Tylenol ordered for pain.

MunoRN, RN · May 3, 2015

Me thinks something else went wrong for this course of events to occur. I highly doubt someone just happened to audit a PRN med list and saw Tylenol given for 0 pain if nothing serious occurred.

Part of what I do is assist with regulatory visits. There are two things you can always count on surveyors checking; restraint charting and whether PRN med indications exist and are being followed.

Dranger · May 3, 2015

@Dranger I know NSAIDs are for fever also and I know Toradol is anti inflammatory and you did say Tylenol was an NSAID you read closely next time I read exactly that âœŒï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¸

I was referring Toradol being an NSAID not Tylenol, look at the OPs post I quoted:

OP: Is toradol an anyipyretic? Wow. I still have so much to learn. Thank you!

Me: Do you look up drugs before you give them? It's an NSAID like ibuprofen, thus it treats fever.

Show my exact quote where I said Tylenol was an NSAID. Is English your first language? I am having my doubts right now.

suanna · May 5, 2015

Part of the problem is the federal govt deciding that "Tylenol 325mg 1 or 2 PRN" wasn't clear enough. Doctors have to give specific reasons for every PRN when in reality they would rather just say " Nurses went to school for 2-5 years, I'm sure the uses for Tylenol are not beyond thier professional judgement." Unfortunately that isn't allowed- so the orders get restrictive, and the patient, nurse and doctor all suffer, because some half-wit in DC dosen't believe that nurses have a brain.

canned_bread · May 6, 2015

You did the correct thing and the doctor is a bum hole.

1) The fever needed to be reviewed. Fevers are bad.

2) Tylenol was for PAIN. Not FEVER. Many medications have dual usage. Anti-psychotics for hallucinations and for sedation etc. That's why we have the usage on the order!

3) You did perfect. Absolutely perfect and outstanding practice. Good on you.

Elvish, BSN, DNP, RN, NP · May 6, 2015

You did the correct thing and the doctor is a bum hole.
1) The fever needed to be reviewed. Fevers are bad.

While I agree with most the rest of this post, I feel the need to point out for anyone reading that fevers are not bad. Uncomfortable, yes. A sign of symptoms that may need to be addressed, yes. But fevers are not bad in themselves. They are the body's way of making itself a less hospitable environment for the pathogen that has taken up residence, and that is a good thing.

Here.I.Stand, BSN, RN · May 6, 2015

@dranger by the way Tylenol it's not like ibuprofen. Ibuprofen is an NSAID because it is anti-inflammatory. Again Tylenol is not anti inflammatory. ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½

Dranger was addressing Toradol, not Tylenol :)

Here.I.Stand, BSN, RN · May 6, 2015

Part of the problem is the federal govt deciding that "Tylenol 325mg 1 or 2 PRN" wasn't clear enough. Doctors have to give specific reasons for every PRN when in reality they would rather just say " Nurses went to school for 2-5 years, I'm sure the uses for Tylenol are not beyond thier professional judgement." Unfortunately that isn't allowed- so the orders get restrictive, and the patient, nurse and doctor all suffer, because some half-wit in DC dosen't believe that nurses have a brain.

It's maddening. That and the new thing that if 2 PRNs are ordered, they have to put "Use 1st" and "Use 2nd." We're taught to always know why and never "just follow orders," like in the military (thank you GrnTea for that comparison.) But all of a sudden, nurses don't have nursing judgment??

What would happen at my work is something like this: Head injury pt has a temp of 39. Tylenol is ordered for "mild pain." You report the fever to any of our staff, residents, or NP, and the first thing they ask is "Did you give Tylenol?" To which I'll respond, "Yes." Because I do have nursing judgment. Fever in TBI *is* dangerous, and that patient doesn't need their bedside ICU RN to say, "Wait, I know your metabolic state in your brain is too high, but first I need to ask the Doctor what to dooooooo."

Besides, the med *has* been prescribed by a licensed provider, and has been verified by the pharmacist. Would a patient all of a sudden have an adverse reaction to Tylenol when given for fever, when s/he never had one when given for pain?

I know what TJC says on the matter. And it's stupid.

Vent over.

Karou · May 8, 2015

Just commenting because I had this situation come up recently at work. Patient spiked a temp (103.2) and had Tylenol ordered for pain. I gave the Tylenol for the temp and then called the doctor to let him know what I did. He was grateful that I gave it and after I received new orders for the new onset of fever, I asked if I could amend the Tylenol order to include for fever. This was a patient who was admitted for pancreatitis so I could say the Tylenol was for pain if I was scrutinized, it would certainly not have been a lie that he was having pain.

I did what I did because I felt comfortable doing it. I know this physician and know the patient, I know I might not get a call back from the MD for over half an hour while I wait to clarify the order. Personally, I would probably give the Tylenol anytime this situation came up and call the doc after the fact. However I would NOT say that you were wrong in the way you handled it.