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Discussion

This is a basic med pass question

ok i am questioning a medicine problem here...pt..is taking lortabs q6hrs.round the clock..ok now theother med order reads ultram tid prn..what times would you give this.........every 8 hrs..or 8am 2pm8pm..this pt. wants this every med pass.............this pt. lives in an assisted living..i thought every 8hrs.am i wrong admin. says it is 8 2 8..i am so confused...please explain..thankyou...

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I would probably go with the 0800 - 1400 - 2000 schedule. Things like antibiotics should be given every eight hours, but pain meds are often ordered while awake. Check your policies or clarify with the doctor..or check with the resident...sometimes resident preference is what counts most.

You need a clarification order to give a PRN time frame like every 8 hours PRN. Because sure enough someone will come in behind you with no common sense and give 3 in a row. Also if the patient is requiring this much pain medication it may be time for an adjustment...

the hospital where i work, q8hrs and tid are totally different times.... q8hrs is 0000, 0800, and 1600... tid is 0800, 1300, 1800... i would check with your facility on tid times.

If the resident is asking for it routinely then call the MD let him/her know and get the order changed. It is actually that simple and ask the MD for specific times so no one has to guess. :wink2: Guessing in nursing is not:nono: a good thing to do. I always err on the side of caution!!:)

What I was taught in dosage calculations is tid = 3 times during waking hours, q8h is three times in every 24hour period obviously. So, the 2 are different.

Do doctors realize this while writing orders? many times no. you need clarification on your facility's policy.

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You also need clarification of these orders for any medication assistants you may have in your building. Where I come from, unlicensed caregivers may administer both scheduled and PRN medications in ALFs, but PRN orders must be written so clearly that med aides do not use their own discretion to determine when to give a medication.

Also, for general purposes, TID and q8hr are totally different animals. (For Ultram, q8hr is safest IMHO, and personally I rarely give it more frequently than q6hr. If pain isn't controlled with 3 doses of Ultram within a 24-hr period plus whatever other pain meds are given routinely, I ask for more and/or better meds.)

Just my two pence worth......

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Thank you...and the admin. says it's 8 2 8 with no exceptions...even if prn...i was very confused i also challenged the lortab and ultram given round the clock together the pt..is so out of it most of the time..I was told you pass the meds and that's it..an lpn that just felt useless totally..and really i guess she's right i am only there for the med pass and that's it..

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