An LPN is preparing to administer medications to a client. The LPN notes that the client's medication administration record (MAR) includes a new order for an antibiotic, but there is no corresponding entry in the client's electronic health record (EHR). What is the LPN's most appropriate action?
- AHold the medication and notify the registered nurse (RN) or healthcare provider (HCP).
- BSearch the client's paper chart for the original order.
- CAdminister the antibiotic as ordered on the MAR, then notify the charge nurse.
- DDocument the discrepancy and administer other scheduled medications.
Show answer & explanationAnswer & explanation
Correct answer: A. Hold the medication and notify the registered nurse (RN) or healthcare provider (HCP).
A discrepancy between the MAR and EHR for a new medication order indicates a potential error in transcription or entry. Administering a medication without a confirmed order in the primary record (EHR) is unsafe. The LPN must hold the medication and clarify the order with the RN or HCP to ensure client safety and accurate medication administration.
Why the other options are wrong
- B. While checking the paper chart might be a step in clarification, the LPN's primary responsibility is to involve the prescribing or supervising authority (HCP/RN) for a new order discrepancy.
- C. Administering a medication with a discrepancy between MAR and EHR is unsafe and could lead to a medication error.
- D. Documenting the discrepancy without addressing it or holding the medication is insufficient and places the client at risk.
Medication Order Discrepancy
When there is a discrepancy between the MAR and EHR for a medication order, the LPN must prioritize client safety by holding the medication and clarifying the order with the prescribing practitioner or supervising RN before administration.
- The EHR is the primary legal record of medication orders.
- Any discrepancy between MAR and EHR requires clarification.
- LPNs must never administer a medication if an order is unclear or unverified.
Memory trick: MAR and EHR must match; if not, stop and dispatch.