Deck 3: Safe Medication Administration

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Maalox 30 mL q4h PRN upset stomach or heartburn
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Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Hydralazine 50 mg po four times daily
Label: Hydroxyzine 50 mg
Given: Hydroxyzine 50 mg

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Amoxicillin 125 mg
Label: Amoxicillin 125 mg per 5 mL, 100 mL vial
Given: Amoxicillin 100 mL

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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1730 hours
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Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: By phone: Ceftizoxime 1 g
Given: Cefotaxime 1 g

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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Tylenol 500 mg tab 1 q6h PO prn for fever over 100° F headache
Question
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Insulin subcutaneous injection daily for an older patient who is newly diagnosed with diabetes. Under supervision, the patient practiced injecting an orange for a few days, followed by self-injections under supervision until discharge shortly thereafter.
Given: At home, the patient injected an orange with insulin and ate the orange each day. The patient complained of the taste to the home-care nurse during the first post-hospital visit.

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
Question
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Fast-acting regular insulin 10 units for a patient with high blood glucose level Given: Intermediate-acting insulin10 units

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
Question
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: 5 mL, 1 tsp Benadryl syrup q8h to be administered by a caregiver at home after discharge for patient allergies. Benadryl, an antihistamine, has a side effect of drowsiness.
Given: 1 soup spoonful Benadryl, 1 household teaspoon Benadryl 8 hours later, <strong>Directions: For each of the following medication-related errors, select the patient right that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.  Ordered: 5 mL, 1 tsp Benadryl syrup q8h to be administered by a caregiver at home after discharge for patient allergies. Benadryl, an antihistamine, has a side effect of drowsiness. Given: 1 soup spoonful Benadryl, 1 household teaspoon Benadryl 8 hours later,   household tablespoon Benadryl 8 hours later, and so forth until the physician was notified about a change in the patient's condition (extreme drowsiness).</strong> A) Right patient B) Right drug C) Right time D) Right dose E) Right route <div style=padding-top: 35px> household tablespoon Benadryl 8 hours later, and so forth until the physician was notified about a change in the patient's condition (extreme drowsiness).

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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Potassium chloride sol. 10 mEq PO daily AM Potassium chloride sol. 10 mEq PO daily AM   juice<div style=padding-top: 35px> juice
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0045 hours
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1410 hours
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Ampicillin oral susp 125 mg PO tid
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Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Potassium Chloride (KCl) 20 mEq verbal order during a bedside emergency to be added to IV infusion solution, and atropine 0.5 mg to be given by direct IV (directly into the vein). Both medications were prepared by Nurse A.
Given: KCl 20 mEq in syringe directly into the vein by nurse B, who was handed two unmarked syringes by nurse A, who verbally identified them.

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
Question
Penicillin G 500,000 units IM daily
Question
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Large amount of narcotic prescribed for Mr. Smith, room 403, bed A, who is a patient of Dr. Davis, whose name was noted on the chart and in the narcotic record. Mr. Smith is a patient with a terminal illness and has been receiving increasingly large amounts of pain medication for the past 2 months.
Given: Large amount of narcotics to Mr. Davis, an underweight patient of another physician, room 403, bed B. Mr. Davis had never received a narcotic medication before.

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
Question
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Percocet 1 tablet q4h prn pain for a patient allergic to aspirin
Given: Percodan 1 tablet

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
Question
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Propranolol LA (long-acting tablet) PO for a patient with a nasogastric (NG) tube (through nose to stomach)
Given: Crushed propranolol LA via the NG tube

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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0930 hours
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Cytotec tab 100 mcg qid PO pc and HS
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Directions: Provide answers for the following statements.
State the appropriate action to take for incomplete labels on medicines.
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Directions: Provide answers for the following statements.
State two safety requirements for identifying patients.
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Codeine tab 5 mg PO for pain
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Potassium Chloride sol 10 mEq daily in morning
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Directions: Provide answers for the following statements.
State the appropriate safeguard to take for transfer and postoperative patients before giving a medication.
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Benadryl 1 tsp PO every 12 hrs for allergies
Question
Directions: Provide answers for the following statements.
State the appropriate action to take for unclear orders.
Question
Digoxin 10 mg daily in AM
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Aspirin 2 tablets PO for headache q4h prn
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Deck 3: Safe Medication Administration
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bid
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liter
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10 AM
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microgram
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1:20 AM
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12:30 PM
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milliliter
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Directions: Spell out the listed abbreviation in the space provided.

