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 ["A","B","D"]
Explanation
A) Notify the health care provider: It is essential to inform the healthcare provider if a
patient refuses a medication. This allows for a reassessment of the patient's treatment plan and ensures that any necessary follow-up or adjustments can be made based on the patient's refusal.
B) Determine the reason for refusal: Understanding why a patient refuses medication is crucial. It may be due to side effects, lack of understanding, personal beliefs, or concerns about the medication. Gathering this information can help the nurse address the patient’s concerns and educate them appropriately.
C) Administer the dose when the next dose is due: Administering a medication that the patient has refused would violate their rights and could be considered coercive. The patient has the right to refuse treatment, and the nurse should respect that decision rather than attempt to administer it later without consent.
D) Document the reason for refusal in the patient's health record: Accurate documentation is vital in healthcare. Recording the patient's refusal and the reason for it in their health record ensures continuity of care and provides information for other healthcare team members regarding the patient's preferences and concerns.
E) Mix it in a small amount of their food: This action is inappropriate and unethical. Coercively administering medication without the patient's consent undermines their autonomy and trust in the healthcare system. The nurse should always respect the patient’s right to refuse medication.