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Example 1:Procan SR 500 mg p.o. q. 6 h 1. Procan SR is the brand name of the drug 2. 500 mg is the dosage 3. p.o. is the route 4. q. 6h is the frequency This order means; Give 200 milligrams of Procan SR orally every 6 hours.
Example 4: Demerol 75 mg IM q.4h, pain; Read:__________________________________ Example 5: Pen-vee K 1 g p.o. 1h pre-op dental surgery Read:__________________________________ Other Doctors order for treatment: 1. 2/3 strength solution Ensure. Give 90 ml qh for 5 hours via NG tube. Read:__________________________________ _____________________________________
2. 5/8 strength solution Isomil 36 ml via NG tube hourly for 8 feedings. Read:__________________________________ _____________________________________ 3. Acetaminophen 240 mg. p.o. q4-6h p.r.n., pain or T>38C. Read:__________________________________ _____________________________________
3. Not checking the correct dosage. SITUATION: A nurse flushed a triple central venous catheter (an IV with three ports). According to hospital policy, the nurse was to flush each port with 10 ml of normal saline followed by 2 ml of heparin flush solution in the concentration of 100 units/ml. The nurse mistakenly picked up a vial of heparin containing 10,000 units/ml. Without checking the label she prepared the label with all three ports. The patient received 60,000 units of heparin instead of 600 units.
Reading the labels of medications is critical, Make sure that the drug you want is what you have or hand before you prepare it.
6-6/12-12
6-12-6 6-10-2-6 6-10-2-6-10-2 6-12-6-12 6-2-10
9 PM
MEDICINE TICKET
Objective: To be able to guide the nurse to follow the doctors written order indication the drug to be given the frequency of doses the amount of each dose and the method of administration.
Scope:1. name of patient 5. name of drugs 2. age 6. route 3. room no. 7. time frequency 4. date 8. doses (doctors name, NOD signature)
Dr:________________
NOD Sig.:_______________
PRN STAT
DOCTORS ORDER - Give Lasix 40 mg. I.M. stat - Start Motrin 600 mg. p.o. b.i.d. Dr. de la Cruz 2:45 p.m.
7-05-08
Complaint of headache
4 5 6
6 6
7-5-08
PRN 6pm
STAT
7-4-08 Lasix 40 mg. I.M. stat
3 pm
- Florence Nightale RN
4 5 6 D C
7-6
6 6
7-5-08
PRN
6pm
STAT
7-4-08 Lasix 40 mg. I.M. stat 3 pm
- Florence Nightale RN
6 7 8
6 10 2 6
2
10
- Florence Nightale RN
6 7 8
6
10 2
6
Oxacillin sodium 0.5 g p.o. q. 8 hrs
123-4
2
10
- Florence Nightale RN
Date:_______________
Age:______________
Date:___7-06-08______
Age:__22_________
Order: __Tranxene
Irregularities in Transcribing MT
If the order is PRN with varied time frequencies If the order is stat and then with regular time frequency To indicate dosage; you can write name of drugs, strength (dosage), time frequency Stat order to be administered less than 1 hr. on a Medicine ordered with a series of doses should also write no. of dosage done on the ticket
Example situation
Date __7-06-08_____
Name:___Penduco, Pedro__________________________ Room No.__ 212____ Bed No.__2____
p.o.
Dosage/Freq:__6 12 -6 - 12__________________ Route:___IVTT______ 1-2-3-4-5-6 NOD:_____________
Keys to Remember:
1. Never transcribe doctors order in a medicine ticket with erasures or tampered. 2. Always write legibly, neatly, and correctly. 3. Do not recycle the used medicine ticket. (as much as possible) 4. A new doctors order is a new medicine ticket. 5. Endorsed to your charged nurse the old ticket that has changed order in; (increase/decrease dosage; route) 6. Do not revise/rephrase what have written in the doctors order. Rewrite completely what have written in the order. 7. If in doubt; check your ticket from the doctors order sheet first before in the medication sheet.
8. Arrange your drugs according to their color coding if for 1 patient with lots of drugs in different frequencies/timing. 9. Make an indication/marks on the medicine ticket for stat orders; to prevent from administering twice. 10. Signing the medication sheet as prompt as possible after administering/given a due medicines. 11. Do not sign the medication sheet in advance; without administering the drugs yet. Especially IVTT meds. 12. Always coordinate with the charge nurse with regards to new orders; new drugs ordered; etc. 13. Be mindful always
Drugs just like a sword that has two sharp edges; Whether it heals you, or kill you for just a minute from miscalculation.