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 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.
Correct Answer is D
Explanation
A) 2: Administering 2 mL of Compazine would provide a total dose of 10 mg (since the concentration is 5 mg/mL), which exceeds the ordered dose of 2.5 mg. This option is incorrect as it would administer too much medication.
B) 1.5: This option suggests giving 1.5 mL, which would equate to 7.5 mg (1.5 mL x 5 mg/mL). This dosage also exceeds the ordered 2.5 mg and is therefore not appropriate.
C) 1: Administering 1 mL would deliver 5 mg of Compazine. This amount is higher than the prescribed 2.5 mg and is not the correct dose.
D) 0.5: This option is correct. Administering 0.5 mL of Compazine would provide a dose of 2.5 mg (0.5 mL x 5 mg/mL). This matches the ordered dosage perfectly, ensuring that the patient receives the correct amount of medication.