PRN Prescription Medication SDS 0812 4/03
| |
|PRN Prescription Medication |
|(RN Parameters) |
This is not a prescription.
Because a non-nurse care provider cannot give PRN prescription medications without specific written parameters from the physician, registered nurse or pharmacist, please complete the following so that medication administration can occur. Thank you.
|Client: | |Date: | |
|Prime #: | |Case Manager: | |
|Medication Name: | | |Generic | |Trade |(Check one) |
|What is the medication for? | |
|Dose of medication: | |Amount to be given: | |
| |(e.g., 4 mg.) | |(e.g,. one tablet) |
|Schedule: | |Route: | |
| |(e.g., every 6 hours) | |(e.g., by mouth, under tongue) |
To be given if: (Specific reason medication is needed, e.g., pain in back – not just pain.)
| |
Not to exceed: (Number of doses in a specific amount of time, e.g., 6 tablets in 24 hours.)
| |
Call Physician/NP/Pharmacist and/or RN: (Specific adverse reactions, side effects.)
| |
|To be discontinued: | |
(When should the medication no longer be given?)
|Physician contacted regarding above information? | |Yes | |No | |Not applicable |
| | | |
|RN Signature | |Date |
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
Related searches
- prescription medication for eye infection
- prescription medication for pain relief
- prescription medication for eyes
- prescription medication for conjunctivitis
- best prescription medication for arthritis
- prescription flea medication for cats
- prescription medication database
- prescription medication dictionary
- prescription medication for stomach pain
- prescription medication for abdominal cramps
- assistance with prescription medication costs
- prescription weight loss medication online