This happen on my 11-7am shift last night. I work in LTC. Here is what happened. A pt. [not mine] was agitated and wet. I helped the CNA walk him to the BR. he told me he was going to die!! Scared the bejeebies out of me!! I tried to divert his thinking by asking what he did for a living. He couldn't remember.
Got him back in bed and we left the room. About a half hr later I could hear him moaning and yelling. I told the other nurse that I was going to get a quick set of vitals on him : 165/92 98.6 24 110 85% c/o chest pain and couldn't lay still on the bed. I got the other nurse and she also assessed him. She sent him to the hospital with elevated BP and chest pain.
Shift continued until the ph call from the hospital. DX UTI!! When asked what the telemetry said they acted like the had NO CLUE what she was talking about! WTH!! When she said EKG they were like yeah its normal!!
Anyway, here is the question for all you older much more experienced nurses.
The order was for levaquin Q48hr x 7 pills = 2 weeks.
We didn't understand the order so she called the hospital back. Talked to a Dr with a thick accent. he said it was 500 mg Levaquin every other day x seven pill and that = 2 weeks!
Has anyone heard of this? I didn't know that ATB could be given every other day!! I know if that was my prescription I would forget to take the dang pills.
Any insights would be greatly appreciated as I try to learn more about my profession!!
Karen. . .in all the LTCs that I worked, we were not allowed to accept orders from any other doctor except the patient's doctor. So, when we had a patient who came back from doctor's appointments or the ER with prescriptions we called their attending physicians (doctor of record) at the nursing home and got a verbal order from them that it was OK to give those medications. At that time, the patient's doctor can then modify the order if he desires since he knows the patient. He also has the option of calling and speaking with the ER physician if he desires. We still saved all the documentation that came back from the ER with the patient, including the prescription. However, it was the patient's physician of record at the nursing home who's order was the only one we could accept.
You might want to check your policy manual on this, but I'm betting that your facility probably does something similar. In any case, this patient's doctor should be called and notified of what has occurred as a matter of notification anyway or the facility and you nurses might get into trouble for not keeping him informed of a change in the patient's condition.
Daytonite is right, this is what Ive seen done in every facility Ive ever worked. Hey Daytonite, I bet you thought you would never hear me agree with you, huh?
I've seen this twice in my 15 month career, once for a UTI and once for pneumonia. In both instances the pt had comprimised renal function. The ABT was effective. I caught both early so that may have had a positive impact on the ABT.
I have seen this order recently. One of our docs at the facility I work at has been giving that dosage for renal patients. Does this guy have some sort of renal diagnosis?
Simplepleasures
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