Chapter 7 Interpreting Drug Orders Copyright 2016 Cengage

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Chapter 7 Interpreting Drug Orders Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Chapter 7 Interpreting Drug Orders Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Objectives • Read and write correct medical notation • Write the standard medical abbreviation

Objectives • Read and write correct medical notation • Write the standard medical abbreviation from a list of common terminology • Interpret medicine orders of MD’s /prescribers • Interpret medication administration records Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

These are the responsibility of the nurse: • • • Interpret order Gather information

These are the responsibility of the nurse: • • • Interpret order Gather information about drug Prepare exact dosage of prescribed drug Identify patient Administer dosage by prescribed route at prescribed time intervals Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Nursing Responsibilities • Educate patient regarding medication • Record administration of prescribed drug •

Nursing Responsibilities • Educate patient regarding medication • Record administration of prescribed drug • Monitor patient’s response for desired and adverse effects Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Medical Abbreviations • Used frequently with drug orders • Must commit to memory •

Medical Abbreviations • Used frequently with drug orders • Must commit to memory • Page 144, fourth Edition of classroom book Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Example of a medication order • Rocephin 750 g IV q 12 hours •

Example of a medication order • Rocephin 750 g IV q 12 hours • Acetaminophen 500 mg p. o. q 4 h prn mild pain • EES 250 mg p. o. a. c. and h. s. • Nitro-Bid 0. 3 mg SL prn, may repeat q 5 min for 2 additional doses for acute attack Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Seven Parts of a Drug Order 1. 2. 3. 4. Patient name 5. Frequency,

Seven Parts of a Drug Order 1. 2. 3. 4. Patient name 5. Frequency, time, and special instructions Name of drug 6. Date and time of order Dosage Route of administration 7. Signature and licensure of person writing order The first five of these must be checked faithfully every time a medication is prepared and administered. Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Caution • If any of the seven parts of the order is missing or

Caution • If any of the seven parts of the order is missing or unclear, the order is incomplete – Therefore, it is not a legal drug order – if ever in doubt, ask writer to clarify – If it is a phone order, must write down, read back Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Six Rights of Medication Administration 1. 2. 3. 4. 5. 6. Right patient Right

Six Rights of Medication Administration 1. 2. 3. 4. 5. 6. Right patient Right drug Right dose Right route Right time Right documentation Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Six Rights of Medication Administration • Right patient must receive right drug in right

Six Rights of Medication Administration • Right patient must receive right drug in right amount by right route at right time, followed by right documentation Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Drug Orders • Sequence: – – Name of drug Dosage Route Frequency Copyright ©

Drug Orders • Sequence: – – Name of drug Dosage Route Frequency Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Drug Orders • Example: metronidazole 300 mg p. o. t. i. d. – –

Drug Orders • Example: metronidazole 300 mg p. o. t. i. d. – – Name of drug = brand name: Flagyl Dosage = 300 mg Route = oral Frequency = three times daily Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Drug Orders • The p. r. n. frequency designates the minimum time allowed between

Drug Orders • The p. r. n. frequency designates the minimum time allowed between doses. There is no maximum time other than automatic stops as defined by hospital or agency policy. Example: hydromorphone 3 mg IM q 4 h p. r. n. , severe pain This order means: Give 3 milligrams of hydromorphone intramuscularly every 4 hours when necessary for moderate to severe pain. Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

What’s Wrong? • • Heparin 5, 000 units IV Lasix b. i. d. Depakene

What’s Wrong? • • Heparin 5, 000 units IV Lasix b. i. d. Depakene 250 mg by mouth Demerol 50 mg IV as needed for pain Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

LET’S PRACTICE Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

LET’S PRACTICE Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Medication Administration Record (MAR) • May be paper form or electronic • Used to

Medication Administration Record (MAR) • May be paper form or electronic • Used to record drug orders • Health care professional must verify and initial each order Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

MAR • Used by nurse as guide to: – Check drug order – Prepare

MAR • Used by nurse as guide to: – Check drug order – Prepare correct dosage – Record drug administration Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Preventing Medication Errors • Nurse can prevent medication errors by: – Clarifying incomplete orders

Preventing Medication Errors • Nurse can prevent medication errors by: – Clarifying incomplete orders – Correctly scheduling doses – Current example: February 2019 Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Preventing Medication Errors v Verify MD medication order v Read entire MAR at beginning

Preventing Medication Errors v Verify MD medication order v Read entire MAR at beginning of shift v Verify times scheduled with ordered frequency v Review all medications to indentify any potential drug interactions or patient allergy Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Quick Review • Drug orders are prescribed on the physician’s order form. • The

Quick Review • Drug orders are prescribed on the physician’s order form. • The person who administers a drug records it on the MAR, either handwritten or computerized. • All parts of the drug order must be stated clearly for accurate, exact interpretation. If you are ever in doubt as to the meaning of any part of a drug order, ask the writer to clarify. Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Critical Thinking • What is the role of a nurse in medication administration? Copyright

Critical Thinking • What is the role of a nurse in medication administration? Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Critical Thinking • What are the legal implications related to medication administration? Copyright ©

Critical Thinking • What are the legal implications related to medication administration? Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Critical Thinking • What are some potential outcomes of unsafe medication administration? Copyright ©

Critical Thinking • What are some potential outcomes of unsafe medication administration? Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Patients are entitled to these: Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

Patients are entitled to these: Copyright © 2016 Cengage Learning. ALL RIGHTS RESERVED.

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