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Discussion

Orders from hell...

From time to time I run into real gems of medical writing.

Levaquin 750 gm P.O. q. 48 hours for 2 more days

the trick is to find how many pills this will be

Can you?

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I had a fresh post-op ortho patient who had orders to ambulate in the hallway 3x/day. Pretty simple, right? Try doing this on a double BKA!

I always like the stool specimen orders for an NPO diet.

When I worked in a TCU/LTC facility, I always chuckled when I got scripts that had the quantity as "sufficient for one month". Ehhh, yeah that's not gonna fly.

I always like the stool specimen orders for an NPO diet.
Or the urine specimen order for an anuric end stage renal dialysis patient.

Ativan 0.5-2mg IV or PO PRN nausea, vomiting, pain, anxiety, insomnia, patient request, RN discretion, or any other complaint

Pharmacy didn't verify that order for some reason

Ativan 0.5-2mg IV or PO PRN nausea, vomiting, pain, anxiety, insomnia, patient request, RN discretion, or any other complaint

Pharmacy didn't verify that order for some reason

Former night nurse here. I can dig that order. ;)

From time to time I run into real gems of medical writing.

Levaquin 750 gm P.O. q. 48 hours for 2 more days

the trick is to find how many pills this will be

Can you?

Levaquin 750 g = 750,000 mg. Levaquin is typically supplied in 250 mg, 500 mg, and 750 mg. Assuming the pharmacy has the 750 mg stocked, then it would be 1,000 pills to be given every two days (48 hours) for two more days. Sounds legit.

I worked at a teaching hospital years ago when orders were hand written (no computer to prompt someone that the order may not be advisable). Each year we got a new set of interns. Without fail I would always get someone to want 40 mg of KCL IVP...no. It got old trying to justify the reason for clarification to this order.

diet orders for a patient with an NGT to LIS.

Respiratory or blood pressure parameters for a comfort measures only patient's Morphine

"Take vital signs at family discretion"

"Encourage abstinence" (from what, to begin with?)

"Do not extubate member" (postop Foley)

"CBC, CMP, LA, Mg, ABGs, blood culture times 2 q1h for 48h" (the whole thing takes, roughly, 30 cc of blood; 30x48=1440 cc... leaving alone everything else which is wrong with this insane order)

"STAT weaning protocol" (you mean, pull switch and let it be??)

"No sodium diet" (I can get "no salt", but "no sodium"?)

"No carbs, fats and sodium diet" (that was a dietary intern, to be honest. I called him and in very naive voice asked if plain water and 21% oxygen were OK).

"Encourage sexual education" (from poor MD soul who was tortured by the permanent question of when and how to have sex with comatose patient).

"Allow family to call for codes" (family was known to push blue button or disconnect vent if they needed a cup of ice and insisting that it was their right to do so).

These are hilarious. More, please.

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