Question

Case 1 please answer and explain how you found the answer, typed, please. Thank you

Ms. Silts is complaining of nausea. You note an antiemetic medication on her MAR:

promethazine, 12.5 mg, IM, q6hr, PRN for nausea

You have the following medication vial available: Phenergan Injection, 50 mg/ml, for deep intramuscular use only, 25x 1 Ml vials (I put the info of the medication just in case the picture won't show here)

1.Describe the process of administering this medication.

2. How many milliliters will you administer?

3. A fellow nurse prepared this medication out of your sight, and is now asking you to administer the medication for them. What would you do?

4. An hour after administration, Ms. Silts reports itching. You find that she has hives on her chest, increased restlessness, and anxiety. What are your next nursing actions and why?

Answer 1

Ans) 1) Process of medication administration:

Stage 1: Ordering and prescribing

Promethazine 12.5mg IM, q6hr, PRN for nausea.

Stage 2: Transcribing and verifying

Follow the instructions properly.

Stage 3: Dispensing and delivering

Order the promethazine ampule from pharmacy.

Stage 4: Administering

Properly follow 10 rights of Medication administration.

Right Patient, Right Drug, Right Dose, Right Route, Right time, Right Assessment, Right Evaluation, Right Education, Right Documentation, Right to Refuse.

Stage 5: Monitoring

Evaluate the medication desired action & possible side effects.

2) Order: Promethazine 12.5 mg, IM, q6hr, PRN for nausea.

Available: Phenargan 50 mg/ ml so to administer 12.5 mg dose as Phenargan is Promethazine only. so,

50= 1

12.5= x

Let x be the dose in ml

x= 12.5/50 = 0.25 ML

Ans) Inorder to administer the ordered dose, O.25 ml must be administered every 6th hrly I.e. 6am- 12pm- 6am- 12am, route Intramuscular.

3)If the nurse prepares the medication & asking me for to administer, I firstly will say no as this medication is prepared out of my sight & without being sure of what she has prepared, I won't administer it instead I would accompy her to the patient & tell her to administer in front of me.

4) An hour after administration, patient reports itching, hives on chest, increased restlessness and anxiety.

Firstly make patient comfortable on bed with side railings up & bed height low. Then take vital signs & inform Doctor about it.

- If Doctor prescribes something carry on the required treatment & then assess patient after every 10-15 mins.

- Inform the incident to the nursing supervisor.

- Fill in CQI form & Adverse drug Reaction form, carefully note the vials batch no. Expiry date, manufacture date, etc.

- Root cause analysis.