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Interpreting Drug
Orders
Chapter 7
MAT 119
Objectives
• Read and write correct medical notation.
• Write the standard medical abbreviation from a
list of common terminology.
• Classify the notation that specifies the dosage,
route, and frequency of the medication to be
administered.
• Interpret physician and other prescribing
practitioner orders.
Nursing Responsibilities
•
•
•
•
Interpret order
Prepare exact dosage of prescribed drug
Identify the patient
Administer dosage by prescribed route at
prescribed time intervals
• Record the administration of the prescribed
drug
• Monitor the patient’s response for
desired and possible adverse effects
Route
Interpretation
IM
Intramuscular
IV
Intravenous
IVPB
Subcut / (SQ)
Intravenous piggyback
Subcutaneous
SL
Sublingual, under the tongue
ID
Intradermal
GT
Gastrostomy tube
NG
NJ
po
pr
Nasogastric (tube)
Nasojejunal (tube)
By mouth, orally
Per rectum, rectally
Frequency
Interpretation
ac
Before meals
pc
After meals
prn
When necessary, as needed
Stat
Immediately
bid
Twice a day
tid
Three times a day
qid
Four times a day
min
Minute
h
qh, q2h, etc.
Hour
Every hour, every two hours
General
Interpretation
ā
before
p
after
c
with
s
without
q
every
NPO
nothing by mouth
gtt
drop
tab
tablet
cap
capsule
hs
hour of sleep, bedtime
Seven Parts of a Drug Order
1. Date and time of order
2. Patient name
3. Drug name
4. Dosage
5. Route of administration
6. Frequency / time and any special instructions
7. Signature and licensure of person writing the
order
Examining Drug Orders
• Drug order must be written clearly
– If any part(s) is missing, it is incomplete
– If ever in doubt, you MUST ask the prescribing
practitioner to clarify
Six Rights of Medication
Administration
1. Right patient
2. Right drug
3. Right dosage/amount
4. Right route
5. Right time/frequency
6. Right documentation
What’s Missing??
• Heparin 5,000 units IV
– frequency
• Lasix bid
– Dosage and route
• Depakene 250 mg po
– frequency
• Demerol 50 mg IV, prn for pain
- frequency
What’s Missing??
• Amoxocillin 250 mg po
– frequency
• Xanax 0.1 mg bid
– route
• Gentamicin sulfate po q 12 h
– dosage
Preventing Medication Errors
• Clarify incomplete orders
• Identify scheduling of doses
• Read entire medication administration record
(MAR) at beginning of each shift
– Verify times scheduled with ordered frequency
– Review all medications to identify any potential
drug interactions or inconsistencies
Critical Thinking
• What are the legal implications related to
medication administration?
• What are some potential outcomes of unsafe
medication administration?
Example of a Written Drug Order
• Patient: Ben Jackson MRN 0651325
• 01/23/12 0730 - Amoxil 500 mg po qid pc & hs
J. Physician, M.D.
• Interpretation:
• Give Amoxil 500 milligrams by mouth four
times a day after meals and at bedtime.
How to interpret…
• Ancef 1 g IVPB q 6 h
– Give Ancef 1 gram by intravenous piggyback every
6 hours
• Humulin R Regular U-100 insulin 5 units
subcut stat
– Give Humulin R Regular U-100 insulin 5 units
subcutaneous immediately
How to interpret…
• Potassium chloride 10 mEq po bid pc
– Give Potassium chloride 10 milliequivalents orally
two times a day after meals
• Keflex 500 mg po qid
– Give Keflex 500 milligrams by mouth four times a day
• Atarax 100 mg po hs prn
– Give Atarax 100 milligrams orally at bedtime,
as necessary
How to interpret…
• Decadron 0.5 mg po q 12 h
– Give Decadron 0.5 milligrams orally every 12
hours
• Tegretol 0.2 g po tid
– Give Tegretol 0.2 grams orally three times a day
Drug Orders
To convert to abbreviations:
• Give Cortisporin otic suspension two drops each ear three
times a day and bedtime:
– Cortisporin otic suspension 2 gtt each ear tid & hs
• Give Digoxin 0.25 milligrams by mouth daily
– Digoxin 0.25 mg po daily
• Give Humulin R Regular U-100 insulin 10 units subcutaneously
30 minutes before meals
– Humulin R Regular U-100 insulin 10 units subcut
30 min ac
Practice
• Prescriber’s order: Digoxin 0.25 mg po daily
• The frequency of administration in this order
is: ____________________
daily
• What is the route? _______________
orally
Practice
• Prescriber’s order: Heparin 8000 units subcut
bid
• The route of administration in this order is:
_________________
subcutaneous
• What is the frequency of administration?
_______________
Two times a day