lunaro16

Her orders were: Oxycodone CR 20mg PO q8h Percocet (Oxycodone 5mg/Acetaminophen 325mg) 2 tabs PRN q4h VS before: BP 115/70, 20 resp/min, 95% on room air (stable throughout her hospital stay) VS after: BP 90/61, 7 resp/min, 88% on 2L of oxygen and +++somnolient The next day after the incident the nurse was explaining to the patient that she was going to give her the oxycodone first and 1h later the percocet because of "what happened last night" (but I think that it wouldn't make a difference because of what some of you have mentioned: it's controlled release oxycodone). The doctors changed the order to only 1 tab PRN q4h, which made her very angry. She has been taking oxycodone for 12 years or so, and is VERY dependent on the medication. She knows when the nurses are assessing her, she starts taking deep breaths or breathing faster to have higher O2 sats or more respirations per min (she thinks this way she'll be able to get the meds).. so they had to assess her while sleeping. Thank you for your answers!! I'm a nursing student. She wasn't my patient, she was my patient's roomate, but I was curious about the whole situation.

What the nurses had done before was giving the oxycodone CR and about 1 or 2 hours later give the percocet and she didn't have any problems, until this time that they were taken together. Maybe she did have something extra on her own, she has been managing her chronic pain for years now. Thank you for sharing your thoughts!! I was curious. I will keep this in mind :)

I saw one patient receive PRN percocet and his scheduled Oxycodone PO at the same time. She is VERY dependent on this narcotic. Would you give these two meds together? Or would you give the scheduled oxycodone and later give the PRN, even if the patient asks to take them together? After taking both at the same time, the patient's BP decreased to 90/60, and respiration rate decreased from 20 to 7 breaths per minute, her O2 sats were 88% on 2L of oxygen. She became +++somnolent and it was very difficult to wake her up, she would fall asleep right in the middle of a conversation. If her respirations dropped to 6 per min, the nurse would have called code 66. She was given narcan and was fine after all. Obviously she had an overdose, but, would you normally give these two meds at the same time if the patient asks? Do you consider this a "bad" nursing practice?