Narcotic administration times

[_meow]

What are your thoughts....

Order: Percocet 1-2 tabs q4h

Nurse gives 1 tab at 1400, patient has unrelieved pain so nurse gives another tab at 1430. Two medication administrations for one medication order. I have been taught that this is not right and should never be done... I have also been taught that it is okay. I am still a nursing student so I need some advice. Thanks

[chrisrn24]

What is your concern with "how it would look"?

If there was an incident with missing narcotics. Although it's explainable it might look odd.

[anon456, BSN, RN]

If there was an incident with missing narcotics. Although it's explainable it might look odd.

If you document that you gave both, then there should not be an incident with missing meds. Any time you give any amount of meds a dishonest person can take them. Whether it's 1 or 2 tabs, or 1 now and one an hour later. If you are worried about that you can always ask someone to witness the patient taking the meds.

[KelRN215, BSN, RN]

If there was an incident with missing narcotics. Although it's explainable it might look odd.

Why would it look odd? If you remove 1 tab at 1400 and sign it out as such and then remove the second at 1430. I don't see the issue.

[MunoRN, RN]

I'm curious what people do if they don't read this as being just a max dose per period of time. Do you just always give 2 tabs to start with? Do you give one tab and then when that's not effective, what do you do? Do you call the Doc?

[wooh, BSN, RN]

To avoid this problem, unless I think it's sure to knock the patient out, or they've been doing 1 tablet for a couple doses and it's working well, I encourage them to go ahead and take two tabs. But I'm admittedly generous with pain medication. Get on top of it rather than chase it.

[loriangel14, RN]

I wouldn't. I just wouldn't like how it would look in our med admin book. At home I will tell my family to do this if they want. But at work I won't.

We do this all the time. it's not all that odd.

[chrisrn24]

Good to know it's not weird. I can't say it's happened to me too much, maybe once or twice. Generally we have parameters with the pain scale so I just go by that.