Medication Administration Question

[LoveNeverDies]

Hello everyone, I have a little question for fellow students or Nurses.

A student friend of mine works as a PCT in the local hospital. Her patient was requesting something for pain and did not have an order. The patient did however have an order for PRN Tylenol for Fever. The nurse gave the Tylenol to treat the pain, stating "I don't have time to call the Doc right now, and this should work just fine." I am not sure what she wrote down on the MAR as the reason for giving the PRN. My friend asked me if this was a violation of the Right Reason medication rule (or any of the administration rules). We did go over that right briefly, but it wasn't discussed about if you could use something against the Ordered reason, even if it can be used that way. (As of my understanding the rule is more in review of is the medication fixing a problem, like if someone has low blood pressure normally and are prescribed an antihypertensive it is a safety net) Since it is summer I do not have contact with my instructors to ask, we have asked a few students and everyone has dissenting opinions. I feel like this is something we should know, and I am embarrassed that I do not know. I feel like this is similar to giving someone an anxiety med to help them sleep, if they are not anxious. Lastly, I think that the nurse doing it simply because she didn't want to call the Doc IS wrong. I really want to know about if the ordered/given reasons can be different. Thanks for your answers!

[DisneyNurseGal, BSN, RN]

This came up with one of my classmates last semester. It was a med error because "it was not given for the reason indicated" - and the incident report went in her student file. I do not know if this is the same for all hospitals/care settings, but we were told not to do it. My teacher compared it to an order for Benadryl for infant allergies. If the child was fussy and couldn't sleep you wouldn't give them the Benadryl. Not quite the same as the Tylenol example, but it stuck with me.

[NICU Guy, BSN, RN]

It was not given for the reason indicated. Although the doctor should have a PRN pain med as an option or state Tylenol PRN for fever or pain.

[RNinthemaking15]

That would be considered a medication error as far as I'm concerned. I've been a CRMA passing meds for several years and I do know that someone in my facility did the same thing and was written up for it... It was for a fever and they gave it for a headache- even wrote down it was for a headache but a team lead overheard the conversation.