Case Study: Patient with Hyper
Case Study: Patient with Hypertension and MedicationError
Handoff report at 0700
You are assigned to the following twopatients:
Mrs. Allen is 67 ye4ars old and has diabetes mellitus type 1 andhypertension. She is in for a pressure ulcer on her right heel. Sheis on bedrest and the right leg elevated and she only has BRP.There is a wet-to-dry dressing change due at 10am. VS are stableand her latest BP is 170/108, denies pain, pulse ox 97% .
Mrs. . Carter is 73 years old and was admitted with dehydration3 days ago. She is eating and voiding well. There is a possibilitythat she is going home today. I removed her saline lock; there wassome redness at the IV site. She is not on any IV meds, so Idecided not to restart. She says that she is going home thisafternoon, although there is no order. Her morning vital signs are:T:97, P:82, R:18, BP:130/90, pluse ox 98%, pain level 0
|
Medication Record Patient: Mrs. Allen Allergies:None Routine Time Humulin N 26u SQqAM 0730 30 minutes ac breakfast Tenormin 25mg podaily 1100 (Pt requests this time) Furosemide 20mg poBID 1100-1700 Ceftazidine 0.5g IVPBq8h 1000-1800- 0200 PRN Medication MOM 30mL prn constipation Temazepam 30mg po at bedtime may Repeat x 1 |
Mrs. Allen and Mrs. Carters medication recordscontain the following:
|
Medication Record Patient: Mrs.Carter Allergies:None Routine Time Prazosin 1 mg poqAM 0900 Multivitamin tab 1 poqAM 0900 PRN Medication MOM 30mL prn constipation |
Use the clinical situation and the flowchartsto:
|
|
|
|
Mrs. Allen Mrs. Carter |
Mrs. Allen Mrs. Carter |
Mrs. Allen Mrs. Carter |
It is 0800; prioritize your plan of care forboth patients for the next 3 hours
|
Time Plan of Nursing Care |
|
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |
You return from lunch ar 1200 and Mrs. Allen is asking for herantihypertensive medication. You know you gave the medication butinsists that you did not give her the medication. As youinvestigate, the nursing assