silly confusion in regards to prn order/standing order

Nursing Students Student Assist

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Specializes in SDU, Tele.

hi guys :)

i just started my generic rn program and i have a silly question i was hoping you could clear up for me.

i am reading about the different kinds of orders in my intro to pharm book and i can't seem to understand the difference between a standing order and a prn order. they seem to be the same thing to me. if anyone could please give me an example of each it would be great... here is what i have in my notes:

2. A standing order is prescribed in anticipation for sudden changes in a patient's condition, such as in a critical care unit. May also be used in long-term care facilities where a physician might ot be readily available.

3. A PRN order is written by prescriber for a drug to be given when a pt needs it....

So a PRN order is like when the MD prescribes let's say, tylenol for a pt with pain or w/e, and it's "take as needed to pain", right? To me its the same thing as a standing order.

It's probably really easy to understand but somehow I'm not getting it:confused: thanks in advance!

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Specializes in Utilization Management.

At my facility we don't necessarily have "standing orders". Standing orders have, for the most part, been replaced with protocols. We have protocols that we follow that basically tell us what we can do if a certain thing happens. Electrolyte protocol, for example, spells out how to manage certain electrolyte levels without needing to call the MD for orders for PO or IV electrolyte replacement. http://www.surgicalcriticalcare.net/Guidelines/electrolyte_replacement.pdf This is an example of what I'm talking about. It's sort of like "If this happens, then do this, and then this..."

I don't know if that helps you at all. I'm sure someone else will come along and explain it more succinctly :twocents:

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Specializes in SDU, Tele.

Thank you for your response. It was nice to know that about the protocols. It makes more sense to me to use protocols in real life in regards to emergency situations like that... as for these definitions, I guess I'll just ask my professor in class tomorrow. Thanks for your input though :)

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Specializes in Infusion.

I don't know about the definitions either but when I think about standing orders, I think about a list of interventions and drugs needed for a certain situation, like after surgery or if a patient comes to the ER with chest pain. PRN or as needed, is a list of medications where the nurse decided which type, dose, form of administration that the patient needs based on the nurse's best judgement. There are some drugs that can be given orally, rectally or by IV. There are drugs for nausea, pain, constipation that are given based on the patient's symptoms and need.

Some of the items on the standing orders ARE PRN and some are not. Maybe that is the difference.

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Specializes in LTC, Hospice.

Just a student here, but aren't standing orders general for all patients in a given setting/situation whereas PRN's would be for a certain patient?

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Specializes in Acute Care, Rehab, Palliative.
Just a student here, but aren't standing orders general for all patients in a given setting/situation whereas PRN's would be for a certain patient?

Yes. Exactly. I work in a hospital setting and our floor has a sheet with "standing orders". It has things like Tylenol, anti emetics, heartburn and bowel meds on it. This can be used for any patient, barring contraindications like allergies.PRNs are prescribed for that particular patient.

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Specializes in SDU, Tele.
Just a student here, but aren't standing orders general for all patients in a given setting/situation whereas PRN's would be for a certain patient?

Thank you!!!! That totally clicked haha :)

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