A nurse is transcribing new orders for a patient with constipation who was admitted by a resident physician after midnight. An order states "methylnaltrexone (Relistor) 8 mg subcutaneous injection QOD in the morning. Begin today." Regarding this order, which of the following is true?


•This order is invalid. The nurse should call the physician.

•Q.O.D., QOD, qod, Q.D., QD, q.d., and qd are all on the Joint Commission's official "Do Not Use" abbreviation list. They are easily mistaken for each other and the periods after Qs were occasionally mistaken for 1s, causing confusion. The Joint Commission requirement is to write out "every other day" or "daily" .

•Other unapproved abbreviations include MSO4, MgSO4, and MS, IU for international units, u for a unit, and trailing zeros or lack of leading zeros.

Incorrect options:

•This order is invalid. This medication should be given now and every other day, but only after the order is rewritten.

•This drug order does not indicate a once daily frequency. QD means once daily, but this abbreviation is also no longer accepted.

•This medication is an appropriate treatment for this patient. Methylnaltrexone (Relistor) is a subcutaneous injection that treats constipation caused by opioid pain medication. It is used when first line laxatives have been ineffective. This injection is given every other day.

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