Which numeric form is appropriate, according to the Joint Commission?
3.0
0.30
0.03
0.3
Calculate all drug dosages by body surface area.
The Correct Answer is D
This numeric form is appropriate, according to the Joint Commission, because it does not use a trailing zero after a decimal point, which is a common cause of medication errors and should be avoided. A trailing zero may be misread or misinterpreted as a larger dose or omited altogether, resulting in a 10-fold overdose or underdose, respectively. For example, when prescriptions have been writen for "Coumadin 1.0 mg," patients have received 10 mg in error¹². Therefore, the Joint Commission requires that a trailing zero may be used only when required to demonstrate the level of precision of the value being reported, such as for laboratory results, imaging studies that report the size of lesions, or catheter/tube sizes. It may not be used in medication orders or other medication-related documentation.
The other options are not appropriate numeric forms because:
a) 3.0 uses a trailing zero after a decimal point, which poses a risk of confusion or error.
b) 0.30 uses a trailing zero after a decimal point, which poses a risk of confusion or error.
c) 0.03 is not equivalent to 0.3, as it is 10 times smaller.
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Correct Answer is D
Explanation
This action should be taken by the nurse before administering the medication because the use of a trailing zero after a decimal point (5.0 mg) is a common cause of medication errors and should be avoided. A trailing zero may be misread or misinterpreted as a larger dose (50 mg) or omited altogether, resulting in a 10-fold overdose or underdose, respectively. For example, when prescriptions have been writen for "Coumadin 1.0 mg," patients have received 10 mg in error. Therefore, the nurse should clarify the intended dose with the healthcare provider and use the correct notation (5 mg) without a trailing zero.
The other options are not appropriate actions because:
a) Discussing the use of PO (by mouth) with the healthcare provider is not necessary, as PO is a standard route of administration for Haldol (haloperidol) and does not pose a risk of confusion or error.
b) Discussing the use of tid (three times a day) with the healthcare provider is not necessary, as tid is a standard frequency of administration for Haldol and does not pose a risk of confusion or error.
c) Discussing the use of Haldol with the healthcare provider is not relevant to the question, as Haldol is the prescribed medication for the patient who is agitated and does not need to be changed or questioned by the nurse.
Correct Answer is A
Explanation
To calculate the dose in milligrams per hour, we need to convert the patient's weight from pounds to kilograms.
Patient's weight: 110 lb
To convert pounds to kilograms, we use the conversion factor: 1 lb = 0.4536 kg
Patient's weight in kilograms: 110 lb * 0.4536 kg/lb = 49.895 kg (rounded to 3 decimal places
The physician has ordered Dobutamine at a dose of 10 mcg/kg/min.
Dose required = 10 mcg/kg/min * 49.895 kg = 498.95 mcg/min
Next, we need to convert the dose from micrograms to milligrams.
498.95 mcg/min = 0.49895 mg/min
Finally, to determine the dose in milligrams per hour, we multiply the dose in milligrams per minute by 60 minutes to convert it to an hourly rate.
0.49895 mg/min * 60 min/hr = 29.937 mg/hr (rounded to 3 decimal places)
Therefore, the correct answer is:
a. 30 mg/hr
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