A nurse is preparing to administer an intravenous push medication to a client. After reviewing the medication order, the nurse notices that the prescribed dose is significantly higher than the usual therapeutic range. Which action should the nurse take first?
- AAdminister a lower, safer dose of the medication.
- BContact the pharmacy to verify the medication dosage.
- CAdminister the medication as prescribed, monitoring the client closely for adverse effects.
- DNotify the nursing supervisor about the questionable order.
Show answer & explanationAnswer & explanation
Correct answer: B. Contact the pharmacy to verify the medication dosage.
When a medication order appears incorrect or outside the usual therapeutic range, the nurse's first action is to clarify the order with the prescribing healthcare provider. However, if the healthcare provider is unavailable, or if the order is still questionable after clarification, consulting with the pharmacy for verification of the dosage is the next crucial step. The pharmacy has extensive drug information resources and can confirm safe dosage ranges or identify potential errors. Administering an incorrect dose could lead to client harm.
Why the other options are wrong
- A. The nurse cannot unilaterally change a prescribed dose; this would be outside the scope of practice and a medication error.
- C. Administering a potentially unsafe dose can cause significant client harm and is a medication error.
- D. Notifying the nursing supervisor is appropriate if the issue cannot be resolved with the prescriber or pharmacy, but direct clarification is the immediate priority.
Questionable Medication Order
A medication order that appears unsafe, inappropriate, or unclear, requiring clarification before administration to prevent medication errors.
- Always clarify questionable orders with the prescribing healthcare provider first.
- If the provider is unavailable or clarification is insufficient, consult the pharmacy for dosage verification.
- Never administer a medication if there is any doubt about its safety or appropriateness.
- Document all communication and actions taken regarding questionable orders.
Memory trick: When in DOUBT, CLARIFY it OUT!