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Content by NurseCR

  1. Long story short, I work in an LTC home and one resident has multiple PRN laxative orders - PEG 17g once daily prn, bisacodyl 10mg PO BID PRN, and bisacodyl 10mg supp once daily PRN. If the patient received a supp and then has an XL BM and is then requesting bisacodyl and PEG together, am I within my rights as the nurse to tell this resident no as 2 further doses of laxative aren’t indicated following an XL BM (and frequent BMs over previous days). Also, if they request 3-4 doses of laxative within 3-4 hours, are you as the nurse able to say they need to allow the medication time to work before taking more? Im worried about diarrhea and possible dehydration as the patients fluid intake is not great, but don’t want to be getting myself in trouble as technically the medications are ordered. Furthermore this residents cognitive state has been declining and they believe they haven’t had a BM for approx. a week when charting Indicates this isn’t the case. My thought process is that I wouldn’t give a patient 4 different types of pain medication at once without allowed previous doses an appropriate amount of time to work so I’m not sure why this would be different but I wanted to get more opinions.
  2. NurseCR

    Can I refuse to give PRN medications

    Thanks for your reply. The patient in question has advanced ms and is on a lot of regularly scheduled opioids, both of which contribute to constipation. We do have hydration plans in place however this resident is very specific and isn’t willing to do a lot of things we recommend for his health. Basically my concern is that if we provide every laxative that is ordered and he ends up with diarrhea, he in the past has gotten angry with us for overloading him on laxatives, even though it was what he requested. He basically believes that if it’s ordered we have to give it, and I just wanted to know if I was in the wrong for not providing it even when they’re not indicated.