1 po med pass demo. supplies needed 2 each spn is to take the following supplies 1. 4 medicine cups...
TRANSCRIPT
1
PO MED PASS DEMO
SUPPLIES NEEDED2
EACH SPN IS TO TAKE THE FOLLOWING SUPPLIES 1. 4 MEDICINE CUPS 2. 4 ENVELOPES 3. 2 UDW 4. 5 POST-IT NOTES 5. MARS and PAPER PILLS FOR ERIN SMITH (already have MAR) STEVEN TYLER JENNIFER ANISTON BRAD PITT 7. HAVE READY: RED AND BLACK PEN, HIGHLIGHTER,
SCISSORS, PAPER, IPOD, PREP PAPERS, SHARPIE
OBJECTIVES3
1. CORRECTLY FILL OUT UNIT DOSE WORKSHEET (UDW)
2. CALCULATE DOSAGES WITH 100% ACCURACY
3. ADMINISTER DRUG CORRECTLY ACCORDING TO ORDER AND FORM OF DRUG 100% OF TIME
4. CORRECTLY ID CLIENT 100% OF TIME5. CORRECTLY RECORD MEDS GIVEN OR
NOT GIVEN ACCORDING TO POLICY
6 PT RITES4
PATIENT DRUG TIME ROUTE DOCUMENTATION DOSE 100% OF THE TIME!!!!!
6 RIGHTS OF MED ADMINISTRATION
5
1. RIGHT PATIENT a. Check the original order b. Check the MAR c. Check client name band- 2 identifiers NAME and MEDICAL RECORD #/ or BIRTHDATE d. Ask client name, DOB, and allergies e. Red flags- same names
6 RIGHTS OF MED ADMINISTRATION
6
2. RIGHT DRUG a. Check the original order b. Check the MAR c. Check the package or container d. Inform the client of med name and
reason for giving
e. Red flags- same color, close names
6 RIGHTS OF MED ADMINISTRATION
7
3. RIGHT ROUTE a. Check the original order b. Check the MAR c. Does this match client and condition? d. Watch abbreviations e. Red flags
6 RIGHTS OF MED ADMINISTRATION
8
4. RIGHT TIME a. Check original orders b. Check the MAR c. Does time match use of drug d. Any conflicts/counteractions with other drugs e. Watch abbreviations for times f. Red flags
6 RIGHTS OF MED ADMINISTRATION
9
5. RIGHT DOSE a. Check original order b. Check MAR c. Is dose within recommended guidelines d. Pay attention to numbers e. Correct calculations f. Red flags
6 RIGHTS OF MED ADMINISTRATION
10
6. RIGHT DOCUMENTATION a. Correct MAR b. Correct signature c. Correct space on MAR d. Correct date and time
ABBREVIATIONS11
WATCH WHICH ABBREVIATONS ARE USED.REVIEW INFORMATION SHEET GIVEN.
PREPARATION: GETTING STARTED
12
1. MUST ARRIVE ON TIME- BE EARLY ON MED PASS DAYS
2. OBTAIN UDW a. OBTAIN CLIENTS TO PASS MEDS ON.3. FILL OUT UDW- will go over in detail4. CHECK MEDS ON MAR TO COMPLETE
UDW5. OBTAIN REPORT ON CLIENTS6. NOTE ANY “NPO” – for any reason7. MAKE SURE CART ADEQUATELY
STOCKED:
PREPARATION: GETTING STARTED
13
8. WILL DO DRUG CALCULATIONS ON BACK OF
UDW9. UDW IS NOT PART OF CHART
14
HOURS
ROOMS
IV’S/NURSE NOTES
UNIT DOSE WORKSHEET
FSBSPRN MEDS MEDS HELD
UNIT DOSE WORKSHEET15
1. Time across top2. Rooms down side3. Use client initials with room numbers4. Fill in each room in your mod, may have
admission later5. 3 columns at bottom: FSBS, PRN MEDS,
MEDS HELD6. IV’s or RN meds on column to right 7. Nurse name and date on top of UDW
16
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
JA
401A
401B
403A
403B
BP
404A
IV’S/NURSE NOTES
UNIT DOSE WORKSHEET
FSBSPRN MEDS MEDS HELD
UDW17
8. Check meds on MAR in order they are written. DO NOT attempt to find all 0800, then 0900, etc.
9. Make a tally mark on UDW in time space that med is due
10. If due at half hour time, can make a diagonal space in time slot.
11. Mark IV meds on worksheet in RN slot in correct client space.
18
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l l l l l l
401A
401B
403A
403B
B.P.l l l l l
404A
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS PRN MEDS MEDS HELD
UDW19
12. Be careful of qod orders, even /odd day orders 13. Be aware of stop/start dates, one time orders,
and expiration dates14. Check client’s allergies and be sure patient is
not getting a med they are allergic to. Put sticky note on UDW for allergies for a red flag for nurse. This is the only information to look up about the med while filling out UDW.
15. Do not look up all information about med while filling out UDW.
16. Put FSBS in column at bottom of unit dose worksheet with time and room # and under appropriate time to be done at top.
