Question

The nurse determines that the transcribed dose of hydromorphone (Dilaudid) on the medication record of the oncology client is not within a safe range. Which action should the nurse take first? ? A. Verify the order was transcribed correctly ? B. Give the dose anyway because client is terminal ? C. Alter the dose to the recommended amount ? D. Call the pharmacy to approve the dosage

Short answer

Answer: A. Verify the order was transcribed correctly

Step-by-step solution

Understand the Situation

In this case, the nurse realizes that the dose of hydromorphone for an oncology client is not within a safe range. The nurse's primary concern should always be the safety and well-being of the patient.

Evaluate the Options

Let's look at each option and evaluate whether it aligns with the nurse's responsibilities in this situation.

Option A: Verify the order was transcribed correctly

The nurse should first determine whether the prescribed dosage was accurately documented. Checking for transcription errors helps ensure the correct dosage is administered and guides the decision-making process for any other necessary actions.

Option B: Give the dose anyway because the client is terminal

It is not within the professional duties of a nurse to make decisions based solely on the client's prognosis. Nurses should ensure that they are providing safe and effective care to patients, regardless of prognosis. This option contradicts the code of ethics in nursing, so we can eliminate this choice.

Option C: Alter the dose to the recommended amount

Nurses should avoid independently altering the prescribed dosage without consulting a doctor or pharmacist. This action may lead to further complications or improper treatment. It is not within the nurse's scope of practice to adjust medication dosages without proper authorization.

Option D: Call the pharmacy to approve the dosage

This alternative might seem like an appropriate action; however, it is important to remember that the priority is to verify if there is a transcription error. The correct procedure would be first to confirm the initial order and then consult with the pharmacy if necessary.

Conclusion

Based on the analysis of the provided choices, the correct answer is: ? A. Verify the order was transcribed correctly

Key concepts

Patient Safety

When it comes to nursing, patient safety is paramount. A nurse's role involves vigilant assessment and prioritization of actions that protect the patient from harm.
One critical element of patient safety is ensuring that medications are administered correctly. An error in medication dosing can lead to severe consequences. Therefore, nurses must always verify medication orders thoroughly.
In the context of administering medication, nurses should:

• Confirm the accuracy of the medication order, as incorrect transcription or interpretation can cause dosage errors.
• Assess each patient's individual needs and circumstances, considering factors such as allergies or interactions with other medications.
• Report and correct any discrepancies found between the prescribed drug order and the actual medication record.

By following these steps, a nurse ensures the safety and improves the quality of care provided to patients.

Medication Administration

Medication administration involves both precision and care. The process begins long before the medication is given to the patient, with transcription accuracy being a crucial responsibility.
Misinterpretations can lead to incorrect dosages, posing potential risks. Here's what effective medication administration involves:

• Double-checking physician's orders and ensuring they are transcribed accurately into the patient's medication record.
• Utilizing the "Five Rights" of medication administration: right patient, right medication, right dose, right route, and right time.
• Recognizing and questioning any dosages that do not seem appropriate to safeguard against potentially harmful errors.

These practices not only enhance patient care but also support best practices in nursing by reducing the risk of medication errors.

Nurse Responsibilities

Nurses hold a multitude of responsibilities that are pivotal to patient care and safety. Understanding and executing these responsibilities help to create a secure environment for patients.
Key responsibilities include:

• Interpreting and verifying medication orders accurately to prevent errors.
• Communicating any discrepancies or uncertainties with a physician or pharmacy.
• Maintaining and updating patient records to reflect current medication and treatment plans.
• Engaging in continuous education to stay informed about best practices in medication administration and patient safety procedures.

Fulfilling these duties enables nurses to provide comprehensive, safe, and effective care, reinforcing the trust and reliance placed on their professional judgment.