The nurse administered a routine scheduled medication of Prozac (fluoxetine hydrochloride), an antidepressant, 20 mg PO to a patient. The nurse checked the medication label against the MAR when getting it out of the automatic dispensing system, again when placing the medication in a cup, and once more at the patient's bedside prior to administration. The label read 20 mg and contained a single capsule. The nurse asked the patient to state her name and administered the medication, offering the patient a drink of water. The nurse documented the administration of the medication. Which of the six rights of medication administration did the nurse violate?
The nurse administered the medication correctly.
The nurse did not have a second nurse verify the dose.
The nurse did not make the appropriate number of checks for the right drug.
The nurse did not use two patient identifiers.
The Correct Answer is D
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.
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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 ["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.