Inpatient Dispensing Verification

PATIENT ORDERS

UNIVERSITY MEDICAL CENTER

Patient Information

Patient Name: Paul Gold

Medical Record: 269874 Ward: 2-North Room Number: 231-2

Age: 79 Weight (kg): 95.4 kg Height: 5' 9"

Allergies: NKDA Adverse Drug Reactions: None

Diagnosis: HTN, Asthma, BPH, RA

Final Medication Reconciliation List

Date

Time

Orders

1-12-XX

08:00

Lasix 40 mg qd

Venoltin Inhaler 2 puffs qid prn

Flovent 110 Inhaler 1 puff bid

Motrin 800 mg tid w/ meals

Proscar 5 mg qd

DW 1/2 NS @ 75 cc/hr

Orders to be entered by treating physician: H. Green

MEDICATION ADMINISTRATION RECORD

24HR MAR - ADMINISTRATION DATE:1-13-XX
Patient Name: Paul Gold Physician: H. Green
Medical Record: 269874 Ward: 2-North Room Number: 231-2
Allergies: NKDA Adverse Drug Reactions: None
Order Start Date	Order Stop Date	Order Type	Medication	Directions	Admin Times	Time / Initials	Notes
1-12-XX	1-26-XX	C	Finasteride 5 mg tab	5 mg PO QD	0900	1145 LM
1-12-XX	1-26-XX	C	Fluticasone 110 mcg/actuation inhaler	1 puff BID	0700 1700	0645 LM 1648 ST
1-12-XX	1-26-XX	C	Furosemide 40 mg tab	40 mg PO QD	0900	0838 LM
1-12-XX	1-26-XX	C	Ibuprofen 800 mg tab	800 mg PO TID w/ meals	0700 1200 1700	0645 LM 1142 ST 1720 ST
1-12-XX	1-26-XX	P	Albuterol 90 mcg/actuation inhaler	2 puffs QID PRN
1-12-XX	1-26-XX	CIV	DW NS 1000 mL	Infuse @ 75 mL/hr	ATC	1013 LM, new bag started 2330 ST, new bag started

PATIENT ARM BAND

Patient Name: Paul Gold
Room Number: 231-2
Allergies: NKDA
ADR: None

MEDICATION DRAWERS

Finasteride 5 mg Tablet Lot Num: 89423 Exp Date: 6-1-XX Pkg by: Merck	Doses: 1
Flunisolide 25 mcg/actuation Inhaler Lot Num: 64852 Exp Date: 3-29-XX Pkg by: Bausch&Lomb	Doses: 1
Furosemide 40 mg Tablet Lot Num: 78964 Exp Date: 6-13-XX Pkg by: Danbury	Doses: 1
Ibuprofen 800 mg Tablet Lot Num: 17964 Exp Date: 2-11-XX Pkg by: UDL	Doses: 3
Albuterol 90 mcg/actuation Inhaler Lot Num: 56411 Exp Date: 4-12-XX Pkg by: Apothecon	Doses: 1
DW NS 1000 mL IV Lot Num: 78463 Exp Date: 5-10-XX Pkg by: Baxter	Doses: 2