meds - confused

[nurs15]

If an EN who has completed and passed the meds subject was to give a patient 500g of oral paracetamol because of a headache which was prescribed, Why would she be reprimanded by the RN for not consulting with her prior.

[poppycat, ADN, BSN]

Post moved to our Nursing and Patient Medications

paracetamol = acetaminophen = tylenol

US tablets come in 325 and 500mg strength and usually give 1-2 tablets per dose.

How many tablets were actually given client?

There is also Tylenol Arthritis strength (and generics) which is 650 mg./tablet. This is what I take for my RA.

[nurs15]

well im glad you saw that cause i didnt haha im hoping t is a typo. yes 500g admisistered and prescribed 4/24 pm

[JustBeachyNurse, LPN]

Is this homework or a work incident? Since you don't know if 500g is a typo?

[nurs15]

just a general discussion not homework

[Tenebrae, BSN, RN]

If an EN who has completed and passed the meds subject was to give a patient 500g of oral paracetamol because of a headache which was prescribed, Why would she be reprimanded by the RN for not consulting with her prior.

I'm assuming you mean milligrams?

The only possible reason I could imagine is if the patient had abnormal liver function or possible liver failure.

Did the nurse check the time the previous dose was last given?

Otherwise some registered nurses want their enrolled nurses to run everything by them, others are happy to trust their judgement. The best suggestion I could offer is ask the nurse. Take it as a learning opportunity ask them something like "I'm keen to learn, could you advise me what was problematic about giving the 500mg paracetamol to Mr/Mrs A"

[Tenebrae, BSN, RN]

i understand, is this classed as a general thing or is there actual guidelines saying that en has to let the rn know, even when they are confident in meds, the med is prescribed to the pt and would be on pt records. i have tried to look at guidelins etc but nothing is really giving me a straight answer, only accountable for their actions.

At the end of the day the registered nurse is the one in charge, if something goes wrong its potentially their registration on the line.

Not sure if you are talking NZ or Australia. In NZ within the enrolled nurse scope of practice they work under the direction and delegation of the registered nurse I would imagine its fairly simiar in Australia.

But like I said, its hard to comment with any accuracy on the details you have given

[Tenebrae, BSN, RN]

to give 500grams of paracetamol in any form would be fairly impossible unless it was someone taking an intentional overdose.

Most paracetamol liquids are either 125mg/5ml or 250mg/5mls. 1g= 20mls. 500grams would equal 10,000mls or 100 litres of paracetmol liquid.

If you are a student, I would suggest checking and double checking your drug calculations because any student nurse that couldnt tell their was a serious problem with a paracetamol dose of 500g would be in high likelihood of failing

[klone, MSN, RN]

This is totally homework.

[Tenebrae, BSN, RN]

This is totally homework.

I suspect. Which also leaves me concerned that a nursing student cant realise what a substantial error 500g paracetamol is.

[klone, MSN, RN]

Better a nursing student than a nurse, I guess.

[nurs15]

Thanks everyone for the comments. No this was not homework at all. We are on holidays over here! Just a general conversation/problem solving issue, just a scenario.

[SierraBravo]

Thanks everyone for the comments. No this was not homework at all. We are on holidays over here! Just a general conversation/problem solving issue, just a scenario.

Well, if someone actually did order 500g of acetaminophen, you might as well have them order acetylcysteine as well and call the ICU to let them know they'll be getting an acetaminophen overdose patient. :/