The patient is to receive 120 mg of PO Lasix (furosemide). The drug book states that the usual dosage is 20 to 40 mg. What steps should the nurse take to avoid medication errors in this situation? (Select all that apply.)
Only administer 40 mg.
Use at least two patient identifiers whenever administering a medication.
Read labels at least two times to make sure it is the correct medication.
Double-check all calculations.
Question unusually large or small doses.
Correct Answer : B,C,D,E
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.
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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.
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.