Medication order correct or no

A nurse should only go with the mg ordered regardless of how many mls or tablets may be involved . In my current agency we are not even allowed to write a verbal order in our tablets or transcribe to MAR without the dose clearly stated "give xxx mg"

What you posted is really a med error looking for a place to happen. I would totally consider that order to be for 500 mg. Period. If what I have on hand is 250 mg tabs well...we kind of learned how to handle that in nursing school ?

Thank you that’s what my gut and brains were telling me while the others argued with me about it. It felt wrong and against what I’ve been taught and I questioned it because they were telling me otherwise.

I would read that as two 500mg tablets. Every single prescription bottle you see, states the mg PER TAB and the number and frequency to be taken. Not a total mg to be taken with a mystery dose per tab. (I say mystery bc you don’t say how much is in each tab, if the 500mg refers to the total.)

Are 500 mg tabs supplied? How do you give 500mg AND two tabs?

Exactly if we don’t understand it it’s a issue. It should state only mg we have enough sense to figure out how tablets based on that.
I didn’t stay how many mg each tab are because it changes depending on the patient and order. So if I have 250mg I’d give two and if I have 500mg on hand I’d give 2 seems like there needs clarification.

What is the drug? I interpret this as 2 500mg tabs, for a total of 1000mg

1 hour ago, Mqnurse13 said:

Exactly if we don’t understand it it’s a issue. It should state only mg we have enough sense to figure out how tablets based on that.
I didn’t stay how many mg each tab are because it changes depending on the patient and order. So if I have 250mg I’d give two and if I have 500mg on hand I’d give 2 seems like there needs clarification.

But you did clarify that, according to your OP. Seems to me you’re getting your gonads in an uproar over something that can be solved with a single phone call, just as it was in the situation you first described.

Enough phone calls and the md just might change the way s/he writes the order. IE: Drug xxmg tab, 2 tabs(xx times 2) po q whatever. In my facility, it’s procedure to write a clarifying telephone order after checking with the provider, then write the MAR entry in the format described above, which specifies the total dose. What does your pharmacy’s policy require?

It’s long term care so there’s no pharmacy to check with. The doctor said if he writes two tabs it’s two tabs not the mg I’m just concerned with how it’s suppose to be done and if I can be liable if there is a error if I give two.

As a basic rule, an appropriate medication order should have the correct dose stated in the order, if the dose is 1000mg then it needs to say 1000mg, not "2 x 500mg" or "318.3099 x pi mg", etc. Otherwise, there is an increased chance the order will be read incorrectly.

32 minutes ago, MunoRN said:

As a basic rule, an appropriate medication order should have the correct dose stated in the order, if the dose is 1000mg then it needs to say 1000mg, not "2 x 500mg" or "318.3099 x pi mg", etc. Otherwise, there is an increased chance the order will be read incorrectly.

Exactly! And a pharmacy label on a bottle or blister package never seemed the same to me as actually seeing the physician order. In home health we used to be able to enter a med on EMR from the pharmacy label and include the Rx number which counted as physician signature. That is no longer allowed per QA in the last six months or so.

xxxxxx

11 hours ago, Mqnurse13 said:

So I just started working at a facility but the medications are written differently than I’m used to.
500mg, 2tabs, twice a day.

whats correct 2 250mg tabs or 2 500mg tabs?
in hospital setting it always says total mg to be given not total tablets.
the reason I’m asking is because the nurse training me says it’s 2 500mg tabs equalling 1000mg. The doctor also verified and said yes 1000mg however all his orders are written like this and I’m uncomfortable with it, it’s confusing and I’m not sure it’s written according to standards? Can I get in trouble for giving 1000mg in this case sense it states 500 mg. I’m not able to clarify every order he’s writing this way, there are way too many.
Thanks!

I think it's weird that you are asking whether or not you will get in trouble.

How would you get in trouble for giving a patient the correct medication?

10 hours ago, Nursee1234 said:

I would totally consider that order to be for 500 mg. Period.

I would not.

But I agree it is written poorly, guaranteeing that it will be read two different ways.

11 hours ago, Mqnurse13 said:

The doctor also verified and said yes 1000mg however all his orders are written like this and I’m uncomfortable with it, it’s confusing and I’m not sure it’s written according to standards? Can I get in trouble for giving 1000mg in this case sense it states 500 mg.

If you are concerned about it, just document having clarified it with the physician. You could even re-write the order based upon your clarification using the following format:

"Clarification of [medication name] order: [Medication name] 1000 mg by mouth two times daily. VORB Dr. X/[Your signature]."

You will have to clarify with the provider any time you have a question about an ambiguously-written order.