400 mg DAILY. and many time the at the lower end of the dosage it is divided into Q6 hour administration. I personally would be wondering why such a low dose in the first place.

This is terrible advice. I've worked CICU for 12 years. we start all MI's and ACS at this dose with ACE inhibitors and NTG q6hr. too.... so a normal HR is 40's, a SBP is 90... lopressor peaks in 2-4 hrs. this med was re-dosed while it was peaking.

By dropping the HR even lower in a fresh MI, you can seriously drop the CO and cause coronary artery ischemia and extend the MI. It is a VERY delicate balancing act that is monitored closely.:angryfire THAT is way such a LOW dose is ordered. GEEZE.

OP, I'm not making excuses for you. you caught it, owned up to it and monitored. THAT is professionalism. My concern, even though you are about to graduate, we don't let our graduate administer meds on orientation without monitoring until MANY med passes later.... HOW were you allowed to give meds as a student without supervision?? :uhoh3:

ps. we all have done this, we still make mistakes, we all get upset... we tell everyone so they won't do the same.... then we make a new one:uhoh21: Keep learning, be villigent... be you.

RNperdiem, RN · May 10, 2007

You made a mistake.

You owned up to it right away.

The patient was not harmed.

Learn from this and keep going.

The weight of responsibility is a heavy one, and one I had not anticipated until I graduated and was left with the care and responsibility of 6 sick people. I do not relax until I have handed off the care of my patients to the next nurse.

Kyrshamarks, BSN, RN · May 10, 2007

this is terrible advice. i've worked cicu for 12 years. we start all mi's and acs at this dose with ace inhibitors and ntg q6hr. too.... so a normal hr is 40's, a sbp is 90... lopressor peaks in 2-4 hrs. this med was re-dosed while it was peaking.
by dropping the hr even lower in a fresh mi, you can seriously drop the co and cause coronary artery ischemia and extend the mi. it is a very delicate balancing act that is monitored closely.:angryfire that is way such a low dose is ordered. geeze.
op, i'm not making excuses for you. you caught it, owned up to it and monitored. that is professionalism. my concern, even though you are about to graduate, we don't let our graduate administer meds on orientation without monitoring until many med passes later.... how were you allowed to give meds as a student without supervision??
ps. we all have done this, we still make mistakes, we all get upset... we tell everyone so they won't do the same.... then we make a new one:uhoh21: keep learning, be villigent... be you.

i also have been an cvicu nurse for about 20 years and i also know how lopressor is given. here is right from the source from the pharma info on lopressor:

myocardial infarction
early treatment: during the early phase of definite or suspected acute myocardial infarction, treatment with lopressor can be initiated as soon as possible after the patient's arrival in the hospital. such treatment should be initiated in a coronary care or similar unit immediately after the patient's hemodynamic condition has stabilized.
treatment in this early phase should begin with the intravenous administration of three bolus injections of 5 mg of lopressor each; the injections should be given at approximately 2-minute intervals. during the intravenous administration of lopressor, blood pressure, heart rate, and electrocardiogram should be carefully monitored.
in patients who tolerate the full intravenous dose (15 mg), lopressor tablets, 50 mg every 6 hours, should be initiated 15 minutes after the last intravenous dose and continued for 48 hours. thereafter, patients should receive a maintenance dosage of 100 mg twice daily (see late treatment below).
patients who appear not to tolerate the full intravenous dose should be started on lopressor tablets either 25 mg or 50 mg every 6 hours (depending on the degree of intolerance) 15 minutes after the last intravenous dose or as soon as their clinical condition allows. in patients with severe intolerance, treatment with lopressor should be discontinued

i was questioning the low pill dose not the low iv dose. i also was letting her know that she would not kill her patient with that dose as it is well within paramaters for the doseage range. i do not need the physiology and practice advice. the peak for a dose of 12.5 mg is actually just under 2 hours. after that point you will get over a 50% reduction in medication effacy. that is with the oral dose. with iv it is much faster than that.