MED PREPARATION20
1. WASH HANDS2. PREPARE MEDS WITH AS LITTLE
DISTRACTION AS POSSIBLE3. PREPARE MEDS FOR ONLY ONE CLIENT
AT A TIME4.PREPARE ONLY ONE MED AT A TIME –
DOING ALL 3 CHECKS ON THAT MED BEFORE MOVING ON TO NEXT MED5. DO NOT PRE-SIGN MEDS
MED PREP (CONTD)21
7. GIVE ONLY WHAT YOU HAVE PREPPED8. IF PILLS FALL ON FLOOR, DISCARD IN
SHARPS9. REPORT ANY ERRORS10. KNOW INFO ABOUT MEDS11. DO NOT LEAVE CART UNLOCKED12. DO NOT LEAVE MEDS OUT ON CART13. DO NOT LEAVE MARS OPEN
MED PREP (COND)22
14. GIVE MEDS IN CORRECT ORDER a. Pills and tabs b. liquids c. syrups d. inhalers e. eye/nose drops f. sublingual g. topicals h. injections
MED PREP (CONTD)23
15. ASSIST PT IN TAKING MEDS16. STAY IN ROOM UNTIL PT. TAKES MEDS17. DISPOSE OF CUPS PROPERLY
PREPARING MEDICATIONS24
DECIDE WHICH PT. TO PREP MEDS FOR FIRST
PRIORITIZETHINK
WHO SHOULD MEDS BE PASSED FIRST ON?
REPORT25
0700 JEN ANISTON ADMITTED YESTERDAY FOR CHF. HISTORY OF DIABETES AND HYPERTENSION. T: 99.0, P: 62 IRREG, R: 24, BP: 140/88. BILAT RALES IN BASES, +1 PITTING EDEMA BLLE.
BRAD PITT ADMITTED 2 DAYS AGO WITH CELLULITIS OF LLE. HISTORY OF HYPERTENSION. T:98.9, P: 88 REG, R: 20, BP: 158/88.
26
ANISTON, JENNIFER GROUP ____DEMO____________ 400 B DOB: 6-6-66 MEDICATION ADMINISTRATION RECORD MR # 001 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of ___1__
ALLERGIES: CODEINE
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Tenormin 50 mg P.O. 1000
Daily
Prinivil 5 mg P.O. 1400
Daily
Lanoxin 0.125 mg P.O. 0800
Every other day
Lasix 20 mg P.O. 0800
BID 1600
Carafate I gm P.O. 0730 1130
AC & HS 1630 2100
INT
Diagnosis
CHF Date of Surgery
NURS
ES’S
SI
GNA
TURE
WHO TO PASS MEDS ON FIRST?
27
JEN ANISTON: Has 0730 med due. PREP J. ANISTON’S MEDS FIRST. CAN GO SPEAK WITH J. ANISTON FIRST if you do
not know the following information:ASK ABOUT ALLERGIES- TYPE OF REACTION.
CODEINE: CAUSES EMESIS. MAKE SURE HAVE STICKY NOTE ON UDW ABOUT ALLERGIES.
HOW TAKE HER MEDS?INFORM PT WILL PREP MEDS AND RETURN.RETURN TO CART TO PREP JEN’S MEDS.
JEN ANISTON MEDS28
1ST CHECK 1. READ PT. NAME, DOB, MED RECORD #,
ALLERGIES AND DATE ON MAR2. DRUG NEEDED IS: CARAFATE 1
GRAM( READ FROM MAR)3. FIND CARAFATE 1 GRAM (FROM DRAWER)4. DUE P.O., A.C., DUE THIS AM ON NOV. 28TH
AND HAS NOT BEEN GIVEN YET, NOT ALLERGIC TO.
5. IF CAN NOT FIND CARAFATE IN DRAWER, LOOK UP CARAFATE TO FIND GENERIC NAME
6. END OF 1ST CHECK.
JEN ANISTON MEDS29
2ND CHECK:SET UP A B C CUPS (Can be set up prior to starting)
1. NEED: CARAFATE 1 GM (READ FROM MAR) 2. HAVE: CARAFATE 1 GM (READ FROM PACKAGE) 3. DUE: PO, A.C., THIS AM FOR NOV 28TH, HAS NOT BEEN
GIVEN YET, NOT ALLERGIC TO (READ FROM MAR). CHECK EXPIRATION DATE ON MED
4. WHAT IS CARAFATE? FOR GASTRIC ULCERS. APPROPRIATE DOSE? YES
5. WHAT CUP TO GO IN? C 6. ANY CALCULATION, CUT, CRUSH? NO 7. ANY ASSESSMENT? NO 8. SIGN TIME TO MAR. 9. END OF 2ND CHECK.
30
ANISTON, JENNIFER GROUP ____DEMO____________ 400 B DOB: 6-6-66 MEDICATION ADMINISTRATION RECORD MR # 001 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of ___1__
ALLERGIES: CODEINE
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Tenormin 50 mg P.O. 1000
Daily
Prinivil 5 mg P.O. 1400
Daily
Lanoxin 0.125 mg P.O. 0800
Every other day
Lasix 20 mg P.O. 0800
BID 1600
Carafate I gm P.O. 0730 1130
0730
AC & HS 1630 2100
INT
Diagnosis
CHF Date of Surgery
NURS
ES’S
SI
GNA
TURE
JEN ANISTON MEDS31
3RD CHECK1. NEED CARAFATE 1 GM (FROM MAR)2. HAVE CARAFATE 1 GM (FROM PACKAGE)3. DUE PO, AC, THIS AM, ON NOV 28TH, NOT
BEEN GIVEN YET, NOT ALLERGIC TO. NOT EXPIRED
4. END OF 3RD CHECK
JEN ANISTON MEDS32
LOOK AT UDW. NEED 0730 MED, HAVE 0730 MED.
