PRN Medications (Nursing)

00:01 So, here's another group of medications.

00:03 We call them PRN medications.

00:05 It just stands for Pro Re Nata.

00:07 Now, you'll never see Pro Re Nata written out, but you will see the letters PRN.

00:12 That just means the thing that is needed, it's for specific signs and symptoms.

00:17 But let's talk through what an order will have.

00:19 PRN medications, we have a responsibility, first of all, to lay out our ad pie.

00:24 So you want to think their assessment, diagnosis, planning, implementing, and evaluating.

00:31 You want to make sure that this drug is safe and appropriate for the patient to receive, and you want to document the patient's response to the PRN medication.

00:40 So, as a nurse, this is what separates you from the level of an LPN.

00:44 RNs are the ones who are responsible for assessment and the appropriate documentation of a PRN medication.

00:53 So, if you've never seen a physician's order, let's walk through what 1 would look like.

00:58 So for example, for a PRN medication, the order should tell you the purpose of the medication… because remember, medications can be used for several different things… the dose of the medication, the route and the time.

01:13 For example, take a look at this order.

01:16 Tylenol 650 mg PO PRN for fever > 101.5°F or 38.6°C, or pain q 4-6 hours not to exceed 4,000 mg in 24 hours.

01:32 Now, I may have lost you as we went through that because there's a lot of words in here that nurses are used to seeing that you might not yet be familiar with.

01:39 So let's take a look at them.

01:41 650 mg is just a unit of measure.

01:44 PO means by mouth.

01:47 PRN, as you know, is Pro Re Nata for fever or pain.

01:52 Q means every, 4-6 hours, and that gives us the maximum amount of milligrams in 24 hours.

01:59 Okay, so we have the purpose of the medication, it's for fever or pain.

02:04 We have the dose, 650 mg.

02:08 We have the route, PO, which is oral.

02:12 And the time, every 4-6 hours, but they're reminding us not to give more than 4000 mg in a 24-hour period.

02:20 So that's a really complete and thorough PRN medication order.

02:24 We know why we're giving the medication.

02:27 We know the amount or dose of the medication, we know the route of the medication, and the timing of the medication.

02:36 So we've talked about this in other videos, but we can't stress it enough that nurses are really important in patient education.

02:43 Thinking through the 5 rights, thinking through the nursing process when teaching your patients how to safely and effectively take the prescribed medications is a great system for you to make sure that you are… give a thorough patient education to keep them safe.

02:58 I want to give you 4 things to think through with each 1 of your patients.

03:02 First of all, can they obtain the medications? There might be problems with finances or resources, and we can figure that out as nurses by asking appropriate questions throughout their stay.

03:13 You want to make sure that they are able to follow their healthcare provider's plan for the medications.

03:18 Sometimes, dosages can be really complex and it's helpful if you write it out on a calendar for them or write it out in longhand, so they're very clear, especially if the dosages change from day to day.

03:29 Third, you want to make sure they can give the medication safely in a home setting.

03:34 If someone has rheumatoid arthritis and we're… and their hands are difficult to maneuver, and we're sending them home to give themselves subcutaneous meds, that's probably not going to work.

03:45 Are they able to see the syringe, is their vision okay? So, you want to be thinking about the patient at home and in their home setting.

03:52 Are they able to administer these medications safely? And last, does the patient understand the potential adverse effects? Does the patient that you're going to send home on a medication that decreases their pulse rate, do they know how to check their pulse rate? Do they know what to watch for? So, you always want to make sure that you think through the whole picture when you're sending a patient home on a medication treatment plan.

04:16 Can they get the medications? Can they follow the directions? Can they administer the medications? And do they understand the potential adverse effects? Now, handing a patient a stack of papers is not the best way to do that.

04:29 But we found that the most effective way is using a teach-back training.

04:34 That means you go in and share the information with your patient, and then you ask them a question.

04:40 Like, look for the example.

04:42 "What was the dose of your medication, again?" and the patient says, "I must take 2 pills a day." That's a great example of how you can actively use teach back in a clinical setting.