Writing Bad Orders

Specialties Geriatric

Published

How would all y'all transcribe this order:

Daily weights

Lasix 40 mg by mouth daily.

If weight increases by 2 kg over 2 days increase Lasix by 20mg

If weight decreased by 2 kg over 2 days decrease Lasix by 20mg.

today I'm 110, tomorrow I'm 112, the next day I'm 115-so I should get 60mg

Then I'm 115, 115...I keep getting 60 mg

Then I'm 110...back to 40mg

then I'm 105...20mg???

Our providers refuse to change the order because 'that's how she was being managed in the hospital'....hate to break it to you, ladies, we are NOT a hospital.

Nope, if the lasix dose really needs to be changed, then the MD needs to change the dose or order a one-time dose with each daily weight as he sees fit. Each time. PRN lasix sounds like a bad idea in an acute setting and a terrible idea in LTC.

What's next, warfarin orders with PRN dosages based on INR results?

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Sounds like a lazy provider who wants nursing to manage the patient's fluid balance and not bother reviewing the chart every day.

Don't let them get away with it.

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