The health care provider has ordered amoxicillin 250 mg PO q8h. The drug label states 125 mg amoxicillin per 5 mL. Based on this information, which of the following would be correct actions by the nurse? (Select all that apply.)
Administer 2.5 mL of amoxicillin per dose.
Administer 10 mL of amoxicillin per dose.
Administer the amoxicillin at 0800, 1200, and 1800.
Compare the patient's name and date of birth on the armband with the MAR.
Administer the medication by the parenteral route.
Correct Answer : C,D
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.
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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.
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.