WILL PREP 0800 MEDS ALSO AT THIS TIME. 1. NEXT MED: 1ST CHECK:2. NEED: LANOXIN 0.125 MG (READ FROM MAR)3. HAVE: LANOXIN 0.125 MG TABLET (READ
PACKAGE)4. DUE: AM AT 0800, PO, NOT BEEN GIVEN
YET,FOR NOV 28TH, ALLERGY TO CODEINE. NOT EXPIRED
5. AN EVERY OTHER DAY MED. MAKE SURE NOT GIVEN YESTERDAY. LOOK AT OLD MAR.
6. END OF FIRST CHECK
J.A. MEDS33
2ND CHECK 1. NEED: LANOXIN 0.125 MG 2. HAVE: LANOXIN 0.125 MG 3. DUE: 0800 AM, PO, NOT BEEN GIVEN YET, NOT GIVEN
YESTERDAY OR TODAY, NOT ALLERGIC TO. NOT EXPIRED 4. WHAT IS LANOXIN? ANTIARRHYTHMIC, INCREASES
C.O., SLOWS HR 5. ANY ASSESSMENT? APICAL 1 MIN. HOLD <60. 6. ANY CALCULATION? CUT, CRUSH, POUR? 7. WHAT CUP? A (APICAL) 8. PUT IN A CUP 9. SIGN TIME OF 0800 ON MAR 10. END OF 2ND CHECK
34
ANISTON, JENNIFER GROUP ____DEMO____________ 400 B DOB: 6-6-66 MEDICATION ADMINISTRATION RECORD MR # 001 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of ___1__
ALLERGIES: CODEINE
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Tenormin 50 mg P.O. 1000
Daily
Prinivil 5 mg P.O. 1400
Daily
Lanoxin 0.125 mg P.O. 0800 0730
Every other day
Lasix 20 mg P.O. 0800
BID 1600
Carafate I gm P.O. 0730 1130
0730
AC & HS 1630 2100
INT
Diagnosis
CHF Date of Surgery
NURS
ES’S
SI
GNA
TURE
J.A. MEDS35
3RD CHECK1. NEED: LANOXIN 0.125 MG2. HAVE: LANOXIN 0.125 MG3. DUE: PO, 0800, NOV 28TH, NOT BEEN
GIVEN TODAY OR YESTERDAY, NOT ALLERGIC TO. NOT EXPIRED
4. IN A CUP5. END OF 3RD CHECK
J.A. MEDS36
NEXT MED DUE: 1ST CHECK1. NEED: LASIX 20 MG (READ FROM MAR)2. HAVE: LASIX 10 MG TAB ( READ FROM
MED PACKAGE)3. DUE: PO, 0800, NOT BEEN GIVEN YET,
ON NOV 28TH, NOT ALLERGIC TO. NOT EXPIRED
4. END OF 1ST CHECK
J.A. MEDS37
2ND CHECK 1. NEED: LASIX 20 MG 2. HAVE: LASIX 10 MG TAB 3. DUE: PO, 0800, NOT BEEN GIVEN YET ON NOV 28TH,
NOT ALLERGIC TO. NOT EXPIRED 4. WHAT IS LASIX? DIURETIC 5. ANY ASSESSMENT? BLOOD PRESSURE. HOLD <100/50 6. ANY CALCULATION? YES. DO MATH ON BACK OF UDW.
NEED 2 10 MG TABS. 7. OBTAIN ANOTHER 10 MG TAB AND DO 1ST AND 2ND
CHECK ON THAT TAB. CHECK EXPIRATION DATE ON NEW TAB
8. WHAT CUP? B CUP 9. TIME MAR FOR 0800 ON 28TH.
10. END OF 2ND CHECK
38
ANISTON, JENNIFER GROUP ____DEMO____________ 400 B DOB: 6-6-66 MEDICATION ADMINISTRATION RECORD MR # 001 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of ___1__
ALLERGIES: CODEINE
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Tenormin 50 mg P.O. 1000
Daily
Prinivil 5 mg P.O. 1400
Daily
Lanoxin 0.125 mg P.O. 0800 0730
Every other day
Lasix 20 mg P.O. 0800 0730
BID 1600
Carafate I gm P.O. 0730 1130
0730
AC & HS 1630 2100
INT
Diagnosis
CHF Date of Surgery
NURS
ES’S
SI
GNA
TURE
J.A. MEDS39
3RD CHECK1. NEED: LASIX 20 MG2. HAVE: LASIX 10 MG- 2 TABS (LOOK AT
BOTH TABS)3. DUE: PO, 0800, TODAY NOV 28TH, NOT
BEEN GIVEN YET, NOT ALLERGIC TO, NOT EXPIRED
4. ALREADY IN B CUP. BOTH TABS5. END OF 3RD CHECK.
PREPARING MEDS (CONTD)40
- Do all 3 checks on each med before preparing another med.
- Check meds with UDW to make sure equal meds are prepared.
J.A. MEDS41
CHECK MEDS HAVE WITH UDW. NEED 3 MEDS.HAVE: CARAFATE, LANOXIN, AND LASIX 2
TABS.CORRECT?READY TO GIVE MEDS!!!!!
42
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l l l l 1 l
401A
401B
403A
403B
B.P.l l l l l
404A
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS
PRN MEDS MEDS HELD
ADMINISTERING MEDS43
1. GATHER EQUIPMENT A. MARS B. MEDS IN CUPS C. CUP, WATER, (FOOD, SPOON) D. STETH, SPHYGMO2. WASH HANDS
ADMINISTERING MEDS44
3. ID PATIENT A. USE 2 MEANS TO IDENTIFY CLIENT:
NAME AND DOB B. PLACE MAR NEXT TO ID BRACELET
AND MATCH NAME, DOB, AND MEDICAL RECORD # C. ASK PT ALLERGIES AND REACTION D. ASK PT HOW FEELING
ADMINISTERING MEDS45
4. DO ASSESSMENT AS NEEDED A. APICAL: 84 B. BLOOD PRESSURE: 142/92 5. ASK YOURSELF IS IT OK TO GIVE MEDS? A. MAY GIVE ALL MEDS
ADMINISTERING MEDS46
6. 4TH CHECK A. NEED: LANOXIN 0.125MG HAVE: LANOXIN 0.125MG DUE: PO, 0800, TODAY, NOT GIVEN YET, APICAL 84, NOT EXPIRED, NOT ALLERGIC B. NEED: LASIX 20MG HAVE: LASIX 20 MG (IN 2 TABS) DUE: PO, 0800, TODAY, NOT GIVEN YET, BP 142/92, NOT EXPIRED, NOT ALLERGIC
ADMINISTERING MEDS47
C. NEED: CARAFATE 1 GM HAVE: CARAFATE 1 GM DUE: PO, 0730, TODAY, NOT GIVEN YET, NOT EXPIRED, NOT ALLERGICEND OF 4TH CHECKOPEN PACKAGES AND GIVE MEDS
ADMINISTERING MEDS48
7. GIVE PT MEDS. OK TO TAKE ALL AT SAME TIME IF ABLE. WAIT WITH PT TIL SWALLOWS PILLS. MAY HAVE TO CHECK IN MOUTH TO MAKE SURE ALL HAVE BEEN SWALLOWED.
