As an experienced hospice nurse, I understand that managing symptoms for comfort is crucial for terminally ill patients. One way we do this is through PRN medications. Today, I want to help you understand PRN medications and how they can be used with scheduled medications.
What Are PRN Medications?
PRN medications are given on an as-needed basis. The doctor prescribes them to manage specific symptoms that a patient may experience, such as pain, anxiety, or nausea. It’s important to note that PRN medications are not meant to be taken on a regular schedule like other medications.
How Do PRN Medications Work?
When a patient is experiencing a symptom, PRN medication can be given to manage that symptom. For example, if a patient is experiencing pain, a pain medication like morphine may be prescribed as a PRN medication. When the patient feels pain, the medication can be given to manage the pain. It’s important to note that PRN medications should only be given when the patient is experiencing the symptoms they were prescribed for.
Can PRN Medications Be Given with Scheduled Medications?
Yes, PRN medications of the same name or class can be given simultaneously as scheduled medications. For example, if a patient is scheduled to receive Tylenol every 4 hours but they’re experiencing a headache in between doses, they can be given a PRN dose of Tylenol to manage the headache. The PRN dose of Tylenol can be given at the same time as the scheduled dose of Tylenol.
It is important to remember that some medications have a maximum dose per 24-hour period. Unless an authorized provider gives an order to go over the maximum dose, you must be aware of the maximum dose and doses given to date. For example, Tylenol (Acetaminophen) has a maximum dose of 3,000 milligrams (3 grams) daily.
What are some common comfort medications and their maximum daily dose?
Acetaminophen (Tylenol) — 3,000 milligrams (3 grams) per day
Ativan (Lorazepam) — 10 milligrams per day
Haloperidol (Haldol) — 30 milligrams per day
Morphine — 1,600 milligrams per day
Ondansetron (Zofran) — 24 milligrams per day
Prochlorperazine (Compazine) — 40milligrams per day
If your patient/loved one is receiving a medication not listed above, and you are unsure, check with a pharmacist or the provider.
Tips for Administering PRN Medications
Here are a few tips to keep in mind when administering PRN medications:
Only give PRN medications when the patient is experiencing the symptoms for which they were prescribed. After you’re ruled out, scheduled medications cannot be given or are not as effective as you would like them for the patient.
Be aware of the maximum dose for the day, adding up the scheduled doses given and the PRN dose you are considering giving to ensure you don’t exceed the maximum dose.
Record the time and dose of each PRN medication in the patient’s chart.
Be aware of the potential side effects of the medication and report any adverse reactions to the doctor or nurse.
I hope this information helps you understand PRN medications better. Remember, managing symptoms for comfort is essential to hospice care, and PRN medications can be useful in achieving this goal.
Conclusion
Understanding PRN medications is crucial for managing symptoms and providing comfort to terminally ill patients. PRN medications, or medications given on an as-needed basis, are prescribed to manage specific symptoms such as pain, anxiety, or nausea. They are not meant to be taken regularly like other medications. PRN medications can be given in conjunction with scheduled medications, and it’s essential to be aware of the maximum daily dose for each medication. Some common comfort medications and their maximum daily doses include Acetaminophen (Tylenol) at 3,000 milligrams per day, Ativan (Lorazepam) at 10 milligrams per day, and Morphine at 1,600 milligrams per day.
When administering PRN medications, it’s essential to give them only when the patient is experiencing the symptom they were prescribed for, be mindful of the maximum daily dose, record the time and dose of each PRN medication given, and be aware of potential side effects. PRN medications can be a helpful tool in managing symptoms for comfort in hospice care. However, it’s essential to communicate with healthcare providers with any questions or concerns.
In summary, PRN medications play a vital role in providing comfort to terminally ill patients by managing specific symptoms as needed. Understanding their use, maximum daily doses and proper administration is essential for effective symptom management and patient comfort in hospice care.
