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 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.
Correct Answer is C
Explanation
A) Use an automated medication dispensing system: While automated systems can enhance efficiency and reduce the risk of errors, they are not foolproof. Errors can still occur due to incorrect entries or malfunctions, so reliance solely on technology without further precautions may not be sufficient.
B) Avoid distractions and take time to prepare medications: Reducing distractions is important for maintaining focus during medication preparation. However, it is just one aspect of a comprehensive approach to medication safety. This practice alone does not encompass the necessary protocols that ensure the correct medication is administered.
C) Adhere to the 6 rights of medication administration: Following the 6 rights—right patient, right drug, right dose, right route, right time, and right documentation—is the most effective strategy for preventing medication errors. This systematic approach provides a framework for nurses to ensure accuracy and accountability in every medication administration.
D) Only give medications to patients who are alert and oriented: While it’s important to assess a patient's alertness before administering medications, this criterion alone does not address the various factors that can lead to medication errors. Patients may require medications even when not fully alert, and it is the nurse's responsibility to ensure safety through proper protocols rather than simply limiting administration based on alertness.