8. FINAL 59. WASH HANDS
DOCUMENTATION49
1. SIGN OFF WITH INITIALS ON MAR IN CORRECT TIME AND DATE SLOT
2. USE 2 OR 3 INITIALS3. SIGN BOTTOM OF MAR. (OK IF DONE
EARLIER)4. CROSS OF MEDS GIVEN ON UDW.5. WRITE AP AND BP ON MAR AND UDW
NEXT TO TIME GIVEN.
50
ANISTON, JENNIFER GROUP ____DEMO____________ 400 B DOB: 6-6-66 MEDICATION ADMINISTRATION RECORD MR # 001 ROUTI NE & SINGLE DOSE MEDICATIONS
Page ___1____ of ___1__
ALLERGIES: CODEINE
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Tenormin 50 mg P.O. 1000
Daily
Prinivil 5 mg P.O. 1400
Daily
Lanoxin 0.125 mg P.O. 0800 0730 84 BJM
Every other day
Lasix 20 mg P.O. 0800 0730 142/92 BJM
BID 1600
Carafate I gm P.O. 0730 1130
0730 BJM
AC & HS 1630 2100
INT
BJM
Diagnosis
CHF Date of Surgery
NURS
ES’S
SI
GNA
TURE
B
.ME
YE
R,
RN
51
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.1 II
AP84 BP142/94
l l l
401A
401B
403A
403B
B.P.l l l l l
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS PRN MEDS MEDS HELD
NEXT PATIENT52
TO BRAD PITT’S MARCAN GO SPEAK WITH BRAD PITT ABOUT
MEDSASK HOW TAKES MEDSASK ABOUT ALLERGIES:NONEINQUIRE ABOUT PAIN. STATES HAVING
PAIN IN LLE. 6/10. FOR LAST ½ HOUR. NOTHING HELPING
INFORM WILL PREP MEDS AND BE BACK
53
PITT, BRAD GROUP ____DEMO____________ 403 B DOB: 6-19-68 MEDICATION ADMINISTRATION RECORD MR# 002 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of _1____
LOCATION CODES
ALLERGIES: NKA
ANT THIGH RT – CODE A LT – CODE B
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
Last Dose
MEDICATION
TIME Interval
Date at 0600 Date at 0600 Date at 0600
DOSE – FREQUENCY - ROUTE 0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Cardizem 60 mg P.O. 0800
BID 1600
Ibuprofen 800 mg P.O. 0600 1400
TID 2200
Zocor 10 mg P.O. 0800
Every other day
Aldomet 2 gms P.O. 0600 1200
Every 6 hrs 1800 2400
Ancef i gm IVPB 1000
Daily
Flagyl 250 mg P.O. 0600 1100
QID 1600 2200
INT
Diagnosis
CELLULITIS
NURS
ES’S
SI
GNA
TURE
Date of Surgery
54
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l II
AP84 BP142/94
l l l
401A
401B
403A
403B
B.P.l l l l l
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS PRN MEDS MEDS HELD
BRAD PITT MEDS55
1ST CHECK1. NEED BRAD PITT’S DRAWER2. HAVE BRAD PITT’S DRAWER, FOR
(READ OFF MAR) BRAD PITT, MR #002, ALLERGY NONE, FOR NOVEMBER 28TH.
3. NEED TO LOOK AT MAR WHILE READING INFORMATION.
4. ONLY HAVE TO ADDRESS NAME AND MEDICAL RECORD NUMBER WHEN OBTAIN MED DRAWER FOR FIRST TIME.
BRAD PITT MEDS56
1ST CHECK1. NEED: CARDIZEM 60 MG( READ FROM
MAR)2. HAVE: CARDIZEM 60 MG (FROM
DRAWER)3. DUE: P.O., 0800, DUE THIS AM ON NOV.
28TH AND HAS NOT BEEN GIVEN YET, NOT ALLERGIC TO.
4. IF CAN NOT FIND CARDIZEM IN DRAWER, LOOK UP OTHER NAME.
5. END OF 1ST CHECK.
BRAD PITT MEDS57
2ND CHECK:SET UP A B C CUPS 1. NEED: CARDIZEM 60 MG (READ FROM MAR) 2. HAVE: CARDIZEM 60 MG (READ FROM PACKAGE) 3. DUE: PO, 0800, THIS AM FOR NOV 28TH, HAS NOT BEEN
GIVEN YET, NOT ALLERGIC TO (READ FROM MAR). NOT EXPIRED
4. WHAT IS CARDIZEM? ANTIANGINAL, ANTIARRYTHMIC, ANTIHYPERTENSIVE. APPROPRIATE DOSE? YES
5. WHAT CUP TO GO IN? AB 6. ANY CALCULATION, CUT, CRUSH? NO 7. ANY ASSESSMENT? YES: AP & BP 8. SIGN TIME TO MAR 9. END OF 2ND CHECK.
