The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [597]
d Creates more space in the treatment room, so there are fewer medication errors.
6 On checking the stock balance in the controlled drug record book as a newly qualified nurse, you and a colleague notice a discrepancy. What would you do?
a Check the cupboard, record book and order book. If the missing drugs aren’t found, contact pharmacy to resolve the issue. You will also complete an incident form.
b Document the discrepancy on an incident form and contact the senior pharmacist on duty.
c Check the cupboard, record book and order book. If the missing drugs aren’t found the police need to be informed.
d Check the cupboard, record book and order book and inform the registered nurse or person in charge of the clinical area. If the missing drugs are not found then inform the most senior nurse on duty. You will also complete an incident form.
7 A patient in your care is on regular oral morphine sulphate. As a qualified nurse, what legal checks do you need to carry out every time you administer it, which are in addition to those you would check for every other drug you administer?
a Check to see if the patient has become tolerant to the medication so it is no longer effective as analgesia.
b Check to see whether the patient has become addicted.
c Check the stock of oral morphine sulphate in the CD cupboard with another registered nurse and record this in the control drug book; together, check the correct prescription and the identity of the patient.
d Check the stock of oral morphine sulphate in the CD cupboard with another registered nurse and record this in the control drug book; then ask the patient to prove their identity to you.
8 As a newly qualified nurse, what would you do if a patient vomits when taking or immediately after taking tablets?
a Comfort the patient, check to see if they have vomited the tablets, and ask the doctor to prescribe something different as these obviously don’t agree with the patient.
b Check to see if the patient has vomited the tablets and, if so, document this on the prescription chart. If possible, the drugs may be given again after the administration of antiemetics or when the patient no longer feels nauseous. It may be necessary to discuss an alternative route of administration with the doctor.
c In the future administer antiemetics prior to administration of all tablets.
d Discuss with pharmacy the availability of medication in a liquid form or hide the tablets in food to take the taste away.
9 Why would the intravenous route be used for the administration of medications?
a It is a useful form of medication for patients who refuse to take tablets because they don’t want to comply with treatment.
b It is cost effective because there is less waste as patients forget to take oral medication.
c The intravenous route reduces the risk of infection because the drugs are made in a sterile environment and kept in aseptic conditions.
d The intravenous route provides an immediate therapeutic effect and gives better control of the rate of administration as a more precise dose can be calculated so treatment can be more reliable.
10 You have been asked to give Mrs Patel her mid-day oral metronidazole. You have never met her before. What do you need to check on the drug chart before you administer it?
a Her name and address, the date of the prescription and dose.
b Her name, date of birth, the ward, consultant, the dose and route, and that it is due at 12.00.
c Her name, date of birth, hospital number, if she has any known allergies, the prescription for metronidazole: dose, route, time, date and that it is signed by the doctor, and when it was last given.
d Her name and address, date of birth, name of ward and consultant, if she has any known allergies specifically to penicillin, that prescription is for metronidazole: dose, route, time, date and that it is signed by the doctor, and when it was last given and who gave it so you can check with them how she reacted.
Answers to the multiple choice