A nurse is reinforcing teaching about home safety needs for a toddler. Which of the following statements by the toddler's parents indicates an understanding of the teaching?

Rationale:

A. Withhold the medication until the provider signs the prescription: Waiting for the provider's signature before administering a telephone order may delay critical care. Verbal or telephone orders can be acted upon immediately if clearly understood, documented, and later signed by the provider within the facility’s required timeframe.

B. Record the date and time of the telephone prescription: Accurate documentation includes noting the date and time the telephone order was received. This ensures clarity, legal compliance, and proper sequencing of medical events in the client's record.

C. Request that the provider confirm the read-back of the prescription: A read-back process reduces the risk of medication errors by confirming that the nurse correctly heard and understood the provider’s order. It is a Joint Commission-recommended safety practice.

D. Ask the provider to spell out the name of the medication: Asking the provider to spell out high-risk or sound-alike medications helps avoid transcription errors. This step is especially important when communication clarity is compromised over the phone.

E. Instruct another nurse to record the prescription in the medical record: The nurse receiving the order is responsible for documenting it. Delegating this task to another nurse increases the chance of miscommunication and errors, and violates proper protocol.

Rationale:

A. Docusate: Docusate is a stool softener that does not interfere with coagulation or increase bleeding risk. It is often safely used in clients taking anticoagulants to prevent straining during bowel movements, which is especially important in post-operative or cardiovascular patients.

B. Cimetidine: While cimetidine may interact with some medications metabolized by the liver, it does not significantly affect bleeding risk when used with enoxaparin. However, it should still be used cautiously due to potential drug interactions and altered metabolism.

C. Calcium supplement: Calcium supplements do not interfere with the anticoagulant action of enoxaparin. They are commonly used for bone health and are generally safe, provided they are taken at recommended doses without excessive vitamin D.

D. Garlic: Garlic, especially in supplement form, can have antiplatelet effects and may increase the risk of bleeding when taken with anticoagulants like enoxaparin. Clients should be advised to avoid herbal products like garlic, ginkgo, or ginseng without provider approval.