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Hi, Newbie here with a question. On our ward, we usually have orders for multiple meds IV at the same time. For instance, the morning could be Pantoprazole 40mg iv, Cefuroxime 1.5g iv, Paracetemol 1g iv. That's pretty normal, but there could be others thrown in there at the same time as well, in addition to any late-hour additions. I don't like giving medications simultaneously (newbie, sorry). Because of this, my meds can sometimes run an hour late. Here's my question: Should I only be concerned with precipitate and interaction risks? Are those the only two things I should be worried about? We have a list that shows precipitates, but it doesn't list every drug that we use. For instance, Levetiracetam is NOT listed at all on the precipitate list (this is the first one that comes to mind). Because of this, I will run it alone due to the fear of it interacting with something not listed. I will also ask more today on the ward, but I like the responses on this website and would like additional perspective. Thank you!

I could hug you. The transition from nursing school to working life has been definitely more challenging than I'd anticipated. This felt like the first time I'd done something that negatively affected a patient, and the fact that his wife was there and scared really affected me. I still remember the look on her face when his monitor started blaring - there were 6 of us in the nursing station and she only looked at me. Sorry to be a wuss but I cried reading these responses as I let it REALLY sink in that I didn't do anything wrong, or there wasn't some rule about Furosemide that I hasn't heard/read, etc etc. Thank you!

Somehow - and I really don't know how - I didn't freak out in front of the patient's family. I hustled over there for sure, but I waited until later to have my moment. What was funny was that it was a very specifically isolated incident. I'd been taking care of that same patient for three days in a row and he'd never had an abnormal HR before that, so at the time it felt like a DIRECT consequence of something I had done, possibly in error (even though I am crazy about checking everything, then double, then triple checking). I didn't even know about the repeat brady episode until the next morning, so any perspective I have came later, and even then, I was worried it was a leftover effect from before. It's not until posting here that I finally feel some relief. So, thank you!

I don't know what exactly I'm looking for here, but I have to get this story out and we don't have counselors available at our hospital. I'm new to both nursing and the unit. About two weeks ago I was caring for a man who was s/p hip fracture/replacement. He ended up with nosocomial pneumonia and had to be intubated and spent some time in the ICU, and post extubation he was moved to us to be stabilized and then sent home. His I/O was off and he has a standing order for Furosemide 5-10mg iv push if he was out of whack (he was about +300 at this point and should have been [+(-)0 -(-)500], and and it was only 12pm). It was the end of my shift and the beginning of visiting hours, and his wife was at the bedside. I went and gave 5mg Furosemide iv push. The injection and flush lasted 3 minutes (our hospital policy is not to exceed 4mg/min, and he hadn't gotten any Furosemide during this hospital stay). After I gave the meds, he reacted okay, but about one minute later his alarm started blaring EXTREME BRADY, and his wife screamed for someone to come help him. I ran over and the monitor didn't show brady, but that he had thrown 3 PVC's in a row. I silenced the alarm to assess him and he was already fine, the episode passed and he was totally normal looking and his HR was back to normal SR. His wife apologized for yelling but said that right when the alarm went off, his face and body movements looked like he was in trouble. I didn't see this, but I believe her. I don't remember what other meds he was on at the moment, but I do remember that I checked the precipitate risk/interactions list and NOTHING could have reacted with the Furesis. His BP before and after was fine. Absolutely no one else besides me and his wife freaked out - all of the other nurses looked calmly and said everything was OK. I checked his chart the next day, and he'd had another bradycardic episode about 6 hours after I left, unrelated to any Furosemide doses. I could still vomit and cry thinking about this episode. Since then I have a crippling fear of giving any medication IV push, and our ward requires a lot of it. Does anyone have any insight they'd like to share? Any ideas about it? I asked several nurses on my ward and they all agreed that it could have just been a ****** side effect, but I'd like to ask a larger group. I wasn't incredibly confident before - I'm new - but this completely shot my confidence to ****, so much that I'm considering resigning.

Hi, new nurse here. I'm having some trouble with concurrent medications and incompatible medications. Just asking for OPINIONS, not professional judgements 1. Concurrent meds: Is it always better to have as few meds running in one cath as possible? For instance, today I had Phospate running with 500mls of G5 as well as an electrolyte solution. The patient had ****** veins and we could only get access in one hand. However, IF IT WERE POSSIBLE to get another line, is it always preferable to run as few as possible in one site? 2. As far as interacting meds go - besides meds that absolutely can't go together (like Furosemide and Potassium Chloride - I don't mean the risk of hypokalemia) is it really okay practice to DC the KCl infusion, flush with saline, push the Furosemide, flush with saline, and then reattach the KCl infusion? Thanks very much!