Professional Documents
Culture Documents
Chapter
Chapter Overview
administers patient medication and the various forms and routes by which medications
are administered. The student will begin to develop a vocabulary of terms necessary to
understand pertinent information about drugs and their administration, which will aid
in understanding the responsibilities of administering drugs safely. Safety, documenta-
tion, and accuracy are stressed throughout the text. Recent Joint Commission recom-
mendations are included, and the “Six Rights” of medication administration are discussed
extensively. The student will learn how to interpret drug prescriptions, medication orders,
medication administration records (MAR), drug labels and package inserts, and military
time. The roles of the FDA and other organizations concerned with decreasing medication
errors are discussed.
Instructor’s Notes
● The PowerPoint slides are particularly useful in presenting the material in
this chapter. Slides of drug prescriptions, medication orders, medication
administration records, drug labels, and package inserts can be projected
as the instructor explains their various components.
● Demonstrate actual examples of various forms of drugs (inhalers, tablets,
capsules, patches, suppositories), if available.
4
© 2016 by Pearson Education, Inc.
Key Terms
automated medication Institute for Safe prescriber
dispensing cart (ADC) Medication Practice prescription
A.M./P.M. (ISMP) prn
bar code intracardiac (IC) q.i.d.
b.i.d. intradermal (ID) registration
body surface area (BSA) intramuscular (IM) symbol (®)
buccal intrathecal route
capsule intravenous (IV) safe dose range
computerized local/systemic side effect
physician order lot number standing order
entry (CPOE) medication stat
controlled substance administration subcutaneous
delayed-release record (MAR) (subcut)
(DR) medication order sublingual (SL)
dosage strength metered dose inhaler suspension
dry powder inhaler (MDI) sustained release (SR)
(DPI) meters squared (m2) syrup
elixir military time tablet
enteral national drug code t.i.d.
enteric-coated (NDC) topical
epidural nebulizer trade name
extended release (XL) oral (PO) trademark (™)
Federal Drug package insert transdermal
Administration parenteral unit dose
(FDA) pharmacist United States
generic name Physician’s Desk Pharmacopoeia
inhalation Reference (PDR) (USP)
(a)
(b)
(c)
• Figure 2.1
Drug Labels for Questions 1–5.
5. What is the dosage strength for the drug whose NDC number is
0069 5810 60?
Study the portion of a MAR in • Figure 2.2 and answer questions 6–10 below.
Order time 18 19 20 21
nifedipine 20 mg po b.i.d. 0900h AD AD AD AD
1700h BK BK BK BK
digoxin 0.25 mg po daily 0900h X AD AD AD
sucralfate 1 g po q.i.d. 0900h AD AD AD AD
1300h BK BK BK BK
1700h BK BK BK BK
2100h WW WW WW WW
• Figure 2.2
6. How many drugs were administered at 1 p.m. on the 18th?
8. What are the initials of the nurse who administered the nifedipine at
5:00 p.m. on the 20th?
DECLOMYCIN®
DEMECLOCYCLINE HYDROCHLORIDE
FOR ORAL USE
Adults: Usual daily dose, four divided doses of 150 mg each or two divided
doses of 300 mg each.
For children above eight years of age: Usual daily dose, 3–6 mg per pound body
weight per day, depending on the severity of the disease, divided into two to
four doses.
Gonorrhea patients sensitive to penicillin may be treated with demeclocy-
cline administered as an initial oral dose of 600 mg followed by 300 mg every
12 hours for four days to a total of 3 grams.
HOW SUPPLIED
DECLOMYCIN® demeclocycline hydrochloride capsules. 150 mg are two-tone, coral
colored, soft gelatin capsules, printed with LL followed by 09 on the light side in
blue ink, are supplied as follows:
NOC 0005-9208-23 – Bottle of 100
• Figure 2.3
Portion of a package insert for questions 11–12.
14. What is missing from the following order: Paxil (paroxetine) 50 mg daily
15. Order: Zyvox (linezolid) 600 mg po q12h. How many mg will you administer?
For the partial orders in questions 16–20, indicate how many milliliters you
would administer.
