Nurse administers 100 mg lorazepam in 500 mL D5W at 10 mg/hr, using MINDS protocol, titrating by 5 mg/hr every 15 min, max 30 mg/hr.
The MINDS protocol, an acronym for Managing INtense Distress and Sedation, is a systematic approach used by healthcare professionals to evaluate and manage agitation in patients.
In this scenario, the nurse is tasked with administering lorazepam, a benzodiazepine, through an intravenous (IV) infusion to address the patient's agitation.
The order specifies starting the IV with 100 mg of lorazepam diluted in 500 mL of D5W.
The initial infusion rate is set at 10 mg/hr. To assess the patient's response, the nurse will employ the MINDS protocol, which involves regularly evaluating and titrating the medication based on the patient's level of agitation.
The protocol recommends titrating by 5 mg/hr every 15 minutes until the desired level of sedation is achieved.
The maximum infusion rate allowed is 30 mg/hr, providing a flexible and responsive approach to tailoring the medication to the patient's specific needs.
This dynamic titration allows for careful adjustment of the lorazepam dosage to maintain a balance between effective sedation and avoiding over-sedation, ensuring the patient's safety and comfort.
Regular monitoring of the patient's response is crucial during this process, with continuous assessment of the MINDS parameters – Mobility, Inattention, Noisy, Disruptive behavior, and Speech – to guide the nurse in making informed decisions regarding the infusion rate adjustments.
This protocol reflects a patient-centered approach to managing agitation, prioritizing individualized care while maintaining safety and efficacy.