How does administering PRN medications work?

[swansonplace]

I am confused as to what the definition of PRN is. I know it means to be given only when a client requires it. But I get confused when it says every 2 hours. Does that mean that the patient gets the medication only every two hours if needed.

Or does it mean they get a minimum dose every two hours and can get more if needed. If this is the case, is the a limit to how much they can get due to overdosing or side effects?

Thank you so much for the clarification.

[MangoGirl]

Or you could have it at 10:00, be fine at 12:00, but want it again at 1:35 and get it. ... So, in this case, if the client had Tylenol at 10:00 and 1:35, then the next earliest time s/he would be able to have it would be 3:45 (any time after 3:45)

The duration between 1:35 and 3:45 is 2 hours and 10 minutes. What are the extra 10 minutes for? Do you have to wait an extra 10 minutes?

(I guess with PRN meds, the 30 min before to 30 min after don't apply either, right, since it is not a scheduled med. ??)

[Hygiene Queen]

^^^^^^^^^

No. There is no need for a 10 minute wait.

Perhaps that was a typo?

[Hygiene Queen]

(I guess with PRN meds, the 30 min before to 30 min after don't apply either, right, since it is not a scheduled med. ??)

A PRN can be given no sooner than it's scheduled interval from the last dose.

Any time after that is kosher, but pain meds are more effective if you don't let too much time go between (if your pt is still having pain).

[MN-Nurse, ASN, RN]

Now let me think about 1-2 mg q 4 hrs. I give 1 mg at 0900. Then let's say I give another 1 mg at 1000 d/t unrelieved pain (assuming that's allowed, per my original question). When could I then give the next dose if it 1mg? If it is 2mg? (I'm thinking I could give 1mg at 1300, or if I wanted to give 2mg I'd have to wait for 1400). Am I doing this right? Thanks!!

I always start with the time of the first dose and use that for starting the interval.

So in your example, you gave 1 mg at 0900. That starts the clock. You gave the other 1 mg at 1000. So the next available dose would be at 1300 - 4 hours from 0900.

At which point, since the 1 mg didn't work, I would give 2 mg. No, I would not wait until 1400.

[Epic_RN]

I usually see orders like this:

Vicodin 5/500 mg one tablet every 6 hours by mouth as needed for pain scale up to 5/10

Vicodin 5/500 mg two tablets by mouth every 6 hours as needed for pain scale 6/10 or greater

So you assess the patient's pain and have them rate it on a scale of 1-10. Based on that assessment, you give the indicated dose of medication.

I also see orders such as:

Hydralazine 5 mg IV push every 6 hours as needed for systolic blood pressure >160 mmHg

So if my patient has a bp of 165/100, I can give this medication but if the bp is 158/100, I can't give it.

Hope that helps!

[HPofBC]

Hello! That just means the meds can be given q2. If the pt doesnt request or require them q2, they can be given further apart. For example, pt gets Apap at, say, 10 am, if they needed it, it can be given again at noon. However, the pt may be comfy, and refuse it. Say, 1600 rolls around and pt feels pain, they can have the meds, because 2 or more hours has passed.

[psu_213, BSN, RN]

The duration between 1:35 and 3:45 is 2 hours and 10 minutes. What are the extra 10 minutes for? Do you have to wait an extra 10 minutes?

(I guess with PRN meds, the 30 min before to 30 min after don't apply either, right, since it is not a scheduled med. ??)

When a PRN is given, the exact time is charted....for example at 1338. If it is a q2h PRN, the next dose can be given at 1538. I does not need to be given at 1538--it can be given later, but not sooner.