When to administer PRN meds?

[Lost_nursehere]

Hello, I would greatly appreciate your insight on a matter that has arisen since I started working in a nursing home. It appears that many of my residents require opioids to manage their pain. I have encountered a situation involving a resident's request for pain medication that I would like guidance on. This particular resident has a PRN order for oxycodone and has expressed her desire to take it proactively, even in the absence of current pain. She underwent neck surgery several years ago and hopes to prevent potential pain and discomfort before it occurs. Should I document this as 'Resident requested Oxycodone 2.5 mg proactively to manage potential pain and discomfort before it occurs?' I want to ensure that I am following the appropriate protocols while providing the best care for my residents. Thank you for your assistance.

Additionally, I am seeking guidance on how to document for my dementia residents. As I have no prior experience in geriatric care, I find everything overwhelming. Any help or advice you can provide would be sincerely appreciated. Thank you once again for your support.

[JKL33]

Lost_nursehere said:

This particular resident has a PRN order for oxycodone and has expressed her desire to take it proactively, even in the absence of current pain. She underwent neck surgery several years ago and hopes to prevent potential pain and discomfort before it occurs. Should I document this as 'Resident requested Oxycodone 2.5 mg proactively to manage potential pain and discomfort before it occurs?'

Personally unless this is a pre-medication for a specific/known pain-inducing event, I would refer this to the prescriber to see if this use is in line with what they had in mind with their PRN order. They may say it's fine, in which case the order itself really should be amended to say that, or they may wish to reassess in case there is a better way to handle the scenario medication-wise. Just my $.02. It's never wrong to ask the provider when you have questions about things that aren't completely straightforward.

Not sure I can help with your second question--can you give a couple of examples of things you're not sure how to document? Maybe others will chime in.

Good luck ~