Medication Range Doses-What if Patient Wants Less?

Nurses Safety

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Sorry if this seems like a pointless question! Say a doctor orders Ativan 0.5mg-1mg IV PRN q 6 hrs. What if the patient says that they want only 0.25 mg? Do I have to call the doctor and get a new order? Or can I just adjust the dose on my own using my "nursing judgement?" In two prior facilities I worked we had to call and get a new order, but in my current facility no one seems to pay attention to this matter. Thanks so much in advance for your advice and opinions!

As for the topic of the thread, if I have an order hay reads 'give two norco PRN' I sometimes give only one norco if that seems more appropriate. It seems implied that, if you can give two, you can also give just one.

Specializes in ICU, telemetry, LTAC.

I would like to point out that the case where I really won't consider giving less than the dose is insulin. Either give it or hold it. With sliding scale, the doses make sense and there's not room, usually, to wonder about it but the patient may refuse it. I haven't seen too many who do refuse their insulin, but it could happen. With Lantus or glargine insulin, it may seem like the prescribed dose is excessive. I will either give and make sure the food intake is adequate, or hold and call the physician and explain the situation. I won't attempt to figure out what the dose should be.

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