IOM/ ISMP
What are the recommendations from the Institute of Medicine (IOM) for nurses in order to reduce medication errors?
Maintain accurate records of all medications.
Display openness regarding errors and problems.
Take greater responsibility for monitoring medications and reporting changes.
What is the standard metric unit for length?
Meter
A nurse prepares to administer 30 mL of an antidiarrheal drug to an infant. What is the Tbs equivalent of 30 mL?
2 Tbs
1 tablespoon is equivalent to 15 mL; therefore; 2 Tbs equals 30 mL.
What is tall man lettering? and why is it used
The use of mixed case letters in a drug name
Tall man lettering is the use of mixed case letters (lower- and uppercase) in a drug name with the specific purpose of highlighting a section of the drug name to help distinguish the name from other similar drug names.
There are two clients with acute pneumonia in the same clinical ward, and the nurse needs to administer a medication to one of them. What identifier should the nurse use to verify the right client?
A.Client name
B.Client date of birth
C.Barcode client identification
D.Any two of the above together
Because two identifiers are needed to identify the right patient, the nurse should consider any two of the above together to verify the right
A nursing instructor asks a nursing student about the Institute of Medicine (IOM). How would you answer
IOM serves to inform government policy makers on national health-care issues.
IOM is an independent, nonprofit organization established in 1970.
The Institute of Medicine (IOM) is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision-makers and the public
What is the standard metric unit for mass?
Gram
The primary health-care provider has prescribed 2 Tbs of a liquid antibiotic for the client every 12 hours. How will the nurse instruct the client in ounces?
Take 1 ounce of the medication every 12 hours
. 2 Tbs is equivalent to 30 mL and 1 ounce is equal to 30 mL. Therefore, the nurse will instruct the client to take 1 ounce of the medication every 12 hours.
What is the difference between the multi-dose and single-dose IV vials?
Multi-dose IV vials contain antimicrobial preservatives, whereas single-dose vials do not contain antimicrobial preservatives.
The nurse is reviewing the client’s medication administration record (MAR). The drug is available as the prescribed dose. The frequency and time of administration is also mentioned in the MAR. However, the nurse finds that the route of administration is missing in the MAR. What is the most appropriate clinical decision the nurse should consider?
Check the medication order to verify the route.
A nursing student is discussing the Institute of Safe Medication Practices (ISMP). What answer given by the student indicates the need for further teaching?
A.“It is a nonprofit agency established in 1975.”
B.“Its primary purpose is to identify the causes of medication errors.”
C.“It recommends evidence-based strategies for the prevention of medication errors.”
D.None of the above
D
A drug is labeled 800 micrograms of the active ingredient in each tablet. How many milligrams is this equivalent to?
0.8 mg
To convert from the micro place to the milli place, the decimal point should be moved three spaces to the left. Therefore, 800 micrograms is equivalent to 0.8 mg.
A primary health-care provider has prescribed a 1.8 mL/kg dose of liquid antibiotic for a child who weighs 8 pounds. Which amount of medication should the nurse instruct the parents to administer?
6.48 mL
2.2 lbs =1 kg
1 lb = 1/2.2 kg
So, 8 lbs = 1/2.2 ´ 8 kg
= 3.6 kg
The primary health-care provider has prescribed 1.8 mL/kg of the liquid medication.
1 kg = 1.8 mL
3.6 kg = 1.8 ´ 3.6 mL
= 6.48 mL or 6.54
A client asks the nurse about the significance of black box warnings included on the label of specific prescription medications. What information should the nurse provide to the client?
“They advise the client about serious potential risks related to the use of the drug.”
“They advise the healthcare professional about serious side effects related to the use of the drug.”
“They advise the healthcare professional about serious potential risks related to the use of the drug.”
“They indicate the need to consult the pharmacist, and seek reliable drug references and U.S. Food and Drug Administration (FDA) recommendations.”
