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Off Topic :
Nursing question… I need quick help!

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 WhatsRight (original poster member #35417) posted at 6:15 PM on Wednesday, July 27th, 2022

As you may know from my other thread, I am presently infusing antibiotics into my husband‘s PICC line.

I do it three times a day, at 7 AM, 3 PM, and 11 PM.

Today I have a doctors appointment at 3 PM. Exactly the same time as I am supposed to give him his anabiotics. My PCP is retiring, and this is the last opportunity I will have to see him. He is booked up until his retirement and I just can’t afford to miss the appointment, unless absolutely necessary.

I called the home health nurse and ask her if I could start the anabiotic treatment right at 3 PM (dr is 1 mile away) and disconnect as soon as I got home, no later than 415. That could possibly leave the anabiotic line hooked up to the PICC line about 15 minutes after it is empty.

She said that she would prefer me to give it to him one hour early, or one hour late. She said there was a one hour cushion on either side of the timing, and that leaving the anabiotic tubing hooked into the PICC line longer than necessary was not recommended.

Do you all agree? I want to do what is best for H, obviously.

"Noone can make you feel inferior without your concent." Eleanor Roosevelt

I will not be vanquished. Rose Kennedy

posts: 8232   ·   registered: Apr. 23rd, 2012   ·   location: Southeast USA
id 8747401
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 WhatsRight (original poster member #35417) posted at 6:39 PM on Wednesday, July 27th, 2022

Well, shit! (Excuse me).

If I was going to give it to him at 2 PM, I am past the window of needing to take it out of the refrigerator so it will reach room temperature by that time.

So now my options are, to put it in just before I go to the doctor and remove it just when I come back, which might be about 15 minutes longer than it takes to empty.

Or, to start it when I come back. But that means that there is an hour gap, and I’m concerned that it could keep all of the bacteria from being killed.

I wonder if I could get my sister to come over here and just show her how to take off the antibiotic line, flush the PICC line, and It off. They taught me in five minutes, I can’t imagine that I wouldn’t be able to teach her.

[This message edited by WhatsRight at 6:52 PM, Wednesday, July 27th]

"Noone can make you feel inferior without your concent." Eleanor Roosevelt

I will not be vanquished. Rose Kennedy

posts: 8232   ·   registered: Apr. 23rd, 2012   ·   location: Southeast USA
id 8747407
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Midlyfewife ( new member #74551) posted at 6:39 PM on Wednesday, July 27th, 2022

Medication guidelines indicate giving a medication one hour before or after is still considered on time. It is best not to leave infusions unattended, to avoid potential complications.
Hope that helps!

WW 52 BH 60-Achilles1101Married 23 years. 2 Kids4.5 year LTA

posts: 34   ·   registered: Jun. 10th, 2020   ·   location: NorCal
id 8747408
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 WhatsRight (original poster member #35417) posted at 6:43 PM on Wednesday, July 27th, 2022

Oh, yes… it DOES help so much!

Thank you thank you thank you. ❤️

"Noone can make you feel inferior without your concent." Eleanor Roosevelt

I will not be vanquished. Rose Kennedy

posts: 8232   ·   registered: Apr. 23rd, 2012   ·   location: Southeast USA
id 8747409
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tushnurse ( member #21101) posted at 6:46 PM on Wednesday, July 27th, 2022

Just give it late.
This should not be that big of deal. The one thing you don't want to do is give it on your way out the door, and be late getting back, and not being able to flush it, and it getting clotted off.

Definitely want to flush that line when the antibiotic is done. Even if your a little more than an hour late, it's not going to make a giant difference in the grand scheme of things.

Me: FBSHim: FWSKids: 23 & 27 Married for 32 years now, was 16 at the time.D-Day Sept 26 2008R'd in about 2 years. Old Vet now.

posts: 20291   ·   registered: Oct. 1st, 2008   ·   location: St. Louis
id 8747410
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 WhatsRight (original poster member #35417) posted at 6:53 PM on Wednesday, July 27th, 2022

Ok. Thanks!

I’m going to the appt early so I can MAYBE get out early.

"Noone can make you feel inferior without your concent." Eleanor Roosevelt

I will not be vanquished. Rose Kennedy

posts: 8232   ·   registered: Apr. 23rd, 2012   ·   location: Southeast USA
id 8747411
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 WhatsRight (original poster member #35417) posted at 6:58 PM on Wednesday, July 27th, 2022

So, if I start it at 4:00 instead of 3:00, should I give the next infusion at 11:30 pm, then the next one at 7:00 AM?

That way the subsequent doses would be off only 30 minutes???

Or should I have a new schedule based on this deviation?

I know, I guess I’m probably overthinking it. But I know how important this situation is, and to be honest, overthinking things is what I do.

"Noone can make you feel inferior without your concent." Eleanor Roosevelt

I will not be vanquished. Rose Kennedy

posts: 8232   ·   registered: Apr. 23rd, 2012   ·   location: Southeast USA
id 8747414
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Midlyfewife ( new member #74551) posted at 7:17 PM on Wednesday, July 27th, 2022

I would resume your normal schedule. No need to move the rest of the infusions around. You will still be on time at 4 and 11.
Arriving early is a great plan and generally appreciated by your nurse and MD. smile

WW 52 BH 60-Achilles1101Married 23 years. 2 Kids4.5 year LTA

posts: 34   ·   registered: Jun. 10th, 2020   ·   location: NorCal
id 8747415
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tushnurse ( member #21101) posted at 9:38 PM on Wednesday, July 27th, 2022

Resume your normal times. It doesn't matter, you are making this much more complex than you need to.
Your goals should be to give the doses close to when they are due, and make sure the lines are flushed, and keep them functioning.

That's it. Please don't worry. We get an hour either way in the hospital setting, and we do our best, but sometimes it's a couple hours late, if pt's are off the floor for a procedure/test, or if the pharmacy doesn't send it up, or it gets lost in the tube system, or whatever. There are million and one reasons that things aren't done "on time". As long as you are getting close, it's good enough. I promise.

Me: FBSHim: FWSKids: 23 & 27 Married for 32 years now, was 16 at the time.D-Day Sept 26 2008R'd in about 2 years. Old Vet now.

posts: 20291   ·   registered: Oct. 1st, 2008   ·   location: St. Louis
id 8747437
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 WhatsRight (original poster member #35417) posted at 10:55 PM on Wednesday, July 27th, 2022

Thanks.

I got it started by 4:20. 1 hour 20 min late.

I’ll just keep the 11:00 time tonight.

"Noone can make you feel inferior without your concent." Eleanor Roosevelt

I will not be vanquished. Rose Kennedy

posts: 8232   ·   registered: Apr. 23rd, 2012   ·   location: Southeast USA
id 8747447
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tushnurse ( member #21101) posted at 4:03 PM on Thursday, July 28th, 2022

Crisis adverted.

Me: FBSHim: FWSKids: 23 & 27 Married for 32 years now, was 16 at the time.D-Day Sept 26 2008R'd in about 2 years. Old Vet now.

posts: 20291   ·   registered: Oct. 1st, 2008   ·   location: St. Louis
id 8747513
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