How can the nurse determine a patient's history of allergies? (Select all that apply.)
By looking at the MAR
By asking the patient
By looking at the patient's allergy bracelet
By looking at the front of the chart or in the patient's electronic health record (EHR)
By administering a dose and monitoring the patient's response
Correct Answer : B,C,D
A. By looking at the MAR: The Medication Administration Record (MAR) is primarily for documenting medications administered, and while it may note some allergies, it is not a comprehensive source for a patient's allergy history.
B. By asking the patient: Directly inquiring about a patient's allergies is one of the most effective methods to gather accurate and specific information. Patients can detail their allergies to medications, foods, and other substances, which might not be documented elsewhere.
C. By looking at the patient's allergy bracelet: An allergy bracelet provides immediate visual identification of known allergies. It serves as an important safety mechanism for healthcare providers to avoid administering any allergens.
D. By looking at the front of the chart or in the patient's electronic health record (EHR): This is a reliable way to find documented allergies. The front of the chart or the EHR often contains essential information about a patient's allergies, which helps inform safe medication administration and treatment planning.
E. By administering a dose and monitoring the patient's response: This method is unsafe and inappropriate. Administering a medication without prior knowledge of allergies could lead to serious and potentially life-threatening reactions. It is critical to know allergy history before any medication administration
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Correct Answer is ["B","C","D","E"]
Explanation
A) Only administer 40 mg: This option is not appropriate without consulting the healthcare provider. Simply administering a smaller dose without confirming the rationale behind the prescribed 120 mg could result in inadequate treatment for the patient.
B) Use at least two patient identifiers whenever administering a medication: Utilizing two patient identifiers (such as name and date of birth) is essential to ensure that the medication is administered to the correct patient. This step is a key practice in medication safety to prevent errors.
C) Read labels at least two times to make sure it is the correct medication: Carefully reading labels at least twice helps confirm that the nurse is administering the correct medication and dosage. This practice reduces the risk of errors and ensures that the right drug is given.
D) Double-check all calculations: Verifying calculations is critical, especially when dealing with high doses or unusual orders. This step ensures accuracy in the dosage administered and helps prevent medication errors that could lead to toxicity or ineffective treatment.
E) Question unusually large or small doses: It is essential to question any dosage that appears significantly outside the usual range, such as the prescribed 120 mg of Lasix, which exceeds the standard dosing guidelines. Consulting with the healthcare provider for clarification is crucial in such cases to ensure patient safety.
Correct Answer is D
Explanation
A) "You could create problems for your family if you don't manage your health.": While this statement highlights the potential impact on family, it may not effectively address the patient's concerns or motivations. This response could come across as judgmental rather than supportive.
B) "You could possibly suffer a stroke if you don't manage your blood pressure.": Although this response underscores the seriousness of uncontrolled hypertension, it might induce fear without encouraging a constructive dialogue about the patient's reasons for discontinuing the medication.
C) "Have you had your blood pressure checked since discontinuing this medication?": This question is relevant but does not directly address the patient's decision to stop taking the medication. It misses an opportunity to explore the underlying reasons behind the patient's choice.
D) "What is the reason you are no longer taking the blood pressure medication?": This response is the most effective because it opens a dialogue for the patient to express his feelings or concerns about the medication. Understanding the patient's perspective allows the nurse to provide better education and support tailored to the patient's needs, potentially addressing any misconceptions or side effects that may have influenced the decision.