58
PITT, BRAD GROUP ____DEMO____________ 403 B DOB: 6-19-68 MEDICATION ADMINISTRATION RECORD MR# 002 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of _1____
LOCATION CODES
ALLERGIES: NKA
ANT THIGH RT – CODE A LT – CODE B
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
Last Dose
MEDICATION
TIME Interval
Date at 0600 Date at 0600 Date at 0600
DOSE – FREQUENCY - ROUTE 0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Cardizem 60 mg P.O. 0800 0800
BID 1600
Ibuprofen 800 mg P.O. 0600 1400
TID 2200
Zocor 10 mg P.O. 0800
Every other day
Aldomet 2 gms P.O. 0600 1200
Every 6 hrs 1800 2400
Ancef i gm IVPB 1000
Daily
Flagyl 250 mg P.O. 0600 1100
QID 1600 2200
INT
Diagnosis
CELLULITIS
NURS
ES’S
SI
GNA
TURE
Date of Surgery
BRAD PITT MEDS59
3RD CHECK1. NEED CARDIZEM 60 MG (FROM MAR)2. HAVE CARDIZEM 60 MG (FROM
PACKAGE)3. DUE PO, 0800, TODAY ON NOV 29TH,
NOT BEEN GIVEN YET, NOT ALLERGIC TO. NOT EXPIRED
4. IN AB CUP5. END OF 3RD CHECK
B.PITT MEDS60
NEXT MED DUE: 1ST CHECK1. NEED: ZOCOR 10 MG (READ FROM MAR)2. HAVE: ZOCOR 10 MG TAB ( READ FROM
MED PACKAGE)3. DUE: PO, 0800, NOT BEEN GIVEN YET
TODAY OR YESTERDAY, ON NOV 28TH, NOT ALLERGIC TO. NOT EXPIRED
4. END OF 1ST CHECK
B. PITT MEDS61
2ND CHECK 1. NEED: ZOCOR 10 MG 2. HAVE: ZOCOR 10 MG TAB 3. DUE: PO, 0800, NOT BEEN GIVEN YET TODAY OR
YESTERDAY,ON NOV 28TH, NOT ALLERGIC TO. NOT EXPIRED
4. WHAT IS ZOCOR? LIPID LOWERING AGENT 5. ANY ASSESSMENT? NO 6. ANY CALCULATION? NO 7. APPROPRIATE DOSE? YES 8. WHAT CUP? C CUP 9. TIME MAR FOR 0800 ON 29TH.
10. END OF 2ND CHECK
62
PITT, BRAD GROUP ____DEMO____________ 403 B DOB: 6-19-68 MEDICATION ADMINISTRATION RECORD MR# 002 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of _1____
LOCATION CODES
ALLERGIES: NKA
ANT THIGH RT – CODE A LT – CODE B
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
Last Dose
MEDICATION
TIME Interval
Date at 0600 10-29-10
Date at 0600 Date at 0600
DOSE – FREQUENCY - ROUTE 0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Cardizem 60 mg P.O. 0800 0800
BID 1600
Ibuprofen 800 mg P.O. 0600 1400
TID 2200
Zocor 10 mg P.O. 0800 0800
Every other day
Aldomet 2 gms P.O. 0600 1200
Every 6 hrs 1800 2400
Ancef i gm IVPB 1000
Daily
Flagyl 250 mg P.O. 0600 1100
QID 1600 2200
INT
Diagnosis
CELLULITIS
NURS
ES’S
SI
GNA
TURE
Date of Surgery
B. PITT MEDS63
3RD CHECK1. NEED: ZOCOR 10 MG2. HAVE: ZOCOR 10 MG3. DUE: PO, 0800, NOV 28TH, NOT BEEN
GIVEN TODAY OR YESTERDAY, NOT ALLERGIC TO. NOT EXPIRED
4. IN C CUP5. END OF 3RD CHECK
B. PITT MEDS64
NEEDED SOMETHING FOR PAIN: PRN MEDLOOK AT PRN MARWHAT ORDERED FOR PAIN?IF UNSURE OF WHAT MEDS ARE ON MAR,
LOOK UP.IF NOT ORDERED ANYTHING, CALL DRIF ORDER FOR PAIN MED, PREPARE MED
B. PITT PRN MED65
ORDERED VICODIN ES 1 TAB Q 4 HRS AS NEEDED FOR PAIN.
VERY IMPORTANT THAT HAS NOT BEEN MEDICATED IN LAST 4 HOURS.
VICODIN ES IS A NARCOTIC. WILL NOT BE IN PT DRAWER. WILL HAVE TO GET FROM SEPARATE LOCKED DRAWER.
NARCS ARE COUNTED AT END OF EACH SHIFT. EACH FACILITY IS DIFFERENT WHERE ARE KEPT.
