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Phys. Assessment for Standing Meds

School   (256 Views | 7 Replies)
by tomn13 tomn13 (New) New Nurse

tomn13 has 8 years experience and specializes in Healthcare Economics.

111 Profile Views; 6 Posts

Hi -- I am a School Nurse for a respite program that runs every other week.  Something interesting happened the other day that I didn't really ever think about and then had a philosophical debate with a nursing-friend over... I wanted to come here for more opinions.

 

I have a student, aged 8, who receives ex-lax (Chocolate Squares) three times a day:  Once during school hours.  Nearly every morning when the child is dropped off, the mother verbally confirms with me that I'll administer the ex-lax.  And, without fail, I administer the ex-lax.

 

Another Nurse had to administer the ex-lax recently, and before administering it she listened for bowel sounds and took the child's blood pressure.  My colleagues at the school thought it was the strangest thing.  I defended the nurse for doing this action that I don't do.  After all, I do suppose it's more correct to do that kind of assessment.

 

I don't want to engage in a philosophical conversation here, exactly, but I'm just curious  As a school nurse, would YOU listen for bowel sounds for the administration of a tid ex-lax?

Edited by tomn13

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NutmeggeRN has 25 years experience as a BSN and specializes in kids.

2 Followers; 6 Articles; 3,999 Posts; 43,293 Profile Views

Curious if you can give w/o MD order (unless you have one) as the sodium phosphate could be an issue. Is it FDA approved for that age group?

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64 Posts; 734 Profile Views

Is it a tid order to be given as needed or no matter what? Is it a signed MD order?

 

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tomn13 has 8 years experience and specializes in Healthcare Economics.

6 Posts; 111 Profile Views

@ NutmeggeRN -- Definitely have an MD order; wouldn't be administering anything without one.

@ cid1 -- a standing TID order.  She receives exlax at 8a, noon (That's mine), and 6p.  And yes, definitely a signed, real, full order from an MD.

 

So I wouldn't say it's "Give no matter what" because, as an example, if she came to my nurse's office and the staff was like "LOL she keeps pooping blood, time for ex-lax?" I'd say heck no.

 

FYI for clarity; this is a school for children with disabilities.  Not that this is directly important, but it could answer some questions that haven't been asked yet.

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64 Posts; 734 Profile Views

I think I would give it as ordered unless she is having diarrhea, etc

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tomn13 has 8 years experience and specializes in Healthcare Economics.

6 Posts; 111 Profile Views

@ cid1 -- would you do any sort of physical assessment?  Listening for bowel sounds, abdominal pain/tenderness/guarding, blood pressure, etc?

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1 Follower; 2,151 Posts; 36,561 Profile Views

I would give the med.  I would advise the mother of any observations or assessments which are relevant.

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Eleven011 has 20+ years experience and specializes in Home Health,Dialysis, MDS, School Nurse.

1,177 Posts; 15,222 Profile Views

I would not do an assesment everytime unless I had guidance from a Dr. order on what to do with results of an assesment - For example - hold med if hyperactive bowel sounds.    Or, like others mentioned, it was told to me student was having obvious diarrhea.   

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