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 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.
Correct Answer is D
Explanation
A) The nurse administered the medication correctly: While the nurse followed many of the correct procedures, this option overlooks the critical issue of patient identification. The nurse's adherence to the six rights is not complete without the appropriate verification of the patient’s identity.
B) The nurse did not have a second nurse verify the dose: While having a second nurse verify high-risk medications is a good practice, it is not a strict requirement for every medication. The focus should be on the established protocols for verification rather than a blanket requirement for all doses.
C) The nurse did not make the appropriate number of checks for the right drug: The nurse followed proper procedures by checking the medication label multiple times against the MAR and at the bedside. Therefore, this option does not accurately reflect any violation.
D) The nurse did not use two patient identifiers: Although the nurse asked the patient to state her name, this alone does not constitute using two identifiers. The best practice is to confirm at least two identifiers (e.g., name and date of birth) to ensure the correct patient receives the medication. This oversight is a violation of the right patient in the medication administration process.