PRN medications

[KeeperOfTheIceRN, ADN]

I only have a couple of PRN OTC medications. One student has PRN sinus medication (you NEED it here in E. Texas!) and the other has ibuprofen (for "intractable headaches"). My question is, if/when a student comes in to request these medications, do you still assess them (temp., other complaints, etc.) or do you just administer the med?

I have one kiddo who rarely comes in to take theirs; they genuinely only come if they really feel they need it (sinus med). However, the other has come in multiple times in the last few weeks since getting the appropriate documentation completed, and so far its, coincidently, been at the same time. I almost feel they ask for it simply because they know they have it here. We've discussed other ways to help relieve a headache before they resort to meds. I should also mention, this particular student has NEVER been in my office until this medication was approved for school.

I ask this because in the hospital I worked at, we weren't supposed to question a patient's pain since its, you know, subjective. I was just curious to know how my counter parts do things in their clinics.

[ruby_jane, BSN, RN]

For PRN asthma meds I always do a PSO2/auscultation/RR and document. And then let the kid have the med because...I don't want to be THAT nurse. For the headaches...if you're noticing a pattern, I'd let the parent know how often Sweet Baby is in the clinic and make a referral to/back to the doctor. Just to cover my assets. As an aside, sometimes the parent won't care how often or if there is a pattern because "that's why I send the meds to school."

[GdBSN, RN]

I always ask students that have PRN OTC to try eating and hydrating before coming to get their medication to see if that gets rid of the headache. I try to explain that taking medicine all the time is not always the best solution. Some get it, others don't care and just come to get out of class. If I see that they are coming more frequently, I do call and inform the parents. Sometimes if parents know how much class time their LD is missing, that stops the visits. I also advise the parents that if their LD is having headaches that frequently, they need to be seen by a doctor. Usually, my visits drop significantly after that.

[Flare, ASN, BSN]

If a student is asking for their prn analgesic, i'll usually just give it - i will probably ask if they had anything in the morning or the last time they had it. Maybe ask about pain, but i don't usually put them off from having it unless they had it too recently to give it. If i see a pattern or a frequency, i will probably call the parent.

[KeeperOfTheIceRN, ADN]

Great advice guys, thanks!!! I do feel I should state that I DO do some kind of assessment on everyone who comes in my office. It's not like I just hand the meds over all "willy nilly" I especially assess my asthma kiddos (and don't deny inhalers either). I was just curious to know if you've ever told a kiddo "no" to their OTC meds. I like the idea of suggesting hydration/food intake first as my ibuprofen kiddo comes in on their way to lunch because they know you have to take it with food. I'll try suggesting they eat/drink first and then come back to take it if they still need it next time.

[WineRN]

I'm jealous, I have an entire basket filled of OTCs that are rarely ever used. I had to throw away so much last year because of things expiring and parents telling me to so that way they didn't need to come and pick it up at the end of the year.

I always assess and there are just a few students who I will have try other methods before giving them their PRN because it's more of an attention thing than an actual medical need

[JenTheSchoolRN, BSN, RN]

I've had a student eat first if they have consumed nothing (so many HS kids don't eat breakfast) because ibuprofen on an empty stomach can not be fun. Sometimes when I do this and tell a student "eat lunch and if it is still hurting, come back and see me" I don't see them again because food is magic.

But, I also have some students with migraines. Migraines that will knock them on their butt unless I treat with ibuprofen at earliest sign of headache. It is usually small, but I've worked with them enough and seen what happens if it ignored that I'll give the ibuprofen to student if requested after a brief check-in. But these students are not abusing it and I'm updating their parents pretty regularly.

I would start with a phone call home just to report that student has been taking ibuprofen fairly often at school and is this information the parent would like to pass on to their child's health care provider?