Address Viagra risks during triage
Address Viagra risks during triage
You may have difficulty addressing sexual issues and medications with patients, says Christine Clare, RN, MN, CEN, CNA, nurse manager for express care/industrial medicine and employee health at Loma Linda (CA) University Medical Center and Children’s Hospital. "But this needs to be addressed matter-of-factly," she advises. "Realize that failure to obtain this information may lead to a life-threatening complication or delay in diagnosis and treatment."
Here are some tips to consider at triage:
• Thoroughly question patients who present with a potential cardiac complaint: syncope, chest pain, shortness of breath, etc., or are hypotensive regarding their medication usage, Clare recommends.
• Ask specific questions regarding the use of Viagra, whether prescription or not.
• Any patient who has taken Viagra and presents with chest pain should not receive nitroglycerin. "As this is our drug of choice, this assessment needs to be made rapidly to prevent potential myocardial ischemia/infarction," says Clare.
• Patients may be reluctant to admit they take the drug. "There is a patient accountability side of care," says Robert Knies Jr., RN, MSN, CEN, clinical nurse specialist for emergency services at HealthSystem Minnesota in St. Louis Park. "They need to tell you all the information they can."
They might not want to tell you they have an impotence problem and take Viagra, he points out. "Then you run the risk of giving them nitroglycerin and having them bottom out horribly."
Trying to obtain the information can be tricky, Clare notes. "I have found that being direct is the best way."
Try the following, Clare suggests: "I know that this may be difficult, but it is very important to know whether or not you have taken Viagra or any other drug to enhance your sexual performance. This is necessary to give you proper treatment. If you have taken certain medications, and we give you nitroglycerin for your chest pain, it can result in severe complications."
Ask questions in private, without the patient’s significant other present. "Also, sometimes the male will not disclose the information, but their partner will," says Clare. "You also need to question the partner in private and explain why the information is so important."
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