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 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) "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.