Medication Administration

You are a new graduate nurse completing your orientation on a very busy intensive care unit. You cannot read a health care provider's order for one of your patient's medications. You have heard from more experienced nurses that this health care provider does not like to be called, and you know that another of the health care provider's patients is very unstable. What is the most appropriate next step for you to take?

• Call the health care provider to clarify the order

• Talk with your preceptor to help you interpret the order

• Refer to a medication manual before giving the medication

• Use your best judgment and critical thinking and administer the dose you think the health care provider ordered

A nurse admits a 72-year-old patient with a medical history of hypertension, heart failure, renal failure, and depression to a general medical patient care unit. The nurse reviews the patient's medication orders and notes that the patient has three health care providers who have ordered a total of 13 medications. What is the most appropriate action for the nurse to take next?

• Give the medications after identifying the patient using two patient identifiers

• Provide medication education to the patient to help with adherence to the medical plan

• Review the list of medications with the health care providers to ensure that the patient needs all 13 medications

• Set up a medication schedule for the patient that is least disruptive to the expected treatment schedule in the hospital

A nursing student is administering ampicillin PO. The expiration date on the medication wrapper was yesterday. What is the appropriate action for the nursing student to take next?

• Ask the nursing professor for advice

• Return the medication to pharmacy and get another tablet

• Call the health care provider after discussing this situation with the charge nurse

• Administer the medication since medications are good for 30 days after their expiration date

After receiving an intramuscular (IM) injection in the deltoid, a patient states, “My arm really hurts. It's burning and tingling where I got my injection. What should the nurse do next? (Select all that apply.)

• Assess the injection site

• Apply ice to the site for relief of burning pain

• Administer an oral medication for pain

• Notify the patient's health care provider of assessment findings

• Document assessment findings and related interventions in the patient's medical record

You are working in a health clinic on a college campus. You need to administer medroxyprogesterone acetate intramuscularly (IM) to a female patient for birth control. You look up this medication in a reference manual and determine that it is viscous and injections can be painful. On the basis of this information, you plan which of the following when administering this medication? (Select all that apply.)

• Inject the medication over 3 minutes to reduce pain associated with the injection

• Administer the medication in the ventral gluteal site

• Use the Z-track method when administering the medication

• Use the deltoid site for medication administration

• Ask the patient questions about her major and which classes she is taking during the injection to provide distraction

After seeing a patient, the health care provider starts to give a nursing student a verbal order for a new medication. The nursing student first needs to:

• Follow ISMP guidelines for safe medication abbreviations

• Explain to the health care provider that the order needs to be given to a registered nurse

• Write down the order on the patient's order sheet and read it back to the health care provider.

• Ensure that the six rights of medication administration are followed when giving the medication

A nurse accidently gives a patient the medications that were ordered for the patient's roommate. What is the nurse's first priority?

• Complete an occurrence report

• Notify the health care provider

• Inform the charge nurse of the error

• Assess the patient for adverse effects.