I need some guidance on PRN pain medications. How do you decide what to give, when to give it, and what you can overlap? I get confused if they have several pain medications ordered as to what to offer them and when to do this. Coworkers all seem to do it very differently. One nurse told me she will not overlap any PRN med because it will put her license in jeopardy - so if she gives one PRN pain medication that is q4-6h, then she will not give any other PRN pain med until the 4-6h on the first one are up. She feels if they were meant to overlap, they'd be scheduled. Is that correct? I'm very new, and I admit I'm itimidated by the PRN med list. I am self-conscious because I have heard nurses make negative comments about the previous nurse's use of PRNs. Any advice would be helpful.
For example, hypothetically, let's say this is your PRN list below and every time you enter the room, your patient reports 9/10 neck and back pain and wants whatever medication you are willing to give them. When you check the previous shifts, what this patient has received varies widely depending on the nurse assigned. The patient is a chronic pain patient and is used to heavy doses of pain medications. In addition to the PRNs, there are scheduled medications too. Where do you start? How do you know what to give?
Oxycodone 10mg PO q4h PRN for severe pain
Oxycodone 5mg PO q4h PRN for moderate pain
Norco 5/325 1 tablet PO PRN q6h for pain
Flexeril 10mg PO TID PRN for pain
Tramadol (don't recall dose) IV PRN for pain - stop after 3 days
Morphine 1-2mg IV q4-6h PRN for pain
Acetaminophen 325mg 2 tablets PO PRN for pain or elevated temp
