mandaaRN

Someone please help me understand the difference between ultram and narcotic pain relievers. How would I explain to the patient what this medication is? Thank you in advance!! :)

What do you do when you suspect a patient is aspirating? Do you turn them on their left side and NT suction?

What if they're both PO?

Thanks 0402! It's been buggin the hell out of me and being a nurse for just a year, I'm still asking so many questions! I always want to do the RIGHT way lol :)

Question! Is it okay to give Ativan IV with dilaudid PO at the same time? Same goes for any narcotic and Ativan together? I ask nurses at work but never get a straight answer as they are always busy themselves. What about narcs and sleeping pills? Do you wait an hour in between? It's been bothering me which meds are and are not okay to give with each other. If any of you could help me and ease my mind a little more, I would appreciate it so much!! :)

How would I run a K-rider with NSS for the purpose of burning sensation? I have ran the K-rider @ 50mL/hr with NSS piggybacked @ 50mL/hr as well on concurrent mode. Is this correct or is there another technique to run this? Was i supposed to run one slower than the other?

Do you still flush with 5cc before and after

Okay so is gingerale okay with cardiac diet

So for our patients who are on heart healthy, carb controlled and renal diets, we have gingerale, cola, and juices plus pudding and jellos in our fridge. What is okay to give to patients on these diets? Is gingerale suitable for diabetic, cardiac and renal diets?

My concern was for if the doc needed to be notified and change the order or if its the nurses discretion?

GRAY AREA! Can the nurse slow down the IV rate fore potassium or magnesium if the patient is complaining of burning or do we need to call the doctor to adjust the rate?

Changing the rate needs an order or is that at the nurses discretion?

Or document it? Although I didn't. But for future reference, god for bid it happened again

So last night when I was giving my patient her meds in the med cup of course, she dropped them on the floor. It was her synthroid and oxycodone. I told her I would get new pills for her but she insisted on taking them and even got down on her hands and knees to find the two pills. She ended up taking the dropped ones even after I said a few times il throw these ones away and get new ones. Now I'm just beating myself up over it for the fact that I don't know if I should have filled out an incident report or not. I asked another nurse I worked with and she told me not to worry about it, it's okay. Technically, it was all the patient but why am I beating myself up over a dropped and taken pill? Any suggestions on when this happens to you?! (If ever) :/

Wouldn't you want to worry about the peak of the PO occurring at the time of IV onset?

So are you saying you give both together? Or space them out such as two hours apart? Sometimes the doc writes for breakthrough pain especially with the multiple IV pain med orders. Alternating with PO and IV isn't against a rule especially as rule of thumb 2 hours apart? Arghh sorry, I'm going to bring this up at work again tonight

I'm having a difficult time understanding how to control pain in post-op patients. Last night my patient was on a PcA pump for the first 15 minutes of my shift, then was d/c'd. There were orders for 4mg IV morphine q4h, 1mg dilaudid IV q4h, Percocet 2tab q4h, and Vicodin 1tab (unsure of frequency). My question is, how am I supposed to choose which is best an how do I wean the patient off of IV pain meds? I started with the 4mg morphine initially since she was a fresh post op and informed the pt I would be weaning her down to PO. I thought I knew what I was talking about and decided to give IV dilaudid this morning. Stupid me didn't realize dilaudid is 10x stronger than morphine. The next nurse coming on told me that 1mg of dilaudid is like giving 10mg of morphine. Wow, well lesson learned there. Pt was fine, no harm. But can someone help me understand how I would wean off iv pain med and so forth? I'm fairly new and not that familiar with post op, I'm used to the chronic drug seeking frequent flyers, therefore pain management was just a slight issue for me. :/ I feel so dumb!

I always look into things too far but it's something that bothers me. I had a patient last night who had prn orders for two seperate Ativan orders. 2mg PO every 4 hours and 4mg IV every 2 hours. However, there was nothin written for breakthrough anxiety or such. My question is, if I give Ativan PO then decide pt needs IV dose, would I wait the 4 hours before giving it? What if it was the other way around and I gave IV Ativan then decided to give PO, would I wait 2 hours as the order for IV calls or wait the 4hours in between before I give PO? Ugh it's been bothering me all night. Simply how do I space out the two different routes of Ativan? I asked a nurse last night who just went on with a flight of ideas and never gave me a straight forward answer. Luckily the pt was not that agitated to need much Ativan, but if it were the case, how would I do it? Please help me :)

I have a question about which IV meds cause burning at the site during infusion? I'm aware that potassium is one of those, which others? Also, What's the difference between vesicant and irritant medications? I had a patient infiltrate last night but was getting IV ciprofloxacin and one of the seasoned nurses said it didn't seem that med or infiltrate was that concerning to call the doc about.Another question that has been on my mind is how do you administer sleep aids, pain meds or antidepressants? For example if a patient wants a sleeping pill and pain med at same time, do you wait an hour between or give together? Same as for sleep aid and antidepressant? With pain medication, the sustained release of morphine or oxy sr, is it okay to give an immediate pain med at same time such as iv morphine or oxy ir whichever is ordered? I know the sustained release doesn't kick in for a few hours so I would believe that giving immediate and sustained at same time would be fine. Or do you wait an hour or two between? These questions have been bugging me and I would like to hear advice from experienced nurses. Thanks so much!

Just trying to learn about the use of Benadryl and Dilaudid. Is benadryl usually given before Dilaudid or after? And why is it used with Dilaudid? I know itchy skin can be a side effect, but what are some other alternative nursing interventions to relieve itching? Thanks so much!

Didn't realize my post is a bother to you. Isn't this site for nursing advice and questions. I'm a new nurse, and criticizing my level of education is highly wrong on your part. Don't answer my post then, I was jusy clarifying what I meant.

If the docs gave parameters, I wouldn't be asking this question. They only give paramters for sliding scale. :/

I'm not talking about sliding scale, the before meal dose

I'm a new nurse and slightly confused. Should I hold AC insulin if blood sugar is below 70mg/dl but they are going to be eating a meal? Or would I administer the AC dose after the meal? As well as the lantus dose, what would I do? I just need advice. Thanksssss :)

I'm having the same anxiety. I also graduated this past May and i'm on my 3rd week of orientation. Everyone tells me it will get better.. I sure hope so! You're not alone! I thought I was until I read your thread.