So often as nurses, we can be on cruise control just going through the motions of our day. Sometimes we forget or we don’t really know what our common medical acronyms mean or why they mean what they do. It’s not until a patient asks us what something means that we start to feel a little silly when we’re stammering for an answering, as well as simultaneously kicking ourselves thinking “I should probably know that one.” Years ago, a patient asked me “You say that I can get morphine PRN, but what does PRN stand for?” I fumbled a little bit and stuttered out “You can get it as you need it.”
It was like that time I had to confirm how many CC’s are in an ounce. In this new example, with the Morphine, the patient was certain she needed every 10 minutes and wanted to debate the meaning of PRN with me. I had to explain that it was only available every two hours, but the inclusion of the “PRN” really threw her. “But you said I can get it as I need it!!!” she yelled at me. Needless to say, that day exhausted me and reminded me that sometimes we all need a little refresher on this oh-so-common acronym. Medical acronyms can often be like nursing symbols. We think we know what they stand for but often don’t really know the history of them or even the history of the nursing profession. Hopefully, by the end of this post, you will be able to confidently respond when someone asks you “What does PRN mean?”
What does PRN Stand for?
I did terribly in college Latin, as much as I tried. But let’s take a little Latin lesson here: PRN is from the latin term “Pro Re Nata”, which literally translates into English “as needed”. We frequently utilize this “as needed” terminology with medicine, and nurses daily hand out PRN medications for a variety of different reasons. Very often, nurses get their clues that the PRN medication is needed from their clinical assessment of their patient, in varying degrees of subjective and objective information that is gathered.
When Should “PRN” Be Used in the Medical World
Now that you had your Latin lesson for the day and you feel comfortable in answering your patient when she asks “So, what does PRN stand for?”, we now need to go on and discuss when PRN should be used in the medical field.
As previously mentioned, we have to hand out PRN medications when our assessment warrants it. If the patient is having chest pain, sublingual nitroglycerin (an “as needed” medication) would be given, as well as morphine. If the patient is nauseated, the PRN order for Zofran or Phenergan would be warranted. The beauty of PRN medications is that nurses get a standing order for some of the most needed and routine medications based on various procedures and conditions.They are not scheduled (we would hardly want our pain-free patient receiving morphine scheduled every four hours), but to administer it as the situation requires it. PRN orders provide nurses with autonomy and authority to decide whether a patient should receive a certain medication and does not mean that a walkie-talkie patient should receive 2mg of morphine while they are sleeping, just because it was 2 hours after the last dose. (Even if they beg you to give it to them even if they are asleep.)
Let’s take a look at a specific example. Our patient just got out of surgery and had their gallbladder removed. The patient states they have 8/10 pain at the incision site. When looking at our orders, we see that we have a morphine order that reads “2mg iv morphine every 4 hours as needed for a pain level 7-10”. It’s in the nursing scope of practice to assess the patient and administer medications that they would deem necessary in light of assessment findings. So if the patient says their pain is 8/10, and they are alert, then we shall give 2mg iv morphine. Now if their pain is not relieved and we come back in an hour and it’s still 8/10, we cannot give another 2 mg of iv morphine because we can only give it every four hours as needed (PRN). Despite what my patient once told me that she needed it every ten minutes, there are still parameters for PRN medications. They are there to keep patients safe. With the post-cholecystectomy patient, it would be appropriate to collect a fresh set of vital signs and call the physician and alert them that the patient is still experiencing pain to see if a one-time order for unrelieved pain would be available.
Some Acronyms You Just Have to Know
Knowing what certain acronyms mean in your nursing profession are vital. They help you “speak the language” and ultimately to be a better nurse to help your patient make a full recovery! It can also help to keep your patients safe and confident in your care, as you’re able to interpret their orders quickly and properly explain to them (especially during discharge) what exactly PRN means, so they will know how they should take their medications. It is essential that our patients are aware of what medications need to be scheduled, and which ones they have a little more liberty with (though we must always emphasize the constraints they have with their as needed medications). We would never want our patients to not fully understand, as that could mean that they are living in pain or discomfort, or worse take more medications than they should and end of in distress. Luckily with our PRN definition, a little Latin goes a long way, and our patients may not exactly remember that PRN stands for “Pro Re Nata” but they will remember the kind nurse that educated them and showed them how to take their medications appropriately.
The Language of Medicine, 10th EditionMedical and Pharmaceutical Latin for Students of Pharmacy and Medicine: A Guide to the Grammatical Construction and Translation of Physicians’ … Upon Foreign Prescriptions (Classic Reprint)Medical Terminology Prefixes Quiz: Check Your Knowledge About Medical Terminology Prefixes With These 240 Questions! (Medical Terminology Quiz)
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