A nurse is preparing to administer a dose of ampicillin to a client. The nurse scans the medication and the client's identification band and realizes the client has a penicillin allergy. Which of the following should the nurse use to document the incident?
Medication reconciliation report
Root cause analysis form
Plan of care
Occurrence report
The Correct Answer is D
A. Medication reconciliation report: A medication reconciliation report is used to compare the client’s current medications with new prescriptions to prevent errors during transitions of care. It is not used to document incidents or near misses.
B. Root cause analysis form: A root cause analysis is a detailed process performed after a serious adverse event to determine underlying system issues. It is not the initial documentation tool for a single medication error or near-miss.
C. Plan of care: The plan of care outlines nursing interventions and goals for the client’s treatment. It is not used to record or report medication-related incidents.
D. Occurrence report: An occurrence (incident) report is the appropriate document for recording medication errors or near misses, such as discovering an allergy before administration. It provides information for quality improvement and risk management without becoming part of the client’s medical record.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "I should monitor the client's electrolytes.": Sodium polystyrene sulfonate (Kayexalate) exchanges sodium for potassium in the intestines, lowering serum potassium levels. Monitoring electrolytes is essential to evaluate therapeutic effectiveness and prevent imbalances such as hypokalemia or hypernatremia.
B. "Antacids can be taken with this medication.": Antacids containing calcium or magnesium can interfere with the medication’s ion-exchange mechanism and increase the risk of systemic absorption, leading to metabolic complications. They should be avoided.
C. "I should administer this medication intravenously.": Sodium polystyrene sulfonate is administered orally or rectally, not intravenously. IV administration would be unsafe and is contraindicated due to the drug’s formulation and mechanism.
D. "This medication is safe to take with sorbitol.": Concomitant use with sorbitol is avoided because it increases the risk of intestinal necrosis. These agents should not be used together due to their additive gastrointestinal effects.
Correct Answer is D
Explanation
A. Rapid rise in temperature: A sudden increase in body temperature is not associated with epidural anesthesia. This symptom is more characteristic of malignant hyperthermia, which occurs with certain general anesthetics, not regional anesthesia.
B. Hypertension: Epidural anesthesia typically causes vasodilation and hypotension rather than hypertension. Monitoring for a drop in blood pressure is more appropriate following this procedure.
C. Tachycardia: While mild tachycardia may occur as a compensatory response to hypotension, it is not a primary adverse effect of epidural anesthesia and usually resolves with fluid or position changes.
D. Severe headache: A severe headache can occur if cerebrospinal fluid leaks due to accidental dural puncture during epidural insertion. This post-dural puncture headache is a known adverse effect requiring monitoring and may necessitate interventions such as a blood patch.
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