N1110 Oral Medication Practice
Sally Anderson
Student Prep Required:
Med Cards for the following drugs:
 Digoxin
 Furosemide
 Atenolol
 Ampicillin
 Potassium Chloride
 Colace
 Acetaminophen
 Percocet
For your own learning review Lewis for Patho related to:
 Congestive Heart Failure (CHF)
 Hypertension (HTN).
DO NOT LOOK AT LAST PAGE (PRACTICE KEY) UNTIL YOU HAVE COMPLETED THE ENTIRE MED
SCENARIO- your partner will read this content to you
Scenario:
Today is November 8th
You are the student nurse caring for Mrs. S. Anderson an 80 year old female who was admitted to
Normandale Community Hospital for a fractured right hip after a fall at home that required a left hip pinning. She is
now post operative day 3. She developed redness yesterday with small amount of yellow drainage at surgical site.
Physician ordered Ampicillin this morning and has yet to receive the first dose.
Past Medical History (PMH) includes: Congestive Heart Failure (CHF) and Hypertension (HTN). Her last
recorded Potassium is 4.2meq/L.
Last recorded VS 11/7 at 0000: T-99.5 P-84 R-20 BP-120/76 sats 96% on room air. She last received
Acetaminophen 650 mg at 0100.
Allergies: Penicillin
Patient Data
Your initial VS and assessment findings when you assessed at 0730:
T-99.2 P-54 reg R-16 non-labored BP-98/60 O2 sats 95% on room air
Pain is present:
 W-ache
 I-8/10
 L-left hip/surgical site
 D-ongoing since surgery
 A-movement of any kind worsens
The notable findings from your head to toe assessment are:
 Alert and oriented x3, though appears uncomfortable and is grimacing
 Breath sounds are clear and equal bilaterally
 Apical pulse is 52 and regular S1S2
 Bowel sounds are hypoactive with no recorded bowel movement since surgery
 Surgical incision is red at the edges, but has no drainage and appears to be healing
 Pulses are 2+ throughout
 2+ pitting edema in both ankles and lower calves
Give the 0800 medications to Sally Anderson in Room 210-1. Validate the MAR before giving medications.
State out loud all checks you are making and any additional patient assessments you would make before giving med
©2011 Keith Rischer/www.KeithRN.com
Anderson, Sally
Page
of 2_
MR # 222555
DOB: 02/05/1930
Room 210-1
Dr. J. Smith
1
N: 2300 - 0659
D: 0700 - 1459
E: 1500 - 2259
Allergies: Penicillin
STAT AND ONE TIME DOSES
RN
Init
Date
Medication/Dose/Route/Time
Date/
Time
Given
Init
Time
D
Time
E
RN
Init
Date
Date: 11/6/2010
Medication/Dose/Route/Time
Date: 11/7/2010
Start
Init
Medication Strength
Frequency route
11/5
GG
Digoxin (Lanoxin) 0.25 mg po
every day
0800
11/5
GG
Furosemide (Lasix) 200 mg po
BID
0800
11/5
GG
Atenolol (Tenormin ) 50 mg po
every day
0800
0800
GG
0800
GG
11/5
GG
Potassium Chloride (K-dur) 20
meq po every day
0800
0800
GG
0800
GG
11/8
GG
Ampicillin 250 mg po every 6
hours
SIGNATURE
INIT
Gloria Gale, RN
GG
Peter Pavlo
PP
Time
N
2400
1200
N
D
0800
GG
1600
E
Date/
Time
Given
N
D
Init
Date: 11/8/2010
E
N
D
E
0830
GG
0800
GG
1630
PP
1800
0600
SIGNATURE
©2011 Keith Rischer/www.KeithRN.com
INIT
SIGNATURE
INIT
SIGNATURE
INIT
PRNs
Anderson, Sally
Page
of 2_
MR # 222555
DOB: 02/05/1930
Room 210-1
Dr. J. Smith
2
N: 2300 - 0659
D: 0700 - 1459
E: 1500 - 2259
Allergies: Penicillin
STAT AND ONE TIME DOSES
RN
Init
Date
Medication/Dose/Route/Time
Medication Strength
Frequency route
11/5
GG
Docusate Sodium (Colace) liquid
50 mg po daily PRN constipation
11/5
GG
Acetaminophen (Tylenol) 650 mg
