A nurse receives an order from a health care provider to administer hydrocodone and acetaminophen (Vicodin ES 7.5/750), to a patient who is experiencing 8/10 postsurgical pain
The order is to give 2 tablets every 6 hours by mouth as needed for pain. What is the nurse's next best action?
a. Give the Vicodin ES to the patient immediately because the patient is experiencing severe pain.
b. Ask the health care provider for a nonsteroidal antiinflammatory drug (NSAID) order.
c. Ask the health care provider to verify the dosage and frequency of the medication.
d. Give the Vicodin ES in addition to playing soothing music for the patient.
ANS: C
The maximum 24-hour dosage for acetaminophen is 4 grams. If the patient took 2 tablets of Vicodin ES every 6 hours, the patient would take in 6 grams of acetaminophen in 24 hours (2 tablets = 750 + 750 = 1500 4 [could have 4 doses in 24 hours every 6 hours] = 6000 mg = 6 g). This exceeds the safe dosage of acetaminophen, so the best action is to question this order. Giving the medication as ordered would possibly result in the patient's taking more acetaminophen than is considered a safe dose. Acetaminophen overdose can result in liver failure. NSAIDs are used to treat mild to moderate pain. At this moment, the patient is experiencing severe pain. Implementing music therapy is a nursing intervention and is an independent nursing action that can be instituted with pain medication, but the possible acetaminophen dose is the priority.
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