I'm wondering if anyone can please answer this question I have about scheduled and PRN doses... But first I will give some background:
We had a lady who had been pacing.. Like really pacing... Around the unit. This lady is on scheduled hydromorphone. The other nurse working with this lady gave her the scheduled hydromorphone along with her scheduled medications to help her sleep. Shortly after, I could hear from the other side of the unit a lady calling out for help... Sure enough, it was the lady who had been apparently been pacing. So this lady usually has no problems with her scheduled night meds. Had always received them and never fell until tonight.
When she was on the floor, she was still restless and wanting to get off the floor. So we get her up off the floor and got her to sit in a wheelchair and at this point, still restless. She wants to get up. So she gets up and we take her to her room. Other nurse is trying to check her BP and she's wanting to get up after we sit her down on the bed.
Before this last had her fall, she was apparently pushing another resident around in their wheelchair.
I take her to my side of the unit. While we're walking, I ask her if she has any pain and she confirms that she does. Once we're there, the CNAs get her to sit down for a glass of juice and a sandwich.
At this point, I decide in addition to her scheduled dose of hydromorphone, I give her a PRN dose as she was complaining of pain post fall. Shortly after the CNAs give this lady a glass of juice and a sandwich, she starts pushing her table towards the unit entrance doors. Only has a few sips of juice. Too restless to eat. The CNAs manage to sit her down once more and spend some time talking with her, then decide to take her to her room. The talking was effective for time until the lady wanted to get up again.
I tell the other nurse that I gave the lady a PRN dose of hydromorphone due to complaints of pain post fall.
So my question is, should I not have given the extra PRN dose if the lady already had a scheduled dose before her fall?
She was VERY restless before her fall and I honestly didn't think that her other scheduled dose was cutting it. I just thought that giving a PRN dose post fall would help to settle this resident?