prn to scheduled

Any change in dosage requires it for us. It's a completely different thing to give meds to an asymptomatic child when the order says PRN is not something I'd do on a parent's say-so alone.

If your parameters for giving the PRN are not met at the time the parent wants you to give it daily (i.e. wheezing, cough, SOB, etc), then giving it is violating the order and at least one medication right (right reason). You definitely need a new order. I would suggest that the doc write "PRN and Prior to (gym, recess)" if that's what the parent is getting at.

Is the child sick or recently been sick and it is for a short amount of time or every day?

Thanks every one - sometimes you just have to check in at the virtual unit desk and get another opinion. The kid had an AAP last year and after a bout of bronchitis with the parent wanted a daily admin before recess. Fine - it was pretty late in the year anyhow, so i didn't argue it for the few weeks of school left. And i'm pretty sure (i'd have to look) that i had the order worded differently. I thought this year when i was given the AAP as just a straight prn that was it until the parent called to complain that she thought the student would continue to get at noon; i explained the order was just written as prn and if she wanted him to get at noon, then she'd have to get another order or an addendum. I don't like to give unnecessary albuterol.

Any change in dosage requires an order for us here.

Just had a 10 year old with headaches come to get his Advil, which I have protocols for, and request 400mg. I told him I don't have orders for that and let his mother know that was excessive dose for a 90 pound 10 year old. I have protocols, but if I didn't I would print out prn sheets to for parents to get signed by their pediatrician, and I would ask for a stamp on the sheet to prove legitimacy.