Controlled substances have a potential for abuse and dependence and are categorized into schedules.Heroin is a medication in Schedule I and has no medical use in the United States. Medicationscategorized in Schedules II through V have approved applications. Each level has decreasing riskof abuse and dependence. For example, morphine sulfate (Duramorph) is a Schedule II medicationthat has a greater risk of abuse and dependence than phenobarbital (Luminal), which is a ScheduleIV medication.

Medication Reconciliation The Joint Commission requires policies and procedures for medication reconciliation. The nurseshould compile a list of current medications ensuring that all medications are included, withcorrect dosages and frequency. This list should be compared with new prescriptions and reconciledto resolve any discrepancies. This list becomes the current list from which medications should beadministered. This process should take place on admission, when transferring between units orfacilities, and at discharge.

Dosage changes are usually made gradually. Question the provider if abrupt and excessivechanges in dosages are made.

Evaluate client response to a medication, and document and report appropriately. Recognize side/adverse effects, and document and report appropriately. Report all errors, and implement corrective measures immediately. Complete an unusual occurrence report within the specified time frame, usually 24 hr. Thisreport should include:XX The clients identificationXX The name and dose of the medicationXX The time and place of the incidentXX An accurate and objective account of the eventXX Who was notifiedXX What actions were takenXX The signature of the person completing the report This report does not become a part of the clients

Depending on therapeutic intent, effectiveness may be evidenced by Decrease in pulmonary or peripheral edema Weight loss Decrease in blood pressure Increase in urine output