When giving medications, which action would be a med error?
Giving Lasix 20mg IV when Lasix 20mg PO was ordered
Administering an 1800 dose at 1820
Measuring 5 mL of vancomycin hydrochloride when 5 mL is ordered
Giving 2 tablets of Clindamycin 500mg when Clindamycin 1 gram is ordered?
The Correct Answer is A
A. Giving Lasix 20mg IV when Lasix 20mg PO was ordered.: Administering a medication by the wrong route is considered a medication error because IV and PO routes differ in absorption rate and potency. Giving Lasix intravenously instead of orally could result in rapid diuresis, electrolyte imbalance, or hypotension, posing a safety risk to the patient.
B. Administering an 1800 dose at 1820.: A 20-minute delay is within an acceptable time frame for most scheduled medications, as institutional policies often allow a 30-minute window before or after the scheduled time.
C. Measuring 5 mL of vancomycin hydrochloride when 5 mL is ordered.: Accurately measuring and administering the exact ordered amount follows correct medication administration practices. This action reflects adherence to the order, not an error.
D. Giving 2 tablets of Clindamycin 500mg when Clindamycin 1 gram is ordered.: This is appropriate because two 500 mg tablets equal the prescribed 1 gram dose. Administering the correct total dose, even in divided tablet form, is not an error.
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Related Questions
Correct Answer is D
Explanation
A. Defer the calculation process to the physician.: It is the nurse’s professional responsibility to calculate and verify medication dosages before administration. Deferring this task to the physician compromises accountability.
B. Call the pharmacy to provide the appropriate calculations.: While pharmacists can assist with complex dosing, the nurse should independently perform and verify dosage calculations. Relying solely on the pharmacy removes a critical safety check within the medication administration process.
C. Consult a current drug book to confirm the new dosage.: Referring to a drug reference is an excellent step for verifying safe dosage ranges and medication information but does not replace the need for independent dose calculation verification.
D. Have another licensed nurse confirm the calculation.: The best way to minimize error is to double-check the dosage with another licensed nurse. Independent verification ensures accuracy, particularly for high-risk medications such as insulin, heparin, and opioids, enhancing overall medication safety.
Correct Answer is D
Explanation
A. Capsule.: Most capsules should not be crushed because they are designed to release the drug in a specific way, such as extended or delayed release. Crushing or opening them can alter absorption, reduce effectiveness, or increase the risk of side effects.
B. Enteric-coated tablet.: Enteric-coated tablets must not be crushed as their coating protects the drug from stomach acid and prevents gastric irritation. Crushing removes this protective layer, causing premature drug release in the stomach and potential mucosal damage.
C. Buccal tablet.: Buccal tablets are formulated to dissolve slowly in the mouth for direct absorption through the oral mucosa. Crushing them would destroy their delivery mechanism and render them ineffective.
D. Scored tablet.: Scored tablets are specifically designed to be safely split or crushed when necessary. The score mark indicates that the medication can be divided without affecting its stability or pharmacologic properties.
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