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stat
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IM
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kilogram
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NPO
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milligram
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gram
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21
Maalox 30 mL q4h PRN upset stomach or heartburn
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22
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Hydralazine 50 mg po four times daily
Label: Hydroxyzine 50 mg
Given: Hydroxyzine 50 mg

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Amoxicillin 125 mg
Label: Amoxicillin 125 mg per 5 mL, 100 mL vial
Given: Amoxicillin 100 mL

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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1730 hours
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Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: By phone: Ceftizoxime 1 g
Given: Cefotaxime 1 g

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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26
Tylenol 500 mg tab 1 q6h PO prn for fever over 100° F headache
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27
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Insulin subcutaneous injection daily for an older patient who is newly diagnosed with diabetes. Under supervision, the patient practiced injecting an orange for a few days, followed by self-injections under supervision until discharge shortly thereafter.
Given: At home, the patient injected an orange with insulin and ate the orange each day. The patient complained of the taste to the home-care nurse during the first post-hospital visit.

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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28
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Fast-acting regular insulin 10 units for a patient with high blood glucose level Given: Intermediate-acting insulin10 units

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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29
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: 5 mL, 1 tsp Benadryl syrup q8h to be administered by a caregiver at home after discharge for patient allergies. Benadryl, an antihistamine, has a side effect of drowsiness.
Given: 1 soup spoonful Benadryl, 1 household teaspoon Benadryl 8 hours later, <strong>Directions: For each of the following medication-related errors, select the patient right that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.  Ordered: 5 mL, 1 tsp Benadryl syrup q8h to be administered by a caregiver at home after discharge for patient allergies. Benadryl, an antihistamine, has a side effect of drowsiness. Given: 1 soup spoonful Benadryl, 1 household teaspoon Benadryl 8 hours later,   household tablespoon Benadryl 8 hours later, and so forth until the physician was notified about a change in the patient's condition (extreme drowsiness).</strong> A) Right patient B) Right drug C) Right time D) Right dose E) Right route household tablespoon Benadryl 8 hours later, and so forth until the physician was notified about a change in the patient's condition (extreme drowsiness).

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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30
Potassium chloride sol. 10 mEq PO daily AM Potassium chloride sol. 10 mEq PO daily AM   juice juice
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31
0045 hours
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32
1410 hours
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33
Ampicillin oral susp 125 mg PO tid
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34
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Potassium Chloride (KCl) 20 mEq verbal order during a bedside emergency to be added to IV infusion solution, and atropine 0.5 mg to be given by direct IV (directly into the vein). Both medications were prepared by Nurse A.
Given: KCl 20 mEq in syringe directly into the vein by nurse B, who was handed two unmarked syringes by nurse A, who verbally identified them.

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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35
Penicillin G 500,000 units IM daily
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36
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Large amount of narcotic prescribed for Mr. Smith, room 403, bed A, who is a patient of Dr. Davis, whose name was noted on the chart and in the narcotic record. Mr. Smith is a patient with a terminal illness and has been receiving increasingly large amounts of pain medication for the past 2 months.
Given: Large amount of narcotics to Mr. Davis, an underweight patient of another physician, room 403, bed B. Mr. Davis had never received a narcotic medication before.

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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37
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Percocet 1 tablet q4h prn pain for a patient allergic to aspirin
Given: Percodan 1 tablet

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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38
Directions: For each of the following medication-related errors, select the patient "right" that was violated (select a, b, c, d, or e for each). Use pharmacology text references if needed. After your selection, discuss the clinical implications and preventive measures you will take in your practice to avoid such errors.

Ordered: Propranolol LA (long-acting tablet) PO for a patient with a nasogastric (NG) tube (through nose to stomach)
Given: Crushed propranolol LA via the NG tube

A) Right patient
B) Right drug
C) Right time
D) Right dose
E) Right route
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39
0930 hours
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40
Cytotec tab 100 mcg qid PO pc and HS
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41
Directions: Provide answers for the following statements.
State the appropriate action to take for incomplete labels on medicines.
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42
Directions: Provide answers for the following statements.
State two safety requirements for identifying patients.
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43
Codeine tab 5 mg PO for pain
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44
Potassium Chloride sol 10 mEq daily in morning
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45
Directions: Provide answers for the following statements.
State the appropriate safeguard to take for transfer and postoperative patients before giving a medication.
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46
Benadryl 1 tsp PO every 12 hrs for allergies
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47
Directions: Provide answers for the following statements.
State the appropriate action to take for unclear orders.
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48
Digoxin 10 mg daily in AM
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49
Aspirin 2 tablets PO for headache q4h prn
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