Safe Medication Administration Flashcards

A client is prescribed metoprolol (Lopressor) 50 mg oral twice daily. The heart rate is 48 bpm before administration. What should the practical nurse do?

Answer: Hold the medication, document the heart rate, and notify the physician

Metoprolol is a beta-blocker that slows heart rate. A pre-dose rate of 48 bpm (bradycardia) is a reason to hold the medication and notify the physician.

A client's INR result is 4.8 and they are prescribed warfarin. What should the practical nurse do?

Answer: Hold the warfarin dose and notify the physician with the INR result

INR 4.8 is supratherapeutic (therapeutic range is typically 2.0-3.0). Warfarin must be held and the physician notified.

A client is to receive amoxicillin (Amoxil) 500 mg. Available is amoxicillin 250 mg/5 mL oral suspension. How many mL should be administered?

Answer: 10 mL

500 mg divided by 250 mg multiplied by 5 mL = 10 mL.

A client receiving IV vancomycin develops diffuse flushing, erythema, and pruritus over the face and upper body during the infusion. No dyspnea or hypotension is noted. What should the practical nurse do?

Answer: Slow the infusion rate and notify the physician, consistent with Red Man Syndrome

Diffuse flushing, erythema, and pruritus during vancomycin without systemic signs is Red Man Syndrome, a rate-related reaction managed by slowing the infusion.

A client is prescribed insulin glargine (Lantus) 20 units at bedtime. Which practice is incorrect?

Answer: Mixing glargine with regular insulin in the same syringe

Insulin glargine (Lantus) must NEVER be mixed with other insulins as mixing alters its pH and destroys the long-acting profile.

Which high-alert medication requires a two-nurse independent double-check (IDC) per Canadian medication safety standards?

Answer: Concentrated electrolytes (e.g., KCl 40 mEq/100 mL IV)

Concentrated electrolytes (potassium chloride) are a high-alert medication per ISMP Canada and require independent double-check due to fatal error potential.