An employee asks the occupational health nurse about measures to prevent inhalation exposure of job-related substances.

Which of the following explanations should the nurse include?

Choice A rationale
While ensuring that nurses demonstrate competency by passing a medication administration test is important, it is not the first step in developing a program to decrease medication administration errors. This strategy focuses on the individual skills of the nurses, but does not address the systemic issues that may have contributed to the errors.
Choice B rationale
Reviewing the circumstances leading up to each medication error is the first step in understanding why the errors occurred. This process allows the committee to identify patterns and common factors that contribute to errors. It is a crucial step in the development of effective strategies to prevent future errors.
Choice C rationale
Developing a quality improvement program for nurses involved in medication errors is a strategy that could be implemented after understanding the root causes of the errors. This approach ensures that the program addresses the specific issues that led to the errors.
Choice D rationale
Conducting an in-service training on medication administration for all nurses is a valuable strategy for preventing medication errors. However, it should be based on the findings from the review of the circumstances leading up to each error. Therefore, it is not the first strategy to consider.

Choice A rationale
A PTT of 70 seconds (control 25-40) indicates that the patient’s blood is taking longer than normal to clot, which could increase the risk of bleeding. This could be a sign of excessive anticoagulation from the Heparin infusion.
Choice B rationale
Ecchymosis at the venipuncture site could be a sign of bleeding under the skin, which could indicate that the patient is receiving too much Heparin.
Choice C rationale
Hematuria, or blood in the urine, could be a sign of bleeding in the urinary tract, which could be a side effect of Heparin therapy.
Choice D rationale
If there is an order for Coumadin 2.5 mg to start today, the healthcare provider should be notified. Coumadin and Heparin are both anticoagulants, and using them together could increase the risk of bleeding.