Documenting Fentanyl

[BettyPalen]

Would Fentanyl 25-50mg IV Q4H PRN go on the IV Therapy part of the Kardex or the PRN? Also, would it also be entered on the 7 day scheduled Meds and Infusions and/or on PCA MAR?

I need to know for my final this Monday.

Thanks!

betty

[nurseprnRN, BSN, RN]

Any IV med that's given as an intermittent or piggyback/rider goes on the med sheet (MAR). Think furosemide, digoxin, KCl, antibiotics, etc. ... If it's a prn, it goes where the prns are listed (like morphine, ...)

I have no idea what you're referring to with the rest of it, so these are guesses to help you figure it out. If it's prn, it's not "scheduled." (Not: "Schedule I, II, III, IV, V drugs" refer to their component status, not their timing.)

If it's given intermittently IV or run 24/7, it's not PCA.

[CardiacKittyRN]

I would document it as a PRN because it would be given as an IV push.. IV infusions would be more like antibiotics, fluids, blood, ect. As for the second part of your question.. It's not scheduled it's PRN.. But is it being given by PCA pump? I'm not sure how to answer that part. Also, just a thought, but wouldn't it be mcg instead of mg for the dose?? What kind of test is this for? Just curious!

[BuckyBadgerRN, ASN, RN]

What were you taught in lecture? This is clearly a homework question, right?

[BettyPalen]

The PCA I am referring to is the Patient Controlled Analgesia and I don't have confirmation if the med is being given by pump. I am studying for my final exam in Order Transcription for HUC. The prof gave us a list of meds to practice documenting.

[Kyrshamarks, BSN, RN]

And if you give someone 25 to 50 mg of fentanyl, call the funeral home. That much would kill. Watch how you write your dosing now. Mistakes like this happen and cause serious consequences.

[BettyPalen]

Thanks very much for the reminder. The prof will be giving us a list of dr orders to document and I just want to know which MAR and also where on the Kardex to document the correct dosage.

[BettyPalen]

also if its not a pump med and will go on the PRN MAR; do I need to figure out a stop date the same as other narcotics?

[nurseprnRN, BSN, RN]

also if its not a pump med and will go on the PRN MAR; do I need to figure out a stop date the same as other narcotics?

Probably. It depends on the local regs and hospital protocols. But yes, fentanyl is a narcotic.

As to the PCA aspect, usage is still charted as dose delivered (the pump tracks that for you), so I think I would still put it in the PRNs and not the IV. If there were an ongoing running baseline amount of a PCA med, like, oh, MS 2mg/hour, then that would be maintenance fluids and med, and the extra the patient gets when she pushes the button would be the prn doses. But that's just me.