Physician' orders

Date/Time Orders

2/20/20      
1200 Lasix 20 mg po bid

           
2/20/20 Glucotrol 5 mg po q AM,
1200

           
2/20/20 Cardizem 10 mg po bid.
1200

Frances Green has been admitted to the hospital for chest pain at 0600. While in the hospital you
must administer her physician ordered medicines. It is vital that your record her medicine intake
on the Medicine Administration Record page within her chart. She will be in your care for 48
hours. Her orders are below:
Follow the physician orders and record each medicine, amount, route, frequency, time
administered and your initials below.
Name:
Medication Administration Record (Page       of      )
Medications Date       Date      
DRUG       TIME INITIAL TIME INITIAL TIME INITIAL TIME INITIAL
AMOUNT                                                      
ROUTE                                                      
FREQ                                                      
DRUG       TIME INITIAL TIME INITIAL TIME INITIAL TIME INITIAL
AMOUNT                                                      
ROUTE                                                      
FREQ                                                      
DRUG       TIME INITIAL TIME INITIAL TIME INITIAL TIME INITIAL
AMOUNT                                                      
ROUTE                                                      
FREQ                                                      
DRUG       TIME INITIAL TIME INITIAL TIME INITIAL TIME INITIAL
AMOUNT                                                      
ROUTE                                                      
FREQ                                                      
DRUG       TIME INITIAL TIME INITIAL TIME INITIAL TIME INITIAL
AMOUNT                                                      
ROUTE                                                      
FREQ                                                      
DRUG       TIME INITIAL TIME INITIAL TIME INITIAL TIME INITIAL
AMOUNT                                                      
ROUTE                                                      
FREQ                                                      
DRUG       TIME INITIAL TIME INITIAL TIME INITIAL TIME INITIAL
AMOUNT                                                      
ROUTE                                                      
FREQ                                                      
DRUG       TIME INITIAL TIME INITIAL TIME INITIAL TIME INITIAL
AMOUNT                                                      
ROUTE                                                      
FREQ