MUST STILL DO 3 CHECKS ON MEDS
B. PITT PRN MED66
1ST CHECKNEED: VICODIN ES 1 TABHAVE: VICODIN ES 1 TAB DUE: PO, EVERY 4 HOURS PRN, HAS NOT
HAD IN LAST 4 HOURS, NOT ALLERGIC, NOT EXPIRED
END OF 1ST CHECK
B. PITT PRN MED67
2ND CHECK NEED: VICODIN ES 1 TAB HAVE: VICODIN ES 1 TAB DUE: PO, EVERY 4 HOURS PRN PAIN, HAS NOT HAD IN
LAST 4 HOURS, NOT ALLERGIC, NOT EXPIRED WHAT IS VICODIN? NARCOTIC PAIN MED ANY CALCULATION? NO, ORDER FOR 1 TAB, HAVE 1 TAB APPROPRIATE DOSE? YES ANY ASSESSMENT? RESPIRATORY RATE WHAT CUP? C TIME MAR FOR 0830 END OF 2ND CHECK
68
PITT, BRAD GROUP ______DEMO__________ 403 B 6-19-68 MEDICATION ADMINISTRATION RECORD MR # 002 PRN MEDICATIONS
Page ___1____ of __1___
ALLERGIES: NKA
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 10-29-10
Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Colace 100 mg P.O. daily
Daily prn prn
Vicodin Es 1 P.O. 0830
Every 4 hrs prn pain
INT
Diagnosis
Cellutitis Date of Surgery
NURS
ES’S
SI
GNA
TURE
B. PITT PRN MED69
3RD CHECKNEED: VICODIN EX 1 TABHAVE: VICODIN ES 1 TABSDUE: PO, EVERY 4 HRS PRN, HAS NOT HAD
IN LAST 4 HRS, NOT ALLERGIC, NOT EXPIRED
IN C CUPEND OF 3RD CHECK
B. PITT MEDS70
CHECK MEDS HAVE WITH UDW. NEED 2 MEDS.HAVE: CARDIZEM AND ZOCORCORRECT?ALSO HAVE PRN MED- VICODIN 1 TAB. READY TO GIVE MEDS!!!!!
71
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l II
AP84 BP142/94
l l l
401A
401B
403A
403B
B.P.l l l l l
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS PRN MEDS MEDS HELD
ADMINISTERING MEDS72
1. GATHER EQUIPMENT A. MARS B. MEDS IN CUPS C. CUP, WATER, (FOOD, SPOON) D. STETH, SPHYGMO2. WASH HANDS
ADMINISTERING MEDS73
3. ID PATIENT A. USE 2 MEANS TO IDENTIFY CLIENT B. PLACE MAR NEXT TO ID BRACELET
AND MATCH. C. ASK PT ALLERGIES AND REACTION D. ASK PT HOW FEELING
ADMINISTERING MEDS74
4. DO ASSESSMENT AS NEEDED A. RESP RATE: 24 B. APICAL: 68 C. BLOOD PRESSURE: 90/605. IS IT OK TO GIVE MEDS? A. MAY GIVE VICODIN ES AND ZOCOR
MEDS B. MUST HOLD CARDIZEM
ADMINISTERING MEDS75
6. 4TH CHECK A. NEED: CARDIZEM 60 MG HAVE: CARDIZEM 60 MG DUE: PO, 0800, TODAY, NOT GIVEN YET, APICAL 68, BLOOD PRESSURE 90/60, NOT EXPIRED, NOT ALLERGIC MUST HOLD DUE TO BP. MED IN AB CUP
HELD B. NEED: ZOCOR 10 MG HAVE: ZOCOR 10 MG DUE: PO, 0800, TODAY, NOT GIVEN YET, NOT EXPIRED, NOT ALLERGIC
ADMINISTERING MEDS76
C. NEED: VICODIN ES 1 TAB HAVE: VICODIN ES 1 TAB DUE: PO, EVERY 4 HRS PRN PAIN, NOT GIVEN IN LAST 4 HOURS, NOT EXPIRED, NOT ALLERGIC TO END OF 4TH CHECKOPEN MEDS AND GIVE
ADMINISTERING MEDS77
7. GIVE PT MEDS. OK TO TAKE ALL AT SAME TIME IF ABLE. WAIT WITH PT TIL SWALLOWS PILLS. MAY HAVE TO CHECK IN MOUTH TO MAKE SURE ALL HAVE BEEN SWALLOWED.
8. FINAL 59. WASH HANDS
DOCUMENTATION78
1. SIGN OFF MEDS GIVEN WITH INITIALS ON MAR2. CIRCLE TIME ON MAR OF MED NOT GIVEN3. USE 2 OR 3 INITIALS4. SIGN BOTTOM OF MAR. (OK IF DONE EARLIER)5. CROSS OFF MEDS GIVEN ON UDW.6. CIRCLE TALLY MARK ON UDW OF MED NOT
GIVEN7. WRITE AP AND BP ON MAR AND UDW NEXT TO
TIME GIVEN. 8. FILL OUT PRN EFFECTIVENESS SHEET9. WRITE PRN MED GIVEN ON UDW10. WRITE MED HELD ON UDW
PITT, BRAD GROUP ____DEMO____________ 403 B DOB: 6-19-68 MEDICATION ADMINISTRATION RECORD MR# 002 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of _1____
ALLERGIES: NKA
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 10-29-10
Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Cardizem 60 mg P.O. 0800 0800 90/60 68
BID 1600
Ibuprofen 800 mg P.O. 0600 1400
TID 2200
Zocor 10 mg P.O. 0800 0800 bjm
Every other day
Aldomet 2 gms P.O. 0600 1200
Every 6 hrs 1800 2400
Ancef i gm IVPB 1000
Daily
Flagyl 250 mg P.O. 0600 1100
QID 1600 2200
INT
bjm
Diagnosis
CELLULITIS Date of Surgery
NURS
ES’S
SI
GNA
TURE
B
.Me
yer,
RN
PITT, BRAD GROUP ______DEMO__________ 403 B 6-19-68 MEDICATION ADMINISTRATION RECORD MR # 002 PRN MEDICATIONS
Page ___1____ of __1___
ALLERGIES: NKA
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 10-29-10
Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Colace 100 mg P.O. daily
Daily prn prn
Vicodin ES 1 P.O. 0830 BJM
Every 4 hrs prn pain
INT
bjm
Diagnosis
Cellutitis Date of Surgery
NURS
ES’S
SI
GNA
TURE
B
.Me
yer,
Rn
DOCUMENTATION81
PRN EFFECTIVENESS SHEET1. DATE2. TIME3. PRE-MED CODE: 64. INITIALS5. LOCATION OF DISCOMFORT: LLE6. MED: Vicodin ES 1 tab7. TIME REASSESSED: MUST REASSESS IN 45-60
MIN.8. POST MED CODE: WHATEVER PAIN LEVEL IS9. INITIALS
82
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l II
AP84 BP142/94
l l l
401A
401B
403A
403B
B.P.ll AP
68BP90/68
l l l
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS PRN MEDS 403B BP 0830 ViicodinPain MEDS HELD
403 B B.P-CARDIZEM 60 MG 0800 BP:90/68
WHERE TO NEXT?83
LOOK AT UDW. WHO TO PASS MEDS ON NOW?
