.
Fax it to pharmacy, they can work it out
Ask the prescriber to clarify the strength on the medication chart
Use the patients own that they brought in
Write the strength on the chart if you are an RN
Take on an empty stomach
Remain upright for half an hour after taking the medication to avoid irritation of the oesophagus
Avoid calcium and iron supplements for 2 hours after taking the medication
Take extra sun precautions whilst on this medicine
A patient is charted for 5mg Panafcortelone PO in the morning. You give the patient a 5mg Prednisolone tablet from your imprest stock.
A patient is charted for Escitalopram 10mg PO. You give the patient HALF of a Citalopram 20mg tablet from your imprest stock.
A patient is charted for Folinic acid IV and you have Folic acid IV on imprest so you give that instead.
A patient is charted for Oxynorm 10mg PO, you can’t find any in the safe so you give Oxycontin 10mg CR tablets instead as they are also oxycodone.
Sertraline
Citalopram
Duloxetine
Mirtazapine
Destroy it with another RN and document it.
Leave the dose in the pill container and isolate in the safe. Fill out a “Recordable Drug Incident” form and place it with the refused dose in the safe. Put an asterisk next to the entry in the register, annotate down the bottom “Patient refused” and contact the pharmacy for it to be destroyed by a pharmacist ASAP or next working day if night shift / weekend.
Put it back in the bottle/secure it with sticky tape back in its original foil packaging and write it back into the register with another RN.
Leave it next to the patient’s bed – in case he feels like it later.
Reassure her it’s OK, that the ward only has the 40mg tablets – but that it adds up to her usual dose.
As you are giving more than 3 tablets, and the patient questions her medication, you decide to look up the usual dosing for Verapamil and contact the doctor to clarify the dose.
Call the pharmacy with your concerns
Both (b) and (c) are acceptable.
Fax the chart to pharmacy – they'll just supply the medication and send it up on the next delivery
Ask the patient if she has her own in her handbag that you can use
Run next door to the other ward to see if you can steal some from them
Look up Norspan to see if there are other brands available. Upon looking up, you realise it is an S8 medication, Buprenorphine. As there isn't any in your safe, you fill out an S8 requisition order and fax it to pharmacy to be collected by an RN later.
A) Open the capsules, crush the pellets and mix in water
B) Do not give the venlafaxine as it is a slow release medication which must not be tampered with
C) Open the capsule and gently mix the pellets in a soft food. Advise the patient to not chew the pellets.
A) Review other wards imprest lists to see if you can borrow
B) Call the CNM
C) Annotate an “N” on the chart
D) Ask the patient if they have brought in their own supply
E) A,B,D are acceptable choices
A) Before a meal, in addition to the patients usual pre-meal insulin
B) At any time when the BSL is taken and is high
C) After the meal
A) Ask the MO to chart the methadone based on the patients previous history
B) Contact the patient’s dosing clinic and obtain a copy of the current methadone prescription and last dose details
C) Use the methadone tablet you have on the ward
D) Use the patient’s takeaway doses they have in their bag
Yes
No
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