kbear

What do you do with your NG residuals? Do you discard or push them back in?

Unfortunately, I gave the drug despite my knowing inside that I shouldn't. I trusted the other nurse's actions and let myself down. It won't ever happen again, that's for sure!!

It just happened last night so not sure how the patient is doing now. Our unit pharmacist is going to let the first pharmacist know of his erroneous advice.

Another nurse and I were covering patients for a nurse who was late for work. One of her patients was ordered iv Tigan . The patient was retching loudly and had already received a prn dose of zofran a few hours earlier as well as phenergan a few hours before that. She had a new order for Tigan which had not yet been given since ordered.(This patient had history of gastroparesis and had chronic nausea). I've never given Tigan IV or heard of it given intravenously--only PR. The other nurse who was covering was trying to be helpful and drew it up and handed me the syringe and said "here". I said " I've never given that--I don't know how fast or if it gets diluted. She said-"oh, I've given it-it can be given straight undiluted as a push." As we learned in nursing school--Don't give a drug that you don't know about--how to give, side effects,etc. or that you didn't draw up. The patient received the dose and within 30 minutes was confused for the remainder of the night. I later found the vial that the other nurse used and it said for IM USE ONLY! I called pharmacy and he said that it can also be used for IV. I still didn't feel right after reading that label. I looked up the literature and EVERY REFERENCE listed administration routes as IM or ORAL!! The physician was informed and proceded to order mental status change work-up (ABG, Chem 7 ) despite being told about IV Tigan given. I spoke to our floor's unit pharmacist in the morning and she said it should not be given IV. It was ordered as IV, transcribed as IV by pharmacy on the CMAR and delivered to our floor with computerized label that indicated IV route (the vial itself said IM use only as I said before). Luckily the patient's confusion gradually wore off over the course of the night. Don't rely on another person to tell you about a drug that you don't know about-- Remember-the person giving the drug has the ultimate responsibility!! Take the time and look up the drugs!!

Our instituiton has a policy that any dose of IV phenergan has to be diluted in 50cc NS and piggybacked over 15 minutes. The Institute of Safe Medication Practice(ISMP) has a website that references awful cases of sloughing and necrosis of tissue and even amputations of fingers from IV phenergan damage!!

Our institution has PICC lines placed in interventional radiology and secured with the statlock device. We found out that they should be replaced weekly which coincides with our dressing change policy. Problem is, they are a bear to change. It doesn't come off easily, hard to maintain sterility, feels like you're going to lose the line and is very hard to resecure. Anyone else having issues with the statlocks??? :angryfire