Wake Tech Community College

Medication Administration Record

Wake Tech Community College

Simulation Suite

Reason for Visit: r/o hip fracture
Admission Date: today / Primary MD: Struthers
Attending: Jones / Room/Bed No.
WTCC LAB, Bed 2
Allergies: NKDA, strawberries / Birthdate: 00/00/00 Gender: Female / Height: 5 ft. 2 in. Weight: 66 kg
Start
Time / Stop
Time / Checked
By / Medication Name (Dose, Route, Schedule) / Day Shift
0700-1459 / Evening Shift 1500-2259 / Night Shift 2300-0659
Phase One / ks / STANDING MEDS:
Oxybutynin (Ditropan) 5 mg PO daily (0900)
Lisinopril (Zestril) 10 mg PO daily (0900)
HCTZ/Triamterene (Dyazide) 2 capsules PO daily (0900)
Calcium Carbonate 500 mg PO twice daily (0900/2100)
PRN MEDS:
Oxycodone 5 mg PO every 4-6 hours PRN pain
Diazepam (Valium) 5 mg HS PO PRN sleep/anxiety
Naproxen (Aleve) 1 tablet PO every 12 hours PRN pain
Zolpidem (Ambien) 5 mg PO at bedtime PRN insomnia
Initials / Signature/Title / Initials / Signature/Title / Initials / Signature/Title
Ks / Kathy Spade RN
Omitted Dose Codes / Injectable Site Codes (Site, Route)
A-NPO Diagnostic / E-Hold Dose / Anterior Thigh (R/L) / RUQ-right upper quadrant
B- NPO Surgery / F-Patient Away from Rm. / Gluteal Region (R/L) / RLQ- right lower quadrant
C-Patient Refused Dose / G-Other (see notes) / Deltoid (R/L) / LUQ- left upper quadrant
D-Nausea / Abdominal (R/L) / LLQ- left lower quadrant

Medication Administration Record

Wake Tech Community College

Simulation Suite

Reason for Visit: r/o hip fracture
Admission Date: today / Primary MD: Struthers
Attending: Jones / Room/Bed No.
Allergies: NKDA, strawberries / Birthdate: 00/00/00 Gender:female / Height: 5 ft 2 in. Weight: 66 kg
Start
Time / Stop
Time / Checked
By / Medication Name (Dose, Route, Schedule) / Day Shift
0700-1459 / Evening Shift 1500-2259 / Night Shift 2300-0659
Phase One- Second order set / ks / Ondansetron (Zofran) 10 mg IV every 4 hours x 2 doses PRN nausea and vomiting
Ketorolac (Toradol) 15 mg IV every 6 hours PRN pain
Percocet 1-2 tablets every 6 hours PRN pain
Initials / Signature/Title / Initials / Signature/Title / Initials / Signature/Title
ks / Kathy Spade RN
Omitted Dose Codes / Injectable Site Codes (Site, Route)
A-NPO Diagnostic / E-Hold Dose / Anterior Thigh (R/L) / RUQ-right upper quadrant
B- NPO Surgery / F-Patient Away from Rm. / Gluteal Region (R/L) / RLQ- right lower quadrant
C-Patient Refused Dose / G-Other (see notes) / Deltoid (R/L) / LUQ- left upper quadrant
D-Nausea / Abdominal (R/L) / LLQ- left lower quadrant

Medication Administration Record

Wake Tech Community College

Simulation Suite

Reason for Visit: r/o hip fracture
Admission Date: POD #2 / Primary MD: Struthers
Attending: Jones / Room/Bed No.
WTCC Lab, Bed 2
Allergies: NKDA, strawberries / Birthdate: 00/00/00 Gender: female / Height: 5 ft. 2 in. Weight: 66 kg
Start
Time / Stop
Time / Checked
By / Medication Name (Dose, Route, Schedule) / Day Shift
0700-1459 / Evening Shift 1500-2259 / Night Shift 2300-0659
Phase Four / ks / Levofloxacin (Levaquin) 500 mg PO once a day x 14 days.
Initials / Signature/Title / Initials / Signature/Title / Initials / Signature/Title
Ks / Kathy Spade RN
Omitted Dose Codes / Injectable Site Codes (Site, Route)
A-NPO Diagnostic / E-Hold Dose / Anterior Thigh (R/L) / RUQ-right upper quadrant
B- NPO Surgery / F-Patient Away from Rm. / Gluteal Region (R/L) / RLQ- right lower quadrant
C-Patient Refused Dose / G-Other (see notes) / Deltoid (R/L) / LUQ- left upper quadrant
D-Nausea / Abdominal (R/L) / LLQ- left lower quadrant

Patient Name: Sara Tompkins

Medication Record Number: 1231230