dj_smooth said:
Doing inpatient right now and was wondering if anyone had some good prn meds that will help keep call nights a little more quiet and fewer worthless pages from nurses. I've sort of heard that you should always write something for pain, sleep, and bowels...anything else?
Here's something I found in my Treo, left over from my intern days. It might help. As always, use at your own risk. "I accept no responsibility..." etc., etc., etc., yada-yada-yada, blah-blah-blah.
😉
Service Medicine On-Call
Agitation:
Ativan 0.5-2.0 mg IM/PO q6-8h
Haldol 1-5 mg IM/PO q4-8h
Constipation:
Dulcolax 10 mg PO/PR PRN
Colace 100 mg PO BID PRN
Indigestion:
Maalox Plus 30 cc PO
Riopan 30 cc PO
(R/O CP of cardiac origin)
Nausea:
Inapsine 1.25-2.5 mg IV q4h
Phenergan 12.5 mg IV or 25 mg IM
Insomnia:
Ambien 5 mg PO qHS PRN, may
repeat x1 (best choice)
Benadryl 25-50 mg PO qHS PRN
(don't use if BPH present)
Restoril 15-30 mg PO qHS PRN
(don't use in elderly)
Hypokalemia:
KCl PO or 10 meq KCl in 100 cc NS
over 1 hour, max. dose 40 meq
(don't fluid overload if CHF
present)
Hypomagnesemia:
2 grams MgSO4 in 100 cc NS over 1h
Hyperglycemia:
Sliding scale insulin
200-250 --------> 2 units reg.
251-300 --------> 4 units reg.
301-350 --------> 6 units reg.
351-400 --------> 8 units reg.
>400 ------------> 10 units, call HO
Hypoglycemia:
Orange juice or skim milk, recheck.
If no change, give 1 amp. D50
Fever:
Tylenol, blood cx. x2, U/A w/C&S,
CXR, sputum cx.
Chest Pain:
EKG, VS, SL NTG, O2, +/- CXR
SOB:
O2, ABG, EKG, CSR, VS, SMA-7,
H/H if anemia suspected
Fall out of bed:
Check for LOC, VS, obvious inj. (lacs, fx.), meds (anticoagulants, seizure meds), neuro exam. May suggest siderails up, posey, night light.
Dobhoff Tube:
Should be in stomach or duodenum (best placement). If in stomach, can give Reglan 10 mg IV and lay on left side for 30 min. then recheck KUB.
ET Tube:
Placement should be 1-2 cm above carina. Always check a CXR after intubation.
Death Pronouncement:
Check for response to painful stimuli, heart sounds, carotid pulse, spontaneous respiration, pupils fixed and dilated. Record findings and time of death. Notify attending and family. ?Autopsy if appropriate. Have family leave the room when pronouncing.
Misc:
If you order an ABG, always order an SMA-7.
