Question

PN 200 Fundamentals of Nursing IT Critical Thinking: Medication Error Prevention Name Date: Precise measurement of doses in I mL and 3mL syringes. In the following situation an incorrect dose was administered because the computed volume was not rounded properly ERROR: Rounding more decimal places than are necessary and selecting the wrong size syringe SCENARIO: A newborn infant was to receive gentamycin sulfate 7.5 mg. intravenously every 24 hours. Using a 2 ml vial supplied with 10mg/mL of gentamycin, the nurse calculated the volume needed as 0.75mL. This volume may be delivered precisely using a 1 mL syringe. No rounding is needed. In this case, the nurse rounded 0.75 to the whole number 1 and administered l mL of medication using a 3mL syringe. He infant was given 0.25 mL or 2.5mg additional medication. If the nurse continued to care for this infant on subsequent days, the error might continue with serious overdosage implications. 1. If the nurse would have cared for this infant, continuing with the wrong dosage how much edditional medication would this infant have received in 7 days? 2. What are at least 3 serious outcomes had this medication error continued for 7 days? Why are blood levels ordered during the administration of gentamycin? 4. What would have been your action(s) had you discovered this medication error? 5. How could this medication error been prevented? A. Compare the calibration of a 1 mL syringe with a 3 mL syringe B Is gentamycin considered a high alert drug? Reviewed 9/18

Answer 1

1. Answer.

The nurse has to administer 7.5 mg drug from 2 ml ampoule, so likewise she will take 0.75 ml drug from the ampoule .

But, instead of taking 0.75 ml she is taking 1 ml .,

That means she is taking 0.25 ml extra and 2.5 mg drug extra and administering to the child ,

In 7 days she will administer

0.25 ml ×7= 1.75 ml extra and 2.5 mg ×7 = 17.5 mg extra drug to the client.

2. Answer.

Serious outcome of medication error continued for 7 days are:

Gentamicin is an anti infective drug given to treat bacterial infection or other microbial infection, it is a class of aminoglycoside, which is given to treat infections,

If overdose of this medication occurs it may cause.

1.Hearing loss.

2.Renal function impairment.

3.Muscular paralysis.

3.Answer.

Gentamicin is an aminoglycoside drug ,if it is not given cautiously it may cause various serious complications, such as renal damage etc, before administering gentamicin blood level should be checked after 6-7 hours of administration.

Initially gentamicin should be started at 7mg /kg and blood level should be checked after 6/7 hrs of administration.

It should be administered according to the lab value of gentamicin,it should not be administered without blood level value.

4.Answer.

1. If I would have discovered this error ,i would have immediately sent blood samples for gentamicin blood level.

2. the level would have increased I would have stopped administering gentamicin for that particular time.

3. I will report to the physician immediately.

4. If toxicity occured prepare client for immediate treatment such as hemodialysis etc.

5. Check for ear and renal function .

5. Answer.

A . Comparing calibration of 3 ml syringe with 1 ml

1 ml syringe has less scale reading which make 0.75 ml drug administration easy, while 3 ml syringe create confusion and estimation has to be taken, while taking estimation error can be occured. To avoid such errors it is important to check the level of drug in the syringe and also use desire syringe to administer desire volume of drugs.

B. Gentamicin is considered as a high alert drug as it causes renal impairment and ototoxicity, it's overdose may cause renal impairment and hemodialysis is needed to remove extra gentamicin from patient's blood , and it also causes serious trouble to the ears and cause hearing problem,

Specially using it for pediatrics take precaution and do not overdose the medicine as it may lead the child in serious trouble.

Before administering the drug check it's doses and administer carefully, check blood level before administering another dose of this drug.