Question

Nurse M, is caring for a 71 year old female client R S on the midnight shift (11p-7a 2300-0700) at the local hospital.

Client R S has a history of Depression, Chronic obstructive pulmonary disease (COPD), and Congestive Heart Failure(CHF). R S was admitted earlier with shortness of breath, to rule out (R/O) pneumonia, and to rule out acute exacerbation of CHF. Client R S is stable at this time.

Upon reconciling mediations for R S, the nurse observes that she takes the following medications at home:

furosemide (lasix) 20mg by mouth daily

fluticasone propionate and salmeterol (advair) 1 puff Q12H

lisinopril (zestril) 20mg by mouth Q day

clopidogrel (plavix) 75mg by mouth daily

It is now 0100 (1am) and RS is scheduled for furosemide (lasix) 20mg IV push and it is not in the medication drawer for R S. Nurse M. asks a fellow RN what to do. Busy, the other nurse states “we have extra doses in the cabinet in back, it comes in a brown bottle, use that.” Nurse M. locates the brown bottles labeled furosemide (lasix) 40 mg/5ml and examines R S's Medication Administration Record (MAR). Nurse M withdraws 2.5ml and prepares to administer it to R S.

1- What laboratory results should Nurse M. consider prior to administering?

2- In light of the above scenario what may contribute to a medication error?

3- Is there any other resource or personnel involved in safe medication administration that Nurse M can consult regarding medication administration other than her co-worker that is busy, if so, who?

Answer 1

1, Lab results should nurse M consider prior to the administration include serum electrolytes, liver function test, and kidney function test, serum glucose, uric acid levels.
2, Mechanism of action differs for each dose strength. balanced prescribing the mechanism of action of the drug should be followed in order to avoid medication error. strength of the 40mg furosemide will differ for the patient disease condition that causes medication error. the choice wrong route, wrong drug, wrong dosage cause medication error.
3, The nurse could have to consult the physician for the medication administration other than her co-worker. It provide safe medication administration when prescribed medication followed. It avoids medication error and risk for the patient.