Use of IV push antihypertensives on the med surg unit

[will robinson]

Hello everybody. This is my first post. This looks like a good site for info. My hospital is currently researching use of IV push meds for hypertenison on the med surg units. Anyone out there with what your hospital allows or p/p would be most helpful. Our units use some IV push meds now, however, with the advent of some of the newer drugs the MD's are ordering meds that can only be given on monitored units. You can see that this could cause some problems. Thanks to all who read and respond to this.

[will robinson]

Thanks again for the continued replies. To Joshua, I am from Kentucky, finished college in Michigan and worked there, back to KY and now live on the crystal coast of North Carolina for the past 7 yrs. Worked at a total of 5 hospitals over the years. All have a few variations in P/P, but, all basically the same, doing our best to provide the best care possible for those entrusted to us.

[RNsRWe, ASN, RN]

I'm on a med-surg, and we push everything except cardizem. The only med requiring us to have patient on tely is metoprolol, and we do have a handful of telys for various purposes (mostly post-ops, but can be other stuff).

When pt is on Lopressor IVPs, we run a strip first, have a nurse watch the tely while we do the push, then run a post strip.

[patwil73]

What states are y'all from?

On my former med-surg floor (also in school) we pushed a wide range of cardiac drugs on the floor (Dig, Vasotec, Lopressor, atropine, various others) even when the patient is not on cardiac monitoring. Only LPN's were not allowed to push cardiac medicines. We also pushed mannitol, versed, fentenyl although the last two in rarer situations. . . however no one in the hospital is allowed to push phenergan!!! :icon_roll

I'm from Washington. We do push other cardiac drugs - but he had asked specifically about antihypertensives. We push digoxin and atropine (not sure about vasotec - I don't think so but I don't have the policy in front of me) also narcotics and sedatives which will reduce HR - although never for specifically HTN issues.

Cardizem bolus is usually a piggyback - and we do give phenergan (although I agree we should change to a piggyback for that also).

Had a doc wanting me to push adenosine on the floor once - said just hook him up to the monitor. Just shook my head no - I'll push it, but the patient needs to be in ICU or PCU so if something goes wrong, I have people around who know what to do to help.

Hope this helps

Pat