1. Interpreting Drug Orders
Chapter 7
Interpreting Drug Orders
Review: 4 t = ? mL …can be measured in what?
insulin can be measured in a TB or 1 mL syring T or F
are medications calibrated from the top or bottom of the syringe?
medications are measured by what part of the plunger tip? (Top ring)
how can 1.27 be measured in a 3 mL syringe?
The 3 mL syringe is calibrated in _____________of an mL? The 1 mL syringe calibrated in _________of an mL?
You need to give a pediatric pt a volume dose of 0.765…what syringe? What is final volume?

2. 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
The prescription or medication order conveys the therapeutic drug plan for the patient
ASK…what do you think are the nurses responsibility for medications???

3. 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
There are many responsibilities a nurse has when administration of a drug is involved

4. Nursing Responsibilities
Educate patient regarding medication
Record administration of prescribed drug
Monitor patient’s response for desired and adverse effects
Before you can prepare the correct dosage of the prescribed drug, you must learn to interpret or read the written drug order.
For speed purposes healthcare profesessions have adopted certain standards and common abbreviations for use in notation

5. Medical Abbreviations
Used frequently with drug orders
Must commit to memory
Page 144, fourth Edition of classroom book
Student activity? Show a typical drug order: Zithromax 250 mg po daily; gentamycin 80 mg iv q 8 h; singulair 10 mg po q noct; insulin Humulin-R regular 10 units subcut ac and hs; cxr ap/lat stat
OR USE NEXT SLIDE AS EXAMPLES

6. 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

7. Seven Parts of a Drug Order
Patient name
Name of drug
Dosage
Route of administration
Frequency, time, and special instructions
Date and time of order
Signature and licensure of person writing order
Parts 1-5 of the drug order are known as the original Five Rights of safe medication administration.
ESSENTIAL!!
The first five of these must be checked faithfully every time a
medication is prepared and administered.

8. 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
Show example from pink index card

9. Six Rights of Medication Administration
Right patient
Right drug
Right dose
Right route
Right time
Right documentation
After checking the 5 rights of medication administration, it is the responsibility of the nurse to DOCUMENT that s/he administered the medication.
This makes it 6 Rights of Med. Admin and is a patient right.

10. Six Rights of Medication Administration
Right patient must receive right drug in right amount by right route at right time, followed by right documentation

11. Drug Orders Sequence: Name of drug Dosage Route Frequency
Each drug should follow a specific sequence…
The name of the drug is written first, followed by the dose, route, time
WRITE EXAMPLE ON BOARD BEFORE NEXT SLIDE: metronidazole 300 mg p.o. t.i.d.

12. 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
This order means: Give 300 mg of flagyl three times a day
Brand name of drug is CAPITALIZED….Trade name is lower case

13. 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 q4h p.r.n., severe pain
This order means: Give 3 milligrams of hydromorphone intramuscularly every 4 hours when necessary for moderate to severe pain.
Ask what prn is

14. 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

15. LET’S PRACTICE
have class do Review Set 18 pg go over the rest with class

16. Medication Administration Record (MAR)
May be paper form or electronic
Used to record drug orders
Health care professional must verify and initial each order

17. MAR Used by nurse as guide to: Check drug order Prepare correct dosage
Record drug administration
Ask: HOW DO YOU THINK NURSES CAN PREVENT MEDICATION ERRORS?

18. Preventing Medication Errors
Nurse can prevent medication errors by:
Clarifying incomplete orders
Correctly scheduling doses
Current example: February 2019

19. Preventing Medication Errors
Verify MD medication order
Read entire MAR at beginning of shift
Verify times scheduled with ordered frequency
Review all medications to indentify any potential drug interactions or patient allergy

20. 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.

21. Critical Thinking
What is the role of a nurse in medication administration?

22. Critical Thinking
What are the legal implications related to medication administration?

23. Critical Thinking
What are some potential outcomes of unsafe medication administration?
Have class do Review Set 19 pt 151 and we will review as a class

24. Patients are entitled to these: