An order is written for phenytoin 500 mg IM q3-4h prn for pain. ...

[elizabeth18]

An order is written for phenytoin 500 mg IM q3-4h prn for pain. The nurse recognizes that treatment of pain is not a standard therapeutic indication for this drug. The nurse believes that the health care provider meant to write hydromorphone.
 
  What should the nurse do?
  a. Call the health care provider to clarify the order.
  b. Give the patient hydromorphone, as it was meant to be written.
  c. Administer the medication and monitor the patient frequently.
  d. Refuse to give the medication and notify the nurse supervisor.

Question 2

The nurse administers a central nervous system stimulant to a patient. Which assessment finding indicates to the nurse that an idiosyncratic event is occurring?
 
  a. Falls asleep during daily activities
  b. Presents with a pruritic rash
  c. Develops restlessness
  d. Experiences alertness

[ecabral0]

Answer to Question 1

ANS: A
If there is any question about a medication order because it is incomplete, illegible, vague, or not understood, contact the health care provider before administering the medication. The nurse cannot change the order without the prescriber's consent; this is out of the nurse's scope of practice. Ultimately, the nurse can be held responsible for administering an incorrect medication. If the prescriber is unwilling to change the order and does not justify the order in a reasonable and evidence-based manner, the nurse may refuse to give the medication and notify the supervisor.

Answer to Question 2

ANS: A
An idiosyncratic event is a reaction opposite to what the effects of the medication normally are, or the patient overreacts or underreacts to the medication. Falls asleep is an opposite effect of what a central nervous system stimulant should do. A stimulant should make a patient restless and alert. A pruritic (itch) rash could indicate an allergic reaction.

[elizabeth18]

Excellent

[amit]

Gracias!