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Difficulty: HardAccident, Error, and Injury Prevention

A practical nurse (PN) is preparing to administer scheduled morning medications to a 72-year-old client who has early-stage dementia and bilateral cataracts. The client touches the medication cup and states, "At home, my blood pressure pill is always a small yellow oval, but this feels like a large round tablet." What is the PN's most appropriate action to prevent a medication error?

  1. Suspend the medication administration, verify the client using two identifiers, and cross-reference the medication label with the Medication Administration Record (MAR).Answer
  2. B
    Inform the client that the hospital pharmacy uses a different generic manufacturer, causing the pill's shape and size to vary.
  3. C
    Attribute the client's statement to their documented cognitive decline and proceed with administering the prescribed medication.
  4. D
    Request that the unlicensed assistive personnel (UAP) contact the facility pharmacy to verify the correct physical appearance of the medication.

Answer

Suspend the medication administration, verify the client using two identifiers, and cross-reference the medication label with the Medication Administration Record (MAR).
The correct answer emphasizes that when a client questions the appearance, dose, or purpose of a medication, the nurse must immediately stop the administration process. The nurse must then re-verify the medication prescription against the Medication Administration Record (MAR), re-check the drug label, and verify the client using two identifiers. This strict adherence to the rights of medication administration is the most effective way to prevent errors. Clients should always be treated as active participants in their safety, and their concerns must never be dismissed simply due to mild cognitive or sensory deficits.

Step-by-Step Solution

1
Analyze the client's statement regarding the medication's physical appearance.
The client has identified a discrepancy between their routine home medication and the hospital-dispensed medication.
Clients, even those with early cognitive decline or sensory deficits, serve as a critical final barrier in preventing medication errors. Their concerns must always be investigated.
2
Identify the immediate priority to ensure client safety.
The administration process must be halted.
Proceeding with administration when a discrepancy is noted risks administering the wrong medication, violating the fundamental rights of medication administration.
3
Determine the appropriate independent nursing action to resolve the discrepancy.
The PN must independently re-verify the client's identity and the medication against the MAR.
This action confirms whether a dispensing error has occurred or if the physical variation is simply due to a different generic formulation.

Key Concept

Medication Error Prevention and Client Advocacy
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Topics

Accident, Error, and Injury Prevention

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