- NO MEDS DUE AT 0900DO REASSESSMENT OF PAIN ON B.PITT BY
0930 AND DOCUMENT1 MED DUE AT 1000 FOR JEN ANISTON.PREP 1000 JEN ANISTON MED-3 CHECKS OF MED-TO ROOM-4TH CHECK-DOCUMENTATION
ANISTON, JENNIFER GROUP ____DEMO____________ 400 B DOB: 6-6-66 MEDICATION ADMINISTRATION RECORD MR # 001 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of ___1__
ALLERGIES: CODEINE
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Tenormin 50 mg P.O. 1000 1000 130/84 bjm
Daily
Prinivil 5 mg P.O. 1400
Daily
Lanoxin 0.125 mg P.O. 0800 0730 84 BJM
Every other day
Lasix 20 mg P.O. 0800 0730 142/92 BJM
BID 1600
Carafate I gm P.O. 0730 1130
0730 BJM
AC & HS 1630 2100
INT
BJM
Diagnosis
CHF Date of Surgery
NURS
ES’S
SI
GNA
TURE
B
.ME
YE
R,
RN
85
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l II
AP84 BP142/94
l BP
130/84
l l
401A
401B
403A
403B
B.P.ll AP
68BP90/68
l l l
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS PRN MEDS 403B BP 0830 Vicodin Pain MEDS HELD
403 B B.P-CARDIZEM 60 MG 0800 BP:90/68
WHAT ABOUT BRAD PITT?86
1000 IVPB MED DUE. REMIND RN TO DO. REASSESS BP AND APICAL. IF ABOVE
PARAMETER, GIVE MED. IF STILL BELOW PARAMETER, HOLD.
REASSESS BP: 110/74 AP:70-OK TO GIVE MED.
PREP HELD MED87
BRAD PITT-CARDIZEMDO 1ST CHECKDO 2ND CHECK. WHAT CUP? AB AT END OF SECOND CHECK, WRITE NEW TIME
ADMINISTERING MED: 1000DO 3RD CHECK.TO BEDSIDE.ID PTDO 4TH CHECKGIVE MEDDOCUMENTATION: MAR AND UDW
PITT, BRAD GROUP ____DEMO____________ 403 B DOB: 6-19-68 MEDICATION ADMINISTRATION RECORD MR# 002 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of _1____
ALLERGIES: NKA
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 10-29-10
Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Cardizem 60 mg P.O. 0800 0800 90/60 68 1000 110/74 70bjm
BID 1600
Ibuprofen 800 mg P.O. 0600 1400
TID 2200
Zocor 10 mg P.O. 0800 0800 bjm
Every other day
Aldomet 2 gms P.O. 0600 1200
Every 6 hrs 1800 2400
Ancef i gm IVPB 1000
Daily
Flagyl 250 mg P.O. 0600 1100
QID 1600 2200
INT
bjm
Diagnosis
CELLULITIS Date of Surgery
NURS
ES’S
SI
GNA
TURE
B
.Me
yer,
RN
89
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l II
AP84 BP142/94
l bp 130/84
l l
401A
401B
403A
403B
B.P.l l AP
68BP90/68
AP 70 BP 110/74
l l l
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS
PRN MEDS 403B BP 0830 Vicodin Pain MEDS HELD
403 B B.P-CARDIZEM 60 MG 0800 BP:90/68
WHAT NOW?90
1100: FOR BRAD PITT? CAN GIVE AT 1100 OR WAIT TIL 1130 AND GIVE 1100 AND 1200 MEDS TOGETHER.