The night shift nurse is reviewing the electronic medication administration record (MAR) of the client and notices a drug that is due to be administered at night was marked as given during the day. What should the nurse doe?
Ask the day nurse whether the medication was given.
According to the guidelines of the Institute of Safe Medication Practices (ISMP) for proper use of abbreviations, symbols, and dose designations, what is the correct method of writing the abbreviations, symbols, and dose designations? Select all that apply.
A.“4 mcg” instead of “4 mg.”
B.“10 cc” instead of “10 mL.”
C.“5.0 mg” instead of “5 mg.”
D.“30 u” instead of “30 units.”
E.“0.3 mg” instead of “.3 mg.”
F.“0.5 mcg” instead of “0.5mcg.”
G.“5000 units” instead of “5,000 units.”
H.“1,500,000 units” instead of “1.5 million units.”
E, F
The nurse is administering 1.5 liters IV fluid every 10 hours to a client. How many milliliters will the patient receive every 10 hours?
1,500 mL
To convert the base unit liter to milliliters, the decimal point should be moved three times to the right. Therefore, the patient will receive 1,500 mL every 10 hours.
The primary health-care provider has ordered 75 mL of a medication to be given orally. How many teaspoons will the nurse administer?
15 tsp
15 mL is equal to 3 tsp. Therefore, 75 mL is equal to 3/15 ´ 75 tsp = 15 tsp.
Prioritize the steps in the medication administration process in order of their occurrence. (Enter the letter of each step in the proper sequence; do not use commas or spaces.)
1. The medication is ordered.
2. The medication order is interpreted.
3. The ordered medication is prepared.
4. The medication is administered to the patient.
5. The medication order is transcribed as written
1, 2, 5, 3, 4
1. The medication is ordered.
2. The medication order is interpreted.
5. The medication order is transcribed as written
3. The ordered medication is prepared.
4. The medication is administered to the patient.
Which specifies the dosage strength of a drug correctly?
A.1 gm
B.5 meQ
C.15 units
D.10 mg/mL
D.
10 mg/mL
10 mg/mL specifies the dosage strength correctly.
A nursing instructor asked the nursing student about the Institute of Safe Medication Practices (ISMP) guidelines for proper use of abbreviations, symbols, and dose designations. What answers given by the student indicate adequate learning? Select all that apply.
A.“Spell out the word ‘units.’”
B.“Use a period after abbreviations.”
C.“Use the abbreviation ‘microg’ for microgram.”
D.“Use trailing zeros to indicate the dose of the drug.”
E.“Use the word ‘million’ for doses expressed in millions.”
F.“Use leading zeros for doses less than one measurement unit.”
A, E, F
The recommended dose of carvedilol is 25 mg once a day. What dose in grams should the nurse advise the client to take
0.025 grams
This is a whole number; a decimal point should be added to the right of the number. Therefore, the decimal point should be moved three place from right to left to convert milli to gram. Hence, the final value is 0.025 grams.
A nurse is providing discharge instructions for a client with a low hemoglobin count. The nurse instructs the client to take 5 tsp of the liquid antianemic drug after lunch every day. How many milliliters should the client take after lunch? Record your answer as a whole number. ______mL
25
1 tsp of the antianemic drug = 5 mL
So, 5 tsp = 5 ´ 5 mL
= 25 mL
In which phases of the medication process does the nurse need to be most cautious about the occurrence of medication errors?
A.Prescribing and dispensing phases
B.Dispensing and monitoring phases
C.Prescribing and administering phases
D.Administering and monitoring phases
C
Both the prescribing and administering phases are the phases most frequently reported to be prone to medication errors
Give 5 examples of medical errors that may occur while dealing with clients and their medication due to at-risk behaviors of the nurse.
“Forgetting to double-check medications per the institutional policy”
“Omitting the use of two patient identifiers prior to giving medications”
“Overlooking the six rights of medication administration, thereby taking shortcuts”