Medication Administration

During medication administration how can the nurse properly confirm he or she has the right patient?

• Ask the patient to state their last name and compared this to the patient's ID arm band.

• Ask the patient to state their full name along with their date of birth and compare this information to the medication administration record and the patient's ID arm band.

• Ask the patient to state their full name and compare this information to the medication administration record and the patient's ID arm band.

• Ask the patient to state their full name and compare this to the patient's ID arm band.

Answer explanation

To confirm you have the right patient the nurse needs to use at least two patient identifiers. Full name and birthday is sufficient.

The nurse notes in the MAR that the patient was ordered to take Acetazolamide 500 mg. The nurse checks the medication packaging on hand and finds it contains Acetohexamide 500 mg. The nurse is assessing which "Rights of Medication Administration", and what should be the next nursing action?

• Right Route and Right Dosage; hold dose and notify pharmacy

• Right Dosage and Right Time; administer the medication on hand

• Right Medication and Right Dosage; administer the medication on hand

• Right Medication and Right Dosage; hold dose and notify pharmacy

Answer explanation

The nurse checked the Right Medication and Right Dosage. Due to this safety check of the medication administration rights, the nurse should note that the medication on hand is not the same medication ordered. The medication names are very similar: acetaZOLAMIDE (diuretic) acetoHEXAMIDE (treats diabetes and helps lower blood glucose}

You received a new medication order on a patient for the treatment of glaucoma. The patient has no other health history and is allergic to Penicillin. The order says to administer Timolol 0.25% 1 gtt twice a day. Your NEXT action is to:

• Administer the medication as ordered.

• Confirm you have been dispensed with the right medication before administering the medication and then administer the medication.

• Hold the order until you can obtain an order clarification from the prescribing physician.

• Educate the patient on how to perform punctual occlusion before administering the medication.

Answer explanation

The order the nurse received is incomplete. When assessing the medication administration rights the nurse will note that the order fails to specify the route (hence which eye the drops should be instilled in). The nurse needs an order clarification before continuing.

A patient is scheduled to take three medications at 1000. The nurse confirms the following about each medication: right medication, right dose, right time, right route, and right documentation. When thinking of the first 6 Rights of Medication Administration what "right" is the nurse missing?

• Right Site

• Right Assessment

• Right Reason

• Right Patient

Answer explanation

Right Patient is missing. The nurse needs to confirm they have the right patient for these medications. The first 5 Rights of Medication Administration include: Right Patient, Right Medications, Right Doses, Right Time, and Right Route

True or False: The purpose of the medication administration rights is to help prevent medication errors.

• True

• False

A nurse administers a dose of an oral medication for hypertension to a patient who immediately vomits after swallowing the pill. What would be the appropriate initial action of the nurse in this situation?

• Readminister the medication and notify the provider

• Readminister the pill in a liquid form if possible

• Assess the vomit, looking for the pill. Then, notify the provider

• Notify the primary care provider

Answer explanation

If a patient vomits immediately after swallowing an oral pill, the nurse should assess the vomit for the pill or fragments of it. Then, the nurse should notify the provider to see if another dosage should be administered.

A medication order reads: "K-Dur, 20 mEq po BID." When and how does the nurse correctly give this medication?

• Daily at bedtime by subcutaneous route

• Every other day by mouth

• Twice a day by the oral route

• Once a week by transdermal patch

A health care provider orders a pain medication for a postoperative patient that is a PRN order. When would the nurse administer this medication?

• A single dose during the postoperative period

• Doses administered as needed for pain relief

• One dose administered immediately

• Doses routinely administered as a standing order

Answer explanation

PRN is on an as needed basis as requested by the patient

A nurse discovers that a medication error occurred. What should be the nurse's first response?

• Record the error on the medication sheet

• Notify the physician regarding course of action

• Check the patient's condition to note any possible effect of the error

• Complete an incident report, explaining how the mistake was made

Answer explanation

The nurse's first responsibility is the patient - careful observation is necessary to assess for any effect of the medication error. The other nursing actions are pertinent, but only after checking the patient' welfare.

The patient has an order for hydromorphone, 2 mg, IV, q4 hours PRN pain. The nurse notes that according to the patient's chart, the patient is allergic to hydromorphone. The order for medication was by Dr. Long. What would be the correct procedure for the nurse to follow in this situation?

• Administer the medication; the doctor is responsible for medication administration.

• Call Dr. Long and ask that the medication be changed.

• Ask the supervisor to administer the medication.

• Ask the pharmacist to provide a medication to take the place of hydromorphone.

Answer explanation

The nurse is responsible for any medications given and must inform the doctor of the patient's allergy to the drug. The nurse should not give the medication and might speak with the supervisor only if uncomfortable with the health care provider's answer when notified. The nurse is legally unable to order a replacement medication, as is the pharmacist.