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Discussion

Med error?

I have a question regarding pain meds. Let's say you have a patient with kidney stones that it awaiting surgery, until then you are keeping them comfortable with pain meds. Ordered meds are norco 10mg q4 prn for moderate pain and dilaudid 0.5mg q2 prn for severe pain. Pt is a large built male, tolerating meds without issue except always has a pain level of 8. Has been in hospital for a day, dilaudid is given for initial pain of 8 and norco is given at the same time for when the dilaudid wears off. Nurse A says this administration method is ok bc the dilaudid acts in about 15 minutes and wears off in about 45 minutes to an hour, and the norco doesnt start to work for about 45 minutes to an hour. Nurse B says this is incorrect and the norco must be given first and dilaudid given 45 minutes to 1 hr after. Nurse A believes Nurse B is incorrect because both meds would be kicking in at the same time with Bs administration method. What do you all think? Note: patients pain is more controlled with As admin schedule vs Bs.

Featured Replies

Perhaps Dilaudid 0.5 mg is oral liquid.

If the order is worded "pain greater than 5" etc. I'd say its not an error. If the order is written for moderate pain give x and for severe pain give z, id say its an error.

If it were me I'd give the dilaudid for severe pain and 30 minutes later the norco for moderate pain.

We have to give PO first and then the IV. Min of an hour apart. Not sure why they would use Norco. We use oxy/PO dilaudid and tylenol separate

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