Nursing 1980

To make it simple, how do others document dose change in phone order at their facilities?

Throughout my nursing practice, I noticed many different ways of documenting dose change in phone order. I want to discuss with others about the best way to document dose change. At page 24, National Residential Medication Chart: https://www.safetyandquality.gov.au/sites/default/files/migrated/SAQ123_NursesUserGuide_V6.pdf The phone order contains the following fields: Medicine. Strength. Dose. Route. Frequency. Start date. Stop date. Reason ordered. Additional instructions. Nurse signature 1, Date. Nurse Signature 2, Date. Prescriber name, Prescriber signature, Date. For example, if there is a phone order about dose change from Amoxillian 250 mg to 500 mg (notes: it is only an example), two ways to document are as follows: 1. Medicine: Amoxcillian. Strength: 500 mg tab. Dose: 500 mg. Route: PO. Frequency: TDS. Reason ordered: UTI. Additional instructions: Cease Amoxcillian 250 mg. 2. Medicine: Amoxcillian. Strength: 250 mg tab. Dose: . Route: . Frequency: . Reason ordered: Ceased due to dose change. Medicine: Amoxcillian. Strength: 500 mg tab. Dose: 500 mg. Route: PO. Frequency: TDS. Reason ordered: UTI. In my opinion, the first way is more neat. The second way is more complete. However, which way is more accurate?

One client with home care vomited. There is PRN Metoclopramide tablet, but without PRN anti-emetic injection. As the client vomited, you can't give PRN Metoclopramide tablet immediately. When is the most appropriate time to give PRN Metoclopramide tablet after vomiting? There are a few options: 1. If the vomiting is settled and there is no further nausea, there is no need to give PRN Metoclopramide tablet after vomiting. 2. After the vomiting, if the client still has nausea, there is need to give PRN Metoclopramide tablet. However, when is the most appropriate time to give PRN Metoclopramide tablet after vomiting? Wait 10, 20, or 30 minutes to give PRN Metoclopramide tablet after vomiting?

What kind of gauze dressing would you use? Please give a few examples of gauze you would like to use. Meanwhile, according to the previous literature: https://cms.qut.edu.au/__data/assets/pdf_file/0003/451767/Book2-wound-dressing-guide.pdf Hydrogel should not be covered by a foam dressing. Is this practice correct or wrong?

If Hydrogel is covered by a gauze, will it be absorbed by the gauze? If Hydrogel is covered by a foam dressing, will it be absorbed by the foam? According to the previous literature: https://cms.qut.edu.au/__data/assets/pdf_file/0003/451767/Book2-wound-dressing-guide.pdf Hydrogel should not be covered by a foam dressing. Please explain the rationales of using a foam to cover Hydrogel. If Hydrogel can be absorbed by a foam, it wouldn't make much sense to use a foam to cover Hydrogel. Also, please explain the rationales of using a gauze to cover Hydrogel.

According to your reply, it seems that the examples from the document "Pressure ulcers – prevention and treatment: A Coloplast quick guide" are not much practically appropriate or even wrong. However, this practical guidance was made from a famous wound dressing organization. Although I don't agree with the examples from this organization, I don't think the examples are wrong practice. I want to have better understanding about the rationale of these dressing examples from this organization. It is highly possible that the examples from this organization would be the best practice for pressure ulcer. In your opinion, if Hydrogel can't be covered by Hydrocolloid or foam dressing, what kind of absorbent dressing would you use to cover Hydrogel? Please feel free to join the discussion.

Just update a typo. "Can Hydrogel be covered with a foam dressing? In my onion, Hydrogel shouldn't be covered with a foam as it can be absorbed by the foam.", would be better explained as follows: Can Hydrogel be covered with a foam dressing? In my opinion, Hydrogel shouldn't be covered with a foam as it can be absorbed by the foam after the breakdown of Hydrogel. https://cms.qut.edu.au/__data/assets/pdf_file/0003/451767/Book2-wound-dressing-guide.pdf At P. 12, the appropriate use of foam is explained. You can apply a hydrogel under a foam dressing? False Reason: The action of the dressing is to absorb fluid. If you moisten the dressing with a hydrogel it will then not be able to absorb any fluid. However, the combination of hydrogel and foam dressing is in practice by some nurses. Could any wound care specialists share your experience?

I read one user manual of wound dressings via online. Pressure ulcers – prevention and treatment A Coloplast quick guide You can get this manual via online. At P. 19, Treatment of pressure ulcers. Deep Wound/Light Drainage Woun'Dres (Hydrogel) cover with Biatain (Foam Dressing) or Comfeel (Hydrocolloid) At P.22, Autolytic Debridement: Purilon (Hydrogel) COVER WITH Biatain (Foam Dressing) Can Hydrogel be covered with a foam dressing? In my onion, Hydrogel shouldn't be covered with a foam as it can be absorbed by the foam. Also, Hydrogel shouldn't be covered with a Hydrocolloid dressing as the water in Hydrogel can interact with Hydrocolloid and turn into a gel, and further make Hydrocolloid less effective. A good way would be to cover Hydrogel with a film dressing or an absorbent gauze dressing. Are the dressing examples at P. 19 and P. 22 practically appropriate? Wound dressing is a common practice for every nurse. Therefore, I put the questions at this forum.