How to Chart a PRN Mylanta Order
When charting a PRN (as needed) Mylanta order, document the medication name, dose, route, frequency, and specific indication for which the medication should be administered.
Proper Documentation Elements
When documenting a PRN Mylanta (aluminum hydroxide and magnesium hydroxide) order, include:
- Medication name: Mylanta (aluminum hydroxide/magnesium hydroxide)
- Dosage: Typically 30 mL (or 2 tablespoons)
- Route: PO (by mouth)
- Frequency: Usually every 4-6 hours PRN
- Specific indication: For heartburn, indigestion, upset stomach, etc.
- Maximum daily dose: Specify maximum number of doses in 24 hours
Example of Complete PRN Order
Mylanta (aluminum hydroxide/magnesium hydroxide) 30 mL PO every 4-6 hours PRN for heartburn or indigestion. Maximum 4 doses in 24 hours.Additional Documentation Considerations
- Timing considerations: Document if the medication should be given at specific times (e.g., after meals, at bedtime)
- Contraindications: Note any patient-specific contraindications
- Special instructions: Include any special administration instructions
Monitoring and Follow-up Documentation
After administering a PRN medication, document:
- Date and time of administration
- Dose given
- Reason for administration (specific symptom)
- Patient's response to medication
- Any adverse effects observed
- Your name/credentials
Common Pitfalls to Avoid
- Incomplete orders: Failing to specify all required elements
- Vague indications: Using general terms like "as needed" without specifying symptoms
- Missing maximum dose limits: Not including maximum daily dose information
- Illegible handwriting: If handwritten, ensure clarity to prevent medication errors
Best Practices
- Use standardized terminology and abbreviations approved by your institution
- Follow your facility's specific documentation policies
- Document both the administration and effectiveness of the medication
- Ensure the order is clearly visible in the patient's chart
- Consider electronic ordering systems if available for improved clarity and safety
Remember that proper documentation is essential for patient safety, continuity of care, and legal protection for healthcare providers.