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Baal, Jackie MAR
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ALLERGIES: MORPHINE
DOB: 2/20/XX
MR# 3487742
ROUTINE MEDICATIONS
furosemide (Lasix) 40 mg
PO Daily
0900
BP
Your answer
lanoxin (Digoxin) 0.5 mg
PO Daily
0900
Apical Pulse
Your answer
lisinopril (Prinivil) 10 mg
PO Daily
0900
metformin (Glucophage) 1000 mg
PO BID
0900
2100
Blood Sugar
Your answer
BP
Your answer
PRN MEDICATIONS
hyrdocodone/apap 5/500 --------------(2 tabs pulled 30 min ago)
PO 1-2 tabs prn ever 4 hrs prn pain (Type Date/Time in box)
Your answer
Pain Level Prior
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Pain Re-evaluations
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OVERRIDE MEDICATIONS
Drug Name, Dose, Route, Frequency
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Time Given
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SIGNATURES
NURSE
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