Question

nursing

3-12 PATIENT WITH PROSTATE CANCER AND MEDICATION ERROR 0700 Handoff Report: S Mr. T, 67 years old, has prostate cancer with metastasis to the bone. I have given him morphine IVP around the clock for pain, the last dose given at 0500. He is lethargic but responds when spoken to. He moans periodically and is mouth breathing so he needs frequent mouth care. His urine is amber. The 0600 vital signs are stable at T 99°F P 76, R 18, BP 126/74. Intake is 100 mL, output is 150 mL. His wife spent the night in the room and is making arrangements for hospice care. The following information is obtained from Mr. T's electronic medical record PatientEn Age:GZ Sex: M ID#[74391 Room:211 Drug allergies: INKDA Food allergies: None Time: 0800 Dx1ProstateCancerwith mets PatienEE Age:团Sex:11 ID#[74891 Room:[211] Drug allergies: INKDA Food allergies: None Patient Plan of Care S: q4h Bed rest Diet: Soft Dx: Saline lock RFA # 22 g angiocath Physician Progress Notes Hosp. day #3 Assess: Skin warm, dry. T 99°F L oral intake Output amber urine <600 mL/24 hr Resp. diminished bilaterally Alkaline phosphatase T Acid phosphatase T Urinary catheter DNR Medication Record PRN Plan: Keep comfortable Morphine sulfate 3 mg IVP q3h prn pain Hospice care being arranged DNR O Collaborative Learning Activity: With a partner, use the clinical situation and the electronic medical record to: 1. Identify the pertinent 2. Identify the pertinent 3. Review the data in patient information made known to you in patient information madecolumns 1 and 2 and known to you from the electronic medical record.needs follow-up. identify information that the handoff report.

Answer 1

Collaboration learning activity

Handoff report

Everything same as EMR record

Medication morphine IVP around the clock for pain doctor has written.but in EMR it is written 3mg Q4hourly prn it is written..

Medication clarity must be done

Plan of care:

Reduce Patient pain level..

Increase his fluid level..

Provide mouth care two times a day

Medication clarity must be done with the doctor

1,nursing intervention

- call doctor immediately

- check patient vitals connect oxygen shift the patient to intensive care unit immediately

- connect cardiac monitor

- start CPR and administrator emergency medicine as per doctor advise.

2, there is ethical issues due to nurse malpractice of medication administration..she administered drug within 15 minutes interval..drug overdoses made Patient worst.

Critical reflection:

- when this situation happen first take ownership of the mistake and make sure that no cover-ups occur

- inform to doctor about medication error

- doctor should inform this to family

- report the error to supervisor or nursing incharge

- document the error in the Patient notes

- good faith nurse must try for her best and rectify the situation based on workplace guidance..