Medication Order

DallasRN · Mar 17

Been there,done that said:

"merely triated"? I don't titrate narcs... that is prescribing.

You are correct and that is the reason I pointed out "back in the day". We did lots of things that were never questioned by anyone but certainly would not fly today. But I would add, according to a few friends who are still working and my own experience in a major hospital ER about 3 years ago, morphine was and is titrated for chest pain.

delrionurse · Mar 18

Nurse1282 said:

OK the order is Dilaudid 0-5mg-2mg every 3-4hours. The nurse decide to give 1mg at 2030. Pt calls and is still in pain and wants more Dilaudid at 2200. Can the nurse give another 1mg ?

I take this as the patient can have this mg every 3-4 hours, no dosing in between. Usually there is either a mild, moderate or severe pain scale and the doses are given accordingly. The emar may have a pop up that states it's too early to give if you give it before the 3 hours.

Tenebrae, BSN, RN · Mar 18

When I have worked palliative care, dose ranges were common

Eg morphine 2.5-5mg Q1-2 hourly.

If 2.5mg was given, another 2.5mg could be given within the 2 hours. If the patient was needing 5mg constantly we would go back to the doctors and advise them the syringe driver dose and breakthough dose needed adjusting

In acutes its usually with a set dose eg 2mg oxycodone