Safe Medication Administration Flashcards

A practical nurse is preparing to administer a high-alert medication, such as insulin. According to the Institute for Safe Medication Practices (ISMP) Canada, which of the following actions is a critical safety step?

Answer: Performing an independent double-check with another regulated healthcare professional.

ISMP Canada identifies high-alert medications as those that bear a heightened risk of causing significant patient harm when used in error. A key recommended safeguard is the use of independent double-checks for these medications to reduce the likelihood of errors reaching the patient.

A client is prescribed a new antihypertensive medication. After administering the first dose, the practical nurse should prioritize monitoring for which of the following?

Answer: Adverse effects

While all options are important aspects of medication management, the immediate priority after administering the first dose of a new medication is to monitor for any adverse effects, such as orthostatic hypotension with an antihypertensive, which could pose an immediate safety risk to the client. The LPN must have the knowledge to manage adverse reactions.

A practical nurse receives a telephone order from a physician for a client. Which of the following actions by the nurse best ensures accuracy and client safety?

Answer: Repeating the order back to the physician for verification before ending the call.

To prevent errors with verbal or telephone orders, the best practice is to write the order down verbatim and then read it back to the prescriber for confirmation. This "read-back" process is a crucial safety check to ensure the nurse heard and transcribed the order correctly before administration. If an order is unclear or incomplete, the LPN must contact the authorized prescriber for clarification.

When a practical nurse is performing the three checks of medication administration, which of the following is the correct procedure?

Answer: Check the medication label against the MAR when removing it from the dispenser, when preparing it, and at the bedside before administering it.

The three checks of medication administration are a fundamental safety protocol. The nurse must check the medication against the Medication Administration Record (MAR) three times: 1) when taking the medication from its storage location, 2) when preparing or pouring the medication, and 3) at the client's bedside just before administering it.

A client refuses to take their prescribed morning dose of an oral medication, stating, "I don't want to take that pill today." What is the practical nurse's most appropriate initial action?

Answer: Exploring the client's reason for the refusal.

Clients have the right to refuse medication. The nurse's first responsibility is to assess the situation by exploring the client's reasons for refusal. This demonstrates respect for client autonomy and allows the nurse to identify and address any misunderstandings, concerns, or adverse effects the client may be experiencing before taking further action.

A practical nurse notes that a physician's handwritten order in a client's chart is illegible. What is the most appropriate action for the nurse to take?

Answer: Contact the prescribing physician directly to clarify the order.

To ensure client safety and prevent medication errors, the practical nurse must never guess or assume what an illegible order says. The only safe and acceptable action is to contact the original prescriber for clarification before preparing or administering the medication.