po every 4 hours prn pain
11/5
GG
Oxycodone 5 mg/Acetaminophen
325 mg (Percocet) 1-2 tabs every
4 hours prn for pain
INIT
Gloria Gale, RN
GG
Peter Pavlo
PP
Init
Time
D
Time
E
RN
Init
Date
Time
N
SIGNATURE
©2011 Keith Rischer/www.KeithRN.com
N
D
Date/
Time
Given
Medication/Dose/Route/Time
Date: 11/6/2010
Start
Init
SIGNATURE
Date/
Time
Given
Date: 11/7/2010
E
N
D
Init
Date: 11/8/2010
E
N
D
E
0100
PP
1630
PP
INIT
SIGNATURE
0630
PP
INIT
SIGNATURE
INIT
N1110 Oral Medication Practice Answer Key with Critical Thinking Questions to be Asked by Your
Partner
Sally Anderson
1. Correlate what medications she is receiving with her past medical history (CHF-Digoxin,
Furosemide) HTN (Atenolol)
2. What is the most likely explanation that Sally is receiving KCL as a po supplement? (Furosemide is
a loop diuretic-waste excess K+ with Na+ and water)
3. Do you have the right patient medication drawer?
4. What allergies does Sally Anderson have listed? Is there any medication ordered that she is allergic
too? Does her name band have the same allergies listed? Did you D/C Ampicillin due to allergy?
Did you document by writing D/C Ampicillin – yellow out, time and date your initials. Did you call MD
for alternative antibiotic?
5. Did you verify the MAR? Did you note the lack of signature at bottom of page? Did you check the
original order; and verify each medication with your initials and sign at the bottom of the page with
your full name, credentials and initials?
6. Did you complete the 1st and 2nd medication check outside the client’s room and then a 3rd
medication at the client’s bedside?
7. Do you need to complete or recheck any nursing assessments before you administer the
medications?
8. Did you check the patient’s name band and allergy band as soon as you enter the room?
9. For the Lanoxin dose, did you assess your client’s AP? What is the client’s baseline AP? Did you
hold the Digoxin dose? (Hold if HR less than 60). Did you chart time, AP and initials?
10. Did you recognize that the dose for Lasix is not in the normal dose range and should not be givenHELD until you con confirm the dose with physician?
11. Should you give the Atenolol? (AP 54/min. at 10 am and BP 94/60 – Baseline BP = 120/76 and AP
baseline = 80) Did you chart the time, held, AP and initials?
12. Did you assess bowel pattern and determine need for Colace? Did you give Colace? (Last BM none
since surgery.)
13. Did you assess pain for the location, intensity and effectiveness of last medication?
14. Based on your assessment did you choose to give Tylenol or Percocet? The better choice is
Percocet starting at 1 tab because of her severity of pain.
15. If you gave Percocet when would you reassess her for pain control?...(Peak in 60”…reassess in
this timeframe)
16. Did you sign the MAR with your full name, SN, NCC and your initials?
17. You’re all done! Good job. Good luck on the med test!
Meds to be given:
Colace…constipated
Potassium Chloride…current lab values are in safe range
Percocet 1 tab…has intermediate to severe pain
Meds NOT to be given:
Furosemide…dose above normal expected range. Do not give until clarified by MD
Digoxin…slows AV node conduction and is not safe to give. Must have HR >60
Atenolol…beta blocker. Must have HR>60 to give safely
Ampicillin…has documented allergy to this drug. Ampicillin is a Penicillin- same pharmacologic category
©2011 Keith Rischer/www.KeithRN.com