My floor gives an incredible amount of PRN meds. I'd never really seen some of these PRN orders in clinicals before. I'm wondering if I just missed this before, if it's because of the field I'm in, or if PRN use varies amongst facilities overall.
Obviously most specialities will see prn pain meds, tylenol, sleeping pills, and maybe some prn benadryl for itching, topical creams, or prn ativan for anxiety.
But what PRN meds do you see that are unique or unusual?
Some common ones we see are PRN orders to start IV antibiotics if the pt spikes a temp or a cx comes back positive, prn one time doses of antibiotics for a temp, prn growth factor shots for low ANCs, prn Lasix based on I&Os, prn hydralazine or lopressor, prn IV potassium, magnesium, calcium, or phosphorus, FFP for too high of an INR, prn baclofen for hiccups, and everyone has parameters for blood and platlet transfusion.
I've also seen caffiene pills and nicotine inhalers.
So what PRN orders do you see commonly where you work?
I have one that's pretty specific to my kind of unit;
On some infants MD's will leave orders for PRN surfactant if their FiO2 requirement is above a certain parameter (>30-40%) at so many hours of life. Most of the time we notify the MD/NNP on call of the infant's symptoms that suggest need for it, but with some infants they just know they might need it or may need a repeat dose.
In our NICU, they don't tend to pass out too much pain medication or sedation (frustrating at times), but the PRN's we do see are usually Morphine, Tylenol, Versed & Fentanyl, in that order, morphine is given far more than probably any of the others.
In psych... I've seen a hell of a lot of Seroquel and Zyprexa given PRN. Along with your regular tmaz and Stilnox for sleep and benzos for anxiety if not the Seroquel or Zyprexa.
I've been on clinical in a colorectal surgical ward this week and a lot of Endone gets given PRN, as well as morphine, panadol, zofran, maxalon and stematil (most patients are on the post-op nausea and vomiting protocol.) I gave hirudoid cream PRN yesterday. The pt wanted something for all the bruising from BD subcuq heparin and daily bloods!
Tait, MSN, RN
2,142 Posts
Dilaudid, morphine, toradol, restoril, ambien, zofran, phenergan, reglan, tylenol, hydralazine, lopressor, vasotec, haldol, ativan, xanax, oxycodone, percocet, lortab (more recently Vicoprofen), seroquel, benadryl, demerol, fentanyl (on occassion).
Tait