Pantoloc infusion + Dimenhydrinate

[leaRNing101]

I wanted to pick all you senior nurses brains on this one...

Have a patient with esophageal varices, POD O for banding of the same.

Has a running octreotide infusion, pantoloc infusion (Y'd to NS with 40K).

Patient needs Gravol stat as is dry-heaving from nausea...do you give it IV though the Y port on the running pantoloc infusion as is compatible?

Thanks for you thoughts...

[REDDOG RN]

I was reading your post and wondering what the term "POD O" means and also what you mean by "POD O banding of the same." Just very curious what that means! I tried looking it up but got nowhere! I would greatly appreciate it if you could explain this to me!

[fiveofpeep]

when in doubt I always just disconnect the drip (unless its a pressor they are vitally dependent on) and flush before and after giving the IVP, then reconnect. Its faster. and if you flush at y-site into a drip, you're really flushing the drip into the patient in addition to the med.

[fiveofpeep]

post op day zero I assume

[leaRNing101]

FiveofPeep: Yes, POD 0 means Post op day 0 (same day as operation) and REDDOG RN: Wikipedia describes banding pretty well:

"Banding is a medical procedure which uses elastic bands for constriction. Banding may be used to tie off blood vessels in order to stop bleeding, as in the treatment of bleeding esophageal varices.[1] The band restricts blood flow to the ligated tissue, so that it eventually dies and sloughs away from the supporting tissue. This same principle underlies banding as treatment for hemorrhoids.[2]"

Five of Peep: Good point. I will do that in the future. My preceptor came and looked at my IV's and didn't say anything (I'm a 4th year nursing student finishing in a week), but I have been awake wondering about it...I know the meds are compatible, but I want to have best practice, and worried that with a Pantoloc infusion, if running another med was OK. I didn't find anything that says it isn't in my med guides or facility policies prior to hanging the med...but I have that pit-of-my-stomach feeling that maybe it wasn't the BEST way to administer the med...

[Esme12, ASN, BSN, RN]

FiveofPeep: Yes, POD 0 means Post op day 0 (same day as operation) and REDDOG RN: Wikipedia describes banding pretty well:

"Banding is a medical procedure which uses elastic bands for constriction. Banding may be used to tie off blood vessels in order to stop bleeding, as in the treatment of bleeding esophageal varices.[1] The band restricts blood flow to the ligated tissue, so that it eventually dies and sloughs away from the supporting tissue. This same principle underlies banding as treatment for hemorrhoids.[2]"

Five of Peep: Good point. I will do that in the future. My preceptor came and looked at my IV's and didn't say anything (I'm a 4th year nursing student finishing in a week), but I have been awake wondering about it...I know the meds are compatible, but I want to have best practice, and worried that with a Pantoloc infusion, if running another med was OK. I didn't find anything that says it isn't in my med guides or facility policies prior to hanging the med...but I have that pit-of-my-stomach feeling that maybe it wasn't the BEST way to administer the med...

I would always check with pharmacy when in doubt as well as look it up my self. You should also check in the policy and procedure manual/on line library for that particular facility as administration policies can very and you need to always practice within policy and procedure to cover your bum.

A patient that has had varicies banded can still bleed out. In the presence of any kind of gtts. I always start that emergency heploc to give any IVP meds or other fluids....that one "open" in case I needed it. I like having my bases covered in case I need it........... instead of trying to find a vein when it's an emergency and you REALLY need it. :)

[leaRNing101]

Thank you Esme12 for your reply! I appreciate your insight and will keep that in mind!