Inpatient Dispensing Verification

PATIENT ORDERS

UNIVERSITY MEDICAL CENTER

Patient Information

Patient Name: Sandra Farrel

Medical Record: 348721 Ward: 3-North Room Number: 327-1

Age: 48 Weight (kg): 76 kg Height: 5' 4"

Allergies: Codeine Adverse Drug Reactions: None

Diagnosis: major depressive episode, insomnia, menopausal symptoms, intermittent heartburn, seasonal allergies, hyperlipidemic

Final Medication Reconciliation List

Date

Time

Orders

1-20-XX

07:42

Prempro 0.3 mg/1.5 mg qd

Zantac 150 mg bid prn

Allegra-D 120 mg/60 mg bid

Serzone 100 mg bid

Zocor 20 mg qpm

Os-Cal 500 mg ii qd

Orders to be entered by treating physician: R. Shumway

MEDICATION ADMINISTRATION RECORD

24HR MAR - ADMINISTRATION DATE:1-21-XX
Patient Name: Sandra Farrel Physician: R. Shumway
Medical Record: 348721 Ward: 3-North Room Number: 327-1
Allergies: Codeine Adverse Drug Reactions: None
Order Start Date	Order Stop Date	Order Type	Medication	Directions	Admin Times	Time / Initials	Notes
1-20-XX	2-4-XX	C	Calcium, Oyster Shell 500 mg tab	1000 mg PO QD	0900	0855 LS
1-20-XX	2-4-XX	C	Conj. Estrogen/Medroxyprogest. 0.3 mg/1.5 mg tab	1 tab PO QD	0900	0846 LS
1-20-XX	2-4-XX	C	Nefazodone 100 mg tab	100 mg PO BID	0900 2100	0901 LS 2303 MC
1-20-XX	2-4-XX	C	Pseudoephedrine/Fexofenadine 120 mg/60 mg tab	1 tab PO BID	0900 2100	0842 LS 2109 MC
1-20-XX	2-4-XX	C	Simvastatin 20 mg tab	20 mg PO QD	0900	0905 LS
1-20-XX	2-4-XX	P	Ranitidine 150 mg tab	150 mg PO BID PRN		0830 LS, dose effective

PATIENT ARM BAND

Patient Name: Sandra Farrel
Room Number: 327-1
Allergies: Codeine
ADR: None

MEDICATION DRAWERS

Conj. Estrogen/Medroxyprogest. 0.3 mg/1.5 mg Tablet Lot Num: 98541 Exp Date: 3-7-XX Pkg by: Watson	Doses: 1
Nefazodone 100 mg Tablet Lot Num: 24679 Exp Date: 5-12-XX Pkg by: Eon	Doses: 2
Oyster Shell Calcium 500 mg Tablet Lot Num: 96432 Exp Date: 12-8-XX Pkg by: Major	Doses: 1
Pseudoephedrine/Fexofenadine 120 mg/60 mg Tablet Lot Num: 13254 Exp Date: 1-25-XX Pkg by: Aventis	Doses: 2
Simvastatin 20 mg Tablet Lot Num: 47123 Exp Date: 11-26-XX Pkg by: Merck	Doses: 1
Ranitidine 150 mg Tablet Lot Num: 64545 Exp Date: 3-1-XX Pkg by: Apotex	Doses: 2