WILL GIVE TOGETHER AT 1130
FOR JEN ANISTON91
1130 MEDS: -NEED CARAFATE-DO 1ST CHECK-DO 2ND CHECK: IN C CUP. TIME 1130 ON MAR.-DO 3RD CHECK-TO BEDSIDE-ID PT4TH CHECK. OPEN MEDS-GIVE PO. -DOCUMENTATION
ANISTON, JENNIFER GROUP ____DEMO____________ 400 B DOB: 6-6-66 MEDICATION ADMINISTRATION RECORD MR # 001 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of ___1__
ALLERGIES: CODEINE
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Tenormin 50 mg P.O. 1000 1000 130/84 bjm
Daily
Prinivil 5 mg P.O. 1400
Daily
Lanoxin 0.125 mg P.O. 0800 0730 84 BJM
Every other day
Lasix 20 mg P.O. 0800 0730 142/92 BJM
BID 1600
Carafate I gm P.O. 0730 1130
0730 BJM 1130 bjm
AC & HS 1630 2100
INT
BJM
Diagnosis
CHF Date of Surgery
NURS
ES’S
SI
GNA
TURE
B
.ME
YE
R,
RN
93
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l II
AP84 BP142/94
l bp 130/84
l l
401A
401B
403A
403B
B.P.l l AP
68BP90/68
AP 70 BP 110/74
l l l
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS PRN MEDS 403B BP 0830 VicodinPain MEDS HELD
403 B B.P-CARDIZEM 60 MG 0800 BP:90/68
NOW TO BRAD PITT94
1130 NOW-HAS FLAGYL AND ALDOMET DUE-PREP EACH MED WITH 3 CHECKS-READY TO GIVE-TO BEDSIDE-ID PT-DO ASSESSMENT: BP 124/744TH CHECK. OPEN MEDS-OK TO GIVE MEDS-DOCUMENTATION
PITT, BRAD GROUP ____DEMO____________ 403 B DOB: 6-19-68 MEDICATION ADMINISTRATION RECORD MR# 002 ROUTINE & SINGLE DOSE MEDICATIONS
Page ___1____ of _1____
ALLERGIES: NKA
GLUTEAL REGION
RT – CODE C LT – CODE D
DELTOID RT – CODE E LT – CODE F
VENTRAL GLUTEAL RT – CODE G LT – CODE H
LOCATION CODES
ANT THIGH RT – CODE A LT – CODE B
MEDICATION
TIME Interval
Date at 0600 10-29-10
Date at 0600 Date at 0600 Last Dose DOSE – FREQUENCY - ROUTE 0600-
1400 1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
0600-1400
1400-2200
2200-0600
Cardizem 60 mg P.O. 0800 0800 90/60 68 1000 110/74 70bjm
BID 1600
Ibuprofen 800 mg P.O. 0600 1400
TID 2200
Zocor 10 mg P.O. 0800 0800 bjm
Every other day
Aldomet 2 gms P.O. 0600 1200
1130 Bjm 124/74
Every 6 hrs 1800 2400
Ancef i gm IVPB 1000
Daily
Flagyl 250 mg P.O. 0600 1100
1130 bjm
QID 1600 2200
INT
bjm
Diagnosis
CELLULITIS Date of Surgery
NURS
ES’S
SI
GNA
TURE
B
.Me
yer,
RN
96
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l II
AP84 BP142/94
l bp 130/84
l l
401A
401B
403A
403B
B.P.l l AP
68BP90/68
AP 70 BP 110/74
l l bp
124/74
l
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS PRN MEDS 403B BP 0830 Vicodin Pain MEDS HELD
403 B B.P-CARDIZEM 60 MG 0800 BP:90/68
WHAT NOW?97
WHO TO PASS ON NEXT? AT 1330BRAD PITT HAS 1, DUE TIDJEN ANISTON HAS 1, DUE QD
WILL PASS TO BRAD PITT
LAST PASS FOR BRAD PITT98
DUE IBUPROFEN 800 MG AT 1400DO 1ST CHECKDO 2ND CHECK: C CUP, TIME MAR FOR
1400DO 3RD CHECKTO BEDSIDEID PTANY ASSESSMENT?4TH CHECK. OPEN MEDGIVE MED.DOCUMENTATION
99
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l II
AP84 BP142/94
l bp 130/84
l l
401A
401B
403A
403B
B.P.l l AP
68BP90/68
AP 70 BP 110/74
l l bp
124/74
l
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS PRN MEDS 403B BP 0830 Vicodin Pain MEDS HELD
403 B B.P-CARDIZEM 60 MG 0800 BP:90/68
LAST PASS FOR JEN ANISTON100
DOCTOR JUST ORDERED HER TO BE NPO FOR A CAT SCAN. UNABLE TO ADMINISTER ANY PO MEDS AT THIS TIME TIL FURTHER NOTICE.
MUST NOTIFY PT. SINCE IS A BP MED, SHOULD DO BP WHILE IN PT ROOM.
MUST DOCUMENT ON MAR AND UDW OF HELD MED
MAKE STICKY NOTES AND PLACE ON UDW AND MAR
101
HOURS
ROOMS 07 08 09 10 11 12 13 14400A
400B
J.A.l II
AP84 BP142/94
l bp 130/84
l l
401A
401B
403A
403B
B.P.l l AP
68BP90/68
AP 70 BP 110/74
l l bp
124/74
l
IV’S/NURSE NOTES
Ancef 1 gm ivpb 1000
UNIT DOSE WORKSHEET
FSBS PRN MEDS 403B BP 0830 Vicodin Pain MEDS HELD
403B B.P-CARDIZEM 60 MG 0800 BP:90/68
400B JA- PRINIVIL NPO 1400
END OF SHIFT102
RECHECK UDW- ALL MEDS GIVEN OR NOTRECHECK MAR- ALL MEDS GIVEN OR NOT
AND SIGNED OFFRESTOCK CARTREPORT ANY INFORMATION TO NEXT
SHIFT. ESPECIALLY PRN’S, MEDS HELD, ANY VITAL SIGNS, FSBS
POURING LIQUID MEDS103
DO PROPER CHECKSPOUR DURING 2ND CHECKPALM LABELREAD AT EYE LEVEL ON FLAT SURFACE.DO NOT POUR OVER MARDO NOT POUR EXTRA BACK INTO BOTTLEIF PREPPING MEDS FROM A MED BOTTLE,
DISPENSE MED INTO LID OF MED BOTTLE, THEN PUT INTO MEDICINE CUP. DO NOT DUMP INTO HAND OR REACH INTO BOTTLE TO GET OUT MED
NEW PATIENTS104
CAN DO STEVEN TYLER AND ERIN SMITH MARS NOW
MAKE UDW FROM THEIR MARSHAVE PAPER PILLS FOR THEM
END OF THE DAY105
EACH INSTRUCTOR TAKE 8-10 STUDENTS AND DO MED PASS ON TYLER AND SMITH.
HAVE SIT IN CIRCLE AND GO AROUND AND HAVE EACH STUDENT DO A PIECE OF THE PASS.