16. 60 mL daily
17. 60 mL b.i.d.
18. 60 mL t.i.d.
20. 60 mL q12h
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
And when hee is once entred to[1805] rule the [beastly]
rout,
Although hee would, he can no way get out:
Hee may bee sure none will to him resorte,
But such as are the vile and rascall sorte:
All honest men, as well the most as lest,
To tast of treason will vtterly detest.
31.
Then let him way how long hee can bee sure,
Where fayth nor frendship may no while endure:
Hee whom hee trusteth most, to gayne a grote
Will fall him from, and assay[1806] to cut his throate:
Among the knaues and slaues where vice is rooted,
There is no other frendship to bee looked.
32.
33.
They lose their lands and goods, their childe and wife
With sorrowe and shame shall leade a wofull lyfe:
If hee bee slayne in fielde hee dyeth accurst,
Which of all wrecks wee should accompt the worst:
And hee that dyeth defending his liege lord
Is blist, and blist agayne by God’s owne worde.
35.
36.
37.
38.
Therefore the rebell is accurst and mad,
That hopeth[1811] for that which rebell neuer had:
Who trusting still to tales doth hang in hope,
Tyll at the last hee hang fast by the rope,
For though that tales bee tolde that hope might feede,
Such foolishe hope hath still vnhappy speede.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
And when wee had prepared euery thing,
Wee went to Tawnton with all our prouision,
And there we slewe the prouost of Penryn,
For that on the subsedy hee sate in commission:[1833]
Hee was not wise, nor yet of great discretion,
That durst approche his enmies in their rage,
When wit nor reason coulde their yre asswage.
54.
55.
56.
57.
58.
59.
60.
[This] my lorde and wee the captaynes of the west,
Tooke [our] inne at Newgate, fast in fetters tide,
Where after tryall[1845] wee had but litle rest:
My lorde through London was drawne on a slide,
To Tower hill, where with an[1846] axe hee dyde,
Clad in his [coate] armour painted all in paper,
Torne[1847] and reuersed[1848] in spite of his behauer.
[1849]
61.
62.
63.
64.
65.
66.
67.
Wherefore, good Baldwine, do[1859] thou record my
name,
To bee ensample to[1860] such as credit lyes,
Or thrist to sucke the sugred cup of fame,
Or doe attempt agaynst their prince to ryse:
And charge them all to keepe within their syse:
Who doth assay to wrest beyond his strength,
Let him be sure hee shall repent at length.
68.
Maister Cauyll.[1864]
[“It is pity,” quoth[1865] one, “that the meeter is no better, seeing
the matter is so good: you may do very well to helpe it, and a lytle
filing would make it formal.” “The author him selfe,” quoth[1866] I,
“could haue done that, but hee would not, and hath desired me that it
may passe in such rude sort as you haue heard it: for hee obserueth
therein a double decorum both of the Smith, and of himselfe: for hee
thinketh it not meete for the Smith to speake, nor for himselfe to write
in any exact kinde of meeter.” “Well,” sayd another, “the matter is
notable to teach al people, as well officers as subiects, to consider
their estates, and to liue in loue and obedience to the highest
powers, whatsoeuer they bee, whome God either by birth, law,
succession, or vniuersall election, doth or shall aucthorise in his
owne roume to execute his lawes and iustice among any people or
nation. For by all these meanes God placeth his deputies. And in my
iudgement there is no meane so good eyther for the common quiet
of the people, or for God’s free choise, as the naturall order of
enheritaunce by lineall discent: for so it is left in God’s handes, to
creat in the wombe what prince hee thinketh meetest for his
purposes: the people also knowe their princes, and therefore the
more gladly and willingly receiue and obay them. And although some
realmes, more carefull then wise, haue entailed theire crowne to the
heire male, thinking it not meete for the feminine sexe to beare the
royall office: yet if they consider all circumstaunces, and the chiefest
vses of a prince in a realme, they shall see how they are deceiued.
For princes are God’s lieutenauntes or deputies, to see God’s lawes
executed among theire subiects, not to rule according to their owne
lustes or deuises, but by the prescript of God’s lawes: so that the
chiefest poynt of a prince’s office consisteth in obedience to God and
to his ordinaunces, and what shoulde let but that a woman may bee
as obedient vnto God, as a man? The second poynt of a prince’s
office is to prouide for the impotent, nedy, and helples, as widowes,
orphanes, lame, and decrepite persons: and seing women are by
nature tender harted, milde and pitifull, who may better then they
discharge this duty? Yea but a woman lacketh courage, boldnesse,
and stomacke, to withstand the aduersarie, and so are her subiects
an open spoyle to their enemies. Debora, Iaell, Iudith, Thomeris, and
other doe proue the contrary. But graunt it were so: what harme were
that, seing victory consisteth not in witte or force, but in God’s
pleasure.[1867] I am sure that whatsoeuer prince doth his duty in
obaying God, and causing iustice to bee ministred according to
God’s lawes, shall not only lacke warre (bee hee man, woman, or
childe) but also bee a terroure to all other princes. And if God suffer
any at any time to be assayled, it is for the destruction of the
assayler, whether he bee rebell or forayne foe, and to the honour
and profit of the vertuous prince, in whose behalfe, rather then hee
shall miscary, God himselfe will fight with enfections and
earthquakes from the lande and waters, and with stormes and
lightenings from the ayre and skies. Moe warres haue bene sought
through the wilfull and hauty courages of kings, and greater
destructions happened to realmes therby, then by any other meanes.
And as for wisdome and pollicy, seing it consisteth in following the
counsayle of many godly, learned, and long experienced heades, it
were better to haue a woman, who considering her owne weaknes
and inability, should be ruled thereby, then a man which presuming
vpon his owne fond brayne, will heare no aduise saue his owne. You
muse peraduenture wherefore I say this. The franticke heades which
disable our queene, because shee is a woman, and our king
because hee is a straunger, to bee our princes and cheife
gouernours, hath caused mee to say thus mutch. For whatsoeuer
man, woman, or childe, is by the consent of the whole realme
established in the royall seate, so it haue not bene iniuriously
procured by rygour of sworde and open force, but quietly by tytle,
either of enheritaunce, succession, lawfull bequest, common consent
or election, is vndoubtedly chosen by God to bee his deputye: and
whosoeuer resisteth any suche, resisteth agaynste God himselfe,
and is a ranke traytour and rebell, and shalbe sure to prosper as well
as the blacke Smith and other suche haue done. All resist that
wilfully breake any lawe, not being agaynst God’s lawe, made by
common consent for the wealthe of the realme, and commaunded to
be kept by the authority of the prince: or that deny to pay such
duties, as by consent of the high court of parliament, are appointed
to the prince, for the defence and preseruation of the realme.” “You
haue saide very truly herein,” quoth[1868] I, “and I trust this terrible
example of the blacke Smith, will put all men in minde of their duties,
and teach them to bee obedient to all good lawes, and lawfull
contributions. The scriptures do forbyd vs to rebell, or forcibly to
withstand princes, though they commaund vniust things: yet in any
case wee may not doe them: but receiue quietly at the prince’s hand
whatsoeuer punishment God shall suffer to bee layd vpon vs for our
refusall. God will suffer none of his to bee tempted aboue their
strength.”[1869] This talke thus being ended: “I was willed my
maisters,” quoth I, “by maister Holinshed, to bring sir Nicholas Burdet
vnto you.” “Were you?” quoth they: “on his word we will heare what
he sayes.” “Read it, I pray you,” quod one. “You must thinke then,”
quoth I, “that you see him all wounded as he was slaine at Pontoise,
to say as foloweth.”]
How the Valiant Knight Sir Nicholas
Burdet, Chiefe Butler of Normandy,
was slayne at Pontoise, Anno 1441.
1.
2.
3.
4.
5.
6.
8.
9.
10.