Inpatient Dispensing Verification

PATIENT ORDERS

UNIVERSITY MEDICAL CENTER

Patient Information

Patient Name: Winnie King

Medical Record: 552699 Ward: 1-South Room Number: 122-3

Age: 59 Weight (kg): 80 kg Height: 5' 6"

Allergies: PCN Adverse Drug Reactions: Codeine (nausea)

Diagnosis: unstable angina, CHF, DM 2, HTN, CAD

Final Medication Reconciliation List

Date

Time

Orders

12-11-XX

07:42

K-Dur 20 mEq qd

Lipitor 20 mg qd

Lasix 40 mg qd

Calan SR 240 mg qd

Glucophage 500 mg bid

Prinivil 20 mg qd

NTG 0.4 mg prn cp

NTG 50 mg/DW 250 mL 20 mcg/min

Heparin 25,000 Units/DW 500 mL 1440 units/hr

Orders to be entered by treating physician: C. Abman

MEDICATION ADMINISTRATION RECORD

24HR MAR - ADMINISTRATION DATE:12-12-XX
Patient Name: Winnie King Physician: C. Abman
Medical Record: 552699 Ward: 1-South Room Number: 122-3
Allergies: PCN Adverse Drug Reactions: Codeine (nausea)
Order Start Date	Order Stop Date	Order Type	Medication	Directions	Admin Times	Time / Initials	Notes
12-11-XX	12-25-XX	C	Atorvastatin 20 mg tab	20 mg PO QD	0900	0832 SC
12-11-XX	12-25-XX	C	Lisinopril 20 mg tab	20 mg PO QD	0900	0846 SC
12-11-XX	12-25-XX	C	Metformin 500 mg tab	500 mg PO BID w/ meals	0900 1800	1719 BK
12-11-XX	12-25-XX	C	Potassium Cl 20 mEq tab	20 mEq PO QD	0900	0826 SC
12-11-XX	12-25-XX	C	Verapamil SR 240 mg tab	240 mg PO QD	0900	0825 SC
12-11-XX	12-25-XX	P	NTG 0.4 mg SL tab	0.4 mg SL PRN CP		1235 LM, dose effective
12-11-XX	12-25-XX	CIV	Furosemide 10 mg/mL, 4 mL vial	40 mg IV QD	0900	0840 SC
12-11-XX	12-25-XX	CIV	Heparin 25,000 Units/DW 500 mL	1440 units/hr IV	ATC	0700 SC, new bag started
12-11-XX	12-25-XX	CIV	NTG 50 mg/DW 250 mL	20 mcg/min IV	ATC	0830 SC, new bag started

PATIENT ARM BAND

Patient Name: Winnie King
Room Number: 122-3
Allergies: PCN
ADR: Codeine (nausea)

MEDICATION DRAWERS

Atorvastatin 40 mg Tablet Lot Num: 69132 Exp Date: 7-21-XX Pkg by: Pfizer	Doses: 1
Lisinopril 20 mg Tablet Lot Num: 99746 Exp Date: 7-6-XX Pkg by: UDL	Doses: 1
Metformin 500 mg Tablet Lot Num: 13257 Exp Date: 7-28-XX Pkg by: Barr	Doses: 2
Potassium Chloride 20 mEq Tablet Lot Num: 45789 Exp Date: 4-6-XX Pkg by: Key	Doses: 1
Verapamil SR 240 mg Tablet Lot Num: 68994 Exp Date: 6-11-XX Pkg by: Geneva	Doses: 1
NTG 0.4 mg Tablet Lot Num: 21145 Exp Date: 4-5-XX Pkg by: Glenmark	Doses: 5
Furosemide 10 mg/mL 4 mL Vial Lot Num: 27954 Exp Date: 2-4-XX Pkg by: Mylan	Doses: 1
Heparin 25,000 Units/DW 500 mL IV Lot Num: 13254 Exp Date: 4-7-XX Pkg by: Abbott	Doses: 1
NTG 50 mg/DW 250 mL IV Lot Num: 67487 Exp Date: 6-19-XX Pkg by: Abbott	Doses: 1