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","E"]
Explanation
A) Only administer 40 mg: This option is not appropriate without consulting the healthcare provider. Simply administering a smaller dose without confirming the rationale behind the prescribed 120 mg could result in inadequate treatment for the patient.
B) Use at least two patient identifiers whenever administering a medication: Utilizing two patient identifiers (such as name and date of birth) is essential to ensure that the medication is administered to the correct patient. This step is a key practice in medication safety to prevent errors.
C) Read labels at least two times to make sure it is the correct medication: Carefully reading labels at least twice helps confirm that the nurse is administering the correct medication and dosage. This practice reduces the risk of errors and ensures that the right drug is given.
D) Double-check all calculations: Verifying calculations is critical, especially when dealing with high doses or unusual orders. This step ensures accuracy in the dosage administered and helps prevent medication errors that could lead to toxicity or ineffective treatment.
E) Question unusually large or small doses: It is essential to question any dosage that appears significantly outside the usual range, such as the prescribed 120 mg of Lasix, which exceeds the standard dosing guidelines. Consulting with the healthcare provider for clarification is crucial in such cases to ensure patient safety.
Correct Answer is ["A","C","F","G","I","J"]
Explanation
A. The right patient: Identifying the correct patient is crucial to prevent medication errors. This typically involves using at least two identifiers, such as the patient's name and date of birth, to ensure the right person receives the medication.
B. The right MAR: While the Medication Administration Record (MAR) is essential for tracking medication administration, it is not classified as one of the six rights.
C. The right route: Administering medication via the appropriate route (e.g., oral, intravenous) is vital for the drug's effectiveness. Different routes can affect absorption and efficacy, making this a key component of safe medication administration.
D. The right expiration date: Although checking the expiration date is important for safety, it is not part of the core six rights of medication administration.
E. The right health care provider: While appropriate prescribing is important, this does not fall under the six rights of medication administration.
F. The right dose: Confirming the correct dose is essential to avoid potential toxicity or ineffective treatment. Dosage calculations must be precise, considering the patient's age, weight, and clinical condition.
G. The right documentation: Accurate documentation of medication administration is crucial for continuity of care. It helps ensure that all healthcare providers are informed of what medications have been given, thereby preventing duplicate doses or missed medications.
H. The right conversion factor: While conversions may be necessary for dosing, this is not considered one of the six rights.
I. The right medication: Verifying the correct medication is fundamental to patient safety. This involves checking the medication label against the MAR to prevent administering the wrong drug, which could have serious consequences.
J. The right time: Administering medications at the correct scheduled times is essential for maintaining therapeutic drug levels in the body. Timely administration helps ensure that the medication works effectively and enhances patient adherence to their treatment plan.