Hypothetical situation: Your patient is ordered 4 to 8 mg of Morphine IVP for pain>4 on 1-10 scale, Q2 hrs PRN. The first dose you give is 4mg, but 30min later he states his pain is unrelieved. I know what I "would" do, but legaly (I'm in Ohio) once you have chosen the 4mg dose, don't you have to wait until the next dose window-in this case 2hrs- before you can give an 8mg dose, or can you give an additional 4mg within the 2hr window to add up to the maximum ordered dose?
If you can give an additional dose- where do you begin the 2hr window- from when you started giving the 8mgs with the first 4mg, or from the 2nd 4mg where you finished giving the 8mg dose?
If anyone has a definitive legal answer to this question please let me know, and where you got this answer. We are in quite a discussion at work.