The nurse is reviewing a client’s PRN pain medications. There is an order for acetaminophen 1,000 mg PO q4 hours as needed for pain. How should the nurse proceed?

  • call the health care provider to clarify the order
  • administer the medication as ordered if needed for pain
  • give other PRN medications for pain and ignore the order
  • avoid giving pain medication every 4 hours and give it every 6 hours
Number 1 is correct.
The nurse should notify the health care provider and ask for another order. At this dose, the client may potentially receive 6,000 mg of acetaminophen in 24 hours, which far exceeds current FDA recommendations of a maximum dose of 4,000 mg per day. This dose can cause liver damage, especially in clients with decreased liver function. Administering the medication as ordered exposes the client to the risk of an excessive dose. Giving other PRN medications and ignoring the order may potentially harm the client if another nurse follows the order as written. Giving the medication on a different schedule than ordered places the nurse in the position of practicing medicine without a license. Client safety is always a priority in administering medication.