If the patient refuses a medication, what should the nurse do? (Select all that apply.)
Notify the health care provider.
Determine the reason for refusal.
Administer the dose when the next dose is due.
Document the reason for refusal in the patient's health record.
Mix it in a small amount of their food.
Correct Answer : A,B,D
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.
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Correct Answer is ["B","C","D"]
Explanation
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
Correct Answer is ["C","D"]
Explanation
A) Administer 2.5 mL of amoxicillin per dose: This option is incorrect because administering 2.5 mL would only provide 62.5 mg of amoxicillin (since 125 mg is in 5 mL). The prescribed dose is 250 mg, so this volume is insufficient.
B) Administer 10 mL of amoxicillin per dose: This option is also incorrect. Administering 10 mL would provide 250 mg of amoxicillin (since 125 mg is in 5 mL, 10 mL equals 250 mg). However, this option may confuse the correct volume with a miscalculation if misunderstood in context, so it should not be selected without a proper calculation verification.
C) Administer the amoxicillin at 0800, 1200, and 1800: This option is correct. Administering the medication every 8 hours at these times ensures that the medication is given according to the prescribed schedule, maintaining appropriate therapeutic levels.
D) Compare the patient's name and date of birth on the armband with the MAR: This action is crucial for ensuring patient safety. Verifying patient identifiers against the MAR helps prevent medication errors and ensures that the right patient receives the correct medication.
E) Administer the medication by the parenteral route: This option is incorrect. The order specifies oral (PO) administration of amoxicillin, so administering it parenterally would not align with the prescribed route and could lead to incorrect dosing or complications.