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Chap - 5


symbols used for medication orders abbreviations
abbreviations are __ for accurate interpretation of a physician's order essential
physician's orders may vary in the used of capital vs. lowercase lettering
When in doubt, always __ the meaning. Never __! question; guess
abbreviations should be written without periods
before a
before meals ac
as desired ad lib
AM, am morning
amp ampule
twice a day bid
with ċ
capsule cap
chloride Cl
centimeter cm
discontinue DC
double strength DS
distilled water DW
enteric coated EC
elixir elix
extended release ER
iron Fe
fluid fl
grain gr
gram Gm, g
drop gtt
hour h, hr
intramuscular IM
intravenous IV
intravenous piggyback IVPB
potassium K
potassium chloride KCl
kilogram kg, Kilo
keep vein open KVO
liter L
long acting
pound lb
milliequivalent mEq
microgram mcg
milligram mg
milliliter (equivalent to cc) ml, mL
millimeter mm
sodium Na
sodium chloride NaCl
nebulizer NEB
nasogastric NG
night noc
nothing by mouth NPO, npo
normal saline (sodium chloride, 0.9%) NS, N/S
none Ø
over the counter OTC
ounce oz
after p
after meals pc
patient controlled analgesic PCA
afternoon PM, pm
by mouth, orally po, PO
whenever necessary PRN, prn
pint, patient pt
every hour qh
every 2 hours q2h
every 3 hours q3h
every 4 hours q4h
quantity not sufficient QNS
quantity sufficient qs
quart qt
rectal R
Ringer's lactate RL, R/L
without š
subcutaneous SubQ, subq
sublingual SL
solution sol
sustained release SR
immediately and once only stat
suppository supp
tablet tab
tablespoon tbsp, T, tbs
three times a day tid
telephone order TO
teaspoon tsp, t
vaginal vag
vitamin Vit
verbal order VO
monitors medication administration & identifies practices that have contributed to medication errors Institute for Safe Medication Practice (ISMP)
list published by ISMP with problematic abbreviations Error-Prone Abbreviations, Symbols, & Dose Designations
minimum list of "dangerous" abbreviations that have been prohibited, effective 01/01/2004, approved by Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
items required to be on organization's DO NOT USE list are highlighted with __ __ in the ISMP list double asterisk (**)
avoidance of periods w/ all medical abbreviations is a required safety practice because poorly written periods could be mistaken as the __ __ and cause an __ __ __ number one; error in dosage
date, patient's name, medication name, dosage/amount of medication, route/manner of administration, & time to be administered/frequency six items contained in all medications orders
medication orders must always be written & signed by a physician
in an emergency the physician may give a verbal order
health care workers are responsible for repeating the order (i.e. medication & amount) before administration
health care workers are responsible for writing down the medication, amount, & time of administration as soon as it is given
most agencies require a __ __ to take telephone orders registered nurse
if you are calling in the prescription to the facility for the physician you must repeat name of drug, dosage, frequency & route
physician's must sign all verbal & telephone orders within 24 hours
regulations for who can call in an order and who can receive a phone order, as well as the time frame for a physician's signature, from state to state
health care workers are responsible for noting the six items for all medications orders and to question any discrepancies, omissions, or unusual orders
in addition to the six items on all medications orders the two additional items are physician's DEA number & number of refills
the physician's DEA number must be on all prescriptions for a controlled substance
if there are to be no refills there must be written NO, NONE, or Ø
never leave a blank space after the __ __ on a prescription refill space
in order to reduce incidences of medication errors some states have passed legislation requiring that the name of the medication to be legibly printed or typed
state regulations also require that the quantity of the drug be in both textual and numerical formats
state regulations also require that the prescriber also print their name under the signature
in order to carry out medication orders accurately the person administering the medication must have an understanding of the different systems of measurement
original system of weights & measures for writing medication orders apothecary system
a pharmacists or druggist can also be called an apothecary
__ drugs are still ordered by the apothecary system few
metric system is the ___ system of measurement and used at the present time preferred
international standard for weights and measurement; invented by French in late 18th century metric system
standardized, on the assumption that the utensils are common enough to be found in any home; not as accurate as the metric system because of a lack of standardization of spoons, cups, and glasses household system
medication orders are concerned with only measuring __ & measuring __ fluids; solids
measuring fluids liquid measure
measuring solids solid weight
includes minim, fluid dram, fluid ounce, pint, quart, & gallon apothecary system of liquid measurement
a drop is approximately equivalent to __ __ of water 1 minim
when minims are ordered they should always be measured with a __ __ or in a __ __ for accuracy minim glass; tuberculin syringe
if a medication order specifies drops, they may be measured with a medicine dropper
aspirin, acetaminophen, iron & phenobarbital are a few drugs that are sometime ordered by the apothecary system in grains
includes liter & milliliter metric system of liquid measurement
milliliter is approximately equivalent to the cubic centimeter
includes gram & milligram; measurement most commonly used for medication prescriptions metric system for measuring solid weights
if necessary to convert from apothecary system to the metric system, always consult conversion table or pharmacist
medicine cups & various syringes calibrated in millimeters &/or minims are equipment most commonly used for measuring medications
calibrated measuring spoons & clearly marked measuring cups are more accurate for dispensing orders in the household measurement
a teaspoon in household measurement is equivalent to __ in metric measurement 5 milliliters
the abbreviation that indicates a medication is to be administered immediately is stat
the abbreviation that indicates that a patient is to take a medication that does not require a prescription OTC
the abbreviation that indicates a medication should be taken whenever necessary prn
abbreviation that means the medication is to be taken every other day qod
abbreviation indicates a medication should be taken twice daily bid
abbreviation indicating a patient is to stop taking a prescribed medication dc
abbreviation indicating a medication should taken before meals ac
three systems used to measure medications apothecary, metric, & household
abbreviation indicating that a medication is to be administered to the right eye OD
abbreviation indicating that a medication is to be administered to the left eye OS
abbreviation indicating that a medication is to be administered to both/each eye OU
metric liter is equivalent to __ quart in household measurement one
the metric system is preferred for __ prescriptions writing
abbreviation that indicates a medication is dispensed in grams g
abbreviation indicates a medication is prescribed in micrograms mcg
a __ is equivalent to 2.2 pounds kilogram
the metric equivalent of 0.5 g is 500 mg
in addition to date, patient name, & medication name, a medication order must also contain __, __, & __ or frequency of administration dosage; route; time
1 tsp in household measurement is equivalent to __ in apothecary measurement 1 dr
15 gr in apothecary measurement is equivalent to __mg in metric measurement 1,000
7-1/2 gr in apothecary measurement is equivalent to __g in metric measurement 0.5
1 gr in apothecary measurement is equivalent to __mg in metric measurement 60-65
be very careful with conversions, metric equivalents of apothecary are not precise
to convert pounds to kilograms you will need to __ number of pounds by 2.2 divide
be very careful when calculating weight in kg, because the slightest error (especially in pediatric dosage) could result in fatal consequences
1 lb in household measurement is equivalent to __ kg in metric measurements 0.453592
1/2 gr in apothecary measurement is equivalent to __mg in metric measurement 30