If you’re a nursing student, one of the first things you’ll notice during clinicals is that your patient’s MAR (Medication Administration Record) can look… well, overwhelming. It’s not just a single tidy list, it’s split into categories, and the two biggest categories are:
- Scheduled meds
- PRN meds
You’ll spend the majority of your time in these tabs. So let’s break down the differences between the two (with some tips sprinkled in!) so you can walk into your shift feeling prepared.
💊 Scheduled meds
Scheduled meds have a specific due time and are meant to be given on, well… schedule.
But, it’s not always as simple as “the clock says it’s time.” Some scheduled medications have what’s called holding parameters. This means you would hold (or not give) the medication if these parameters are met.
Cardiac medications are the most frequent meds with parameters. For example:
- Hold for HR < 60 (hold for a heart rate less than 60)
- Hold for SBP < 90 (hold for a systolic blood pressure less than 90)
Your rule of thumb: For scheduled meds, you either administer the med, or document why you didn’t (with a clear, valid reason).
💊 PRN meds
PRN means “as needed,” which gives you flexibility, within limits. These meds save you from calling the provider every time your patient needs/requests something small like:
- Acetaminophen for a mild fever
- Pain meds for breakthrough pain
- Stool softeners for constipation
- BP meds for a mildly elevated result
They’re a wonderful time saver and expedite patient care. The catch? You can’t just give them whenever you want. Every PRN order must have an indication, which means you can only administer them for the specific indication listed, otherwise you’re practicing outside of your scope.
Example: Let’s say you have a patient who as a PRN lorazepam ordered for seizures lasting longer than 2 minutes, but you decide to give it for anxiety. That’s inappropriate. If the patient is so anxious they need lorazepam and the patient has a history of seizures, the physician should be notified and an appropriate order for that specific indication should be placed.
🚑 Quick takeaways for students
- Always check holding parameters before giving a scheduled med.
- For PRNs, read the indication every time. If it doesn’t match your patient’s current need, call the provider for a new order.
- Document clearly whether you administered (or why you held) the med.
🧰 More Resources on meds for nursing students
- This is just scratching the surface of med management. If you’re a student, check out this full post on: Medication Administration for Nurses & Nursing Students
- If you’re already on the floor and want to master meds in real-time, my Med-Surg Nurse Crash Course is made just for you.
Until next time,
Kati 🪴
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