what is the nurse responsible for when a drug is prescribed to a client

Question

study guide questions

Answer 1

You are responsible for the 5 rights as has already been posted multiple times.

Also:

1) making sure that the MD didn't make a mistake! We are the 2nd to last check to stop an accident so you pretty much will need to know just about as much about meds and their uses as the doctors do. Never hesitate to give the pharmacy a call for advice.

2) Being sure the med is appropriate to give at that time. Such as checking their vitals before administering antihypertensives, or checking their QT interval before giving drugs like Zofran or Haldol

Answer 2

The question is a bit vague. I am assuming you mean that the nurse will be administrating the drug to the patient.

In a nutshell, a nurse is responsible for safe administration and the multiple checks surrounding it.

If your patient (client in NCLEX world) is in the hospital and you as the nurse receive a prescription (order) for a medication, you as the nurse are responsible for:

1. Right patient (get in the habit of always doing at least a 2 patient identifier)
2. Right med (please don't just pick up the med without verifying what it is. This is also the right time to verify the med against the MAR and specifically look for any interactions or reasons not to admin the drug)
3. Right dose (keep in mind you may be dispensed a full tablet but the order only calls for 1/2)
4. Right time (always check that it's time to give the med)
5. Right route (IV push vs bolus vs drip, IM vs SubQ injection. there are very deadly effects to administering incorrectly)
6. Right documentation (rule of thumb: if it wasn't documented, it didn't happen, if it was documented, that's how it happened unless you have other documentation or proof to alter and adjust it)
7. Right vitals (this is not one you are always taught or tested on but it's good practice to have a recent set of vitals before admin a drug, especially certain drugs that can only be administered if vitals are in a certain range like Digoxin)

Med administration should always be taken seriously. There are way too many medication errors that occur in the hospital setting. Many can be stopped on the nursing level if the nurse takes the time to verify everything correctly.

Answer 3

When I try to get this concept down about all drugs, I look at what time and place do errors occur. Could the physician write the drug in error about dosage, could pharmacy misread the physicians hand writing, could I have an unexpected outcome if I give this drug to the patient, do I know the rate at which the drug can be delivered safely, do I need to check drug panels on this patient regarding this drug, do I have the right patient, am I giving it at the right time, am I giving the correct dosage and am I giving it through the correct route, dosage, drug. Are there any initial assessments I should do before giving this drug and what are the common side effects. How do I treat these side effects or an allergy reaction. Do I know my patient well enough to understand that this drug will not cause a problem with any other subsystem that may be in trouble.

Answer 4

The nurse is responsible for checking the original order written by the prescribing physician to the transcribed orders from the pharmacy to ensure the second matches the first. She should look up the medication in a nursing drug book if she is not familiar with it, to ensure there are no extra assessments necessary on her part before giving it. Finally, when she is preparing to give the medication she should check her "5 rights":

 

1. Right drug

2. Right dose

3. Right route

4. Right time

5. Right patient 

 

The final step should be checked against the patient's wristband and the order sheets carried by the nurse before actually giving the drug to the patient.