nursing quiz help

  1. Our instructors gave us a written quiz to complete before we go back for the semester, and none of my fellow students nor myself can figure one question out:

    What part or parts of the following order would you question?
    Give 50-100mg of Demerol IM q3-4 hours prn pain

    I've done quite a bit of research on this, and all parts seem legitimate, except maybe a range shouldn't have been ordered. Please help!!
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  2. 10 Comments

  3. by   allthingsbright
    Quote from puretexan
    Our instructors gave us a written quiz to complete before we go back for the semester, and none of my fellow students nor myself can figure one question out:

    What part or parts of the following order would you question?
    Give 50-100mg of Demerol IM q3-4 hours prn pain

    I've done quite a bit of research on this, and all parts seem legitimate, except maybe a range shouldn't have been ordered. Please help!!

    I am thinking the range? Wouldn't an order be specific about the dosage even on a PRN med??
  4. by   puretexan
    that's the only thing i can think of. thanks for your help
  5. by   ms. ky.
    According to Davis' Drug Guide, repeated IM injections may cause local irritation, other than that, I don't know either.
  6. by   cardiacRN2006
    You can't have the ranges of 50-100, or q3-4 hours. It makes you choose one and then you're practicing medicine.

    Ours would be 50mg for a pain scale of 1-5 Q4hours IM PRN pain and 100mg Demerol for a pain scale of 6-10 Q4 IM PRN pain
  7. by   Jolie
    I would question the range, but also wonder if Demerol itself might be an issue. It is rapidly falling from favor as a first-line pain med, as there are other safer alternatives.
  8. by   wvlpn2
    The dosage ordered should be specific.
  9. by   puretexan
    very helpful feedback guys, thanks!
  10. by   JillyT
    I think that the order for an IM injection itself should be questioned. IM injections are painful and Demerol is for pain...hmm. So, maybe ask if the doc would like to order PO ir IV instead?
  11. by   burn out
    I would definetly question the 50-100 because not everyone can handle a 100mg of demerol no matter how severe the pain mostly to its lowering of blood pressure plus a small person could not handle it. I would also question the time frequency where I work it seems like demerol is q6hours prn. or that's just how our docs order it..usually for breakthrough pain with the use of a pca pump
  12. by   wtbcrna
    Quote from puretexan
    Our instructors gave us a written quiz to complete before we go back for the semester, and none of my fellow students nor myself can figure one question out:

    What part or parts of the following order would you question?
    Give 50-100mg of Demerol IM q3-4 hours prn pain

    I've done quite a bit of research on this, and all parts seem legitimate, except maybe a range shouldn't have been ordered. Please help!!
    It is a double ended medication order...Our pharmacy has been all over us about these orders. The provider needs to have write 50-100mg or 3-4hrs not both.

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