[NPInfo] valium preMRI

[Jeffrey Hazzard]

   If you gave me Valium 10mg and Propanolol 20mg you could do an MRI -or anything you wanted to -- without objection, resistance, or even awareness from me.

--- On Tue, 9/23/08, David or Diane Dito <dddito at charter.net> wrote:

From: David or Diane Dito <dddito at charter.net>
Subject: RE: [NPInfo] valium preMRI
To: "'NP Info'" <npinfo at nurse.net>
Date: Tuesday, September 23, 2008, 2:09 PM

I spend a few extra minutes educating the pt on what to expect when they
have an MRI and tell them up front that some people feel may feel
claustrophobic or panicky when placed in the tube. I offer them strategies
for coping, such as closing their eyes and using imagery or controlled
breathing, meds, and tell them that someone is always watching them from the
control room and that they're never alone, etc. I've found that nearly
all
of the pts whom I've prepared with education make it through the test w/o
any meds; it's the ones that make it to MRI before I've had a chance to
educate them that tend to freak out.

Personally, I never considered myself claustrophobic until I had an MRI. I
found that imagery worked very well for me...until I had a cervical MRI when
they strapped my head down and sandwiched it between some pads. And it was
with that exam that I also found that "open" MRI really isn't
very open. I
made it through, but not without a stern talking to myself to stay calm. Yet
I think if I'd known what to expect BEFOREHAND, I might not have reacted so
strongly.

Diane Dito, NP

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Ted Rigney
Sent: Tuesday, September 23, 2008 11:49 AM
To: NP Info
Subject: RE: [NPInfo] valium preMRI


Rose,
You've already gotten some info on pharmacokinetics. Peak plasma levels
occur anywhere from 30 minutes to 2 hours, so giving the med 30 minutes
prior to the procedure is a good estimate. Of course, these numbers are all
general....... What's the MRI for? How old is she? Is she in good health?
Just how claustraphobic is she? Also, I'm assuming she doesn't take any
kind
of benzos on a regular basis. Others may disagree with me, but I've given
10
mg to healthy, young folks without a problem. 5 mg 60 min prior to the MRI ,
with another 5mg 30 min prior might really do the trick for her. Obviously
she is going to have someone with her after the procedure to drive her home,
yes?
 
Also, I don't know the case or the setting, of course, but if you have the
time, some non-pharm interventions can be really helpful. Let her walk
around the MRI suite, let her get on the table and put her in with you
standing right there talking to her about how you'll be right outside the
room and then pull her out- just keeping her in the tube long enough to get
a sense of what it feels like. Assuming you have earplugs and headphones,
ask if she wants music or would rather hear someone talking to her during
the procedure (telling her how great she's doing- talking about anything
really), or if perhaps she'd prefer silence and try to zone out with the
valium, Give her some choices over how this happens.
Others have things they do to help the claustraphobic patient?
Ted




> Date: Mon, 22 Sep 2008 21:42:13 -0400> From:
rosemorankelly at gmail.com> To:
npinfo at nurse.net; np-clinical at nurse.net; ACC-CIRCLE at listserve.com> Subject:
[NPInfo] valium preMRI> > Hi, How early should a 135 lb female take a
valium
5 mg. before an MRI?> She has a second tab to take as well. Order reads: 1
tab po prior to> MRI....may be repeated....> Thanks guys...I know I will
have an answer before she needs to know.....> (tomorrow AM...)> Rose>
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