Medication Order

Nurses General Nursing

Published

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 ? 

Specializes in ICU/ER/Med-Surg/Case Management/Manageme.
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.  

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 ? 

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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. 

Specializes in Mental Health, Gerontology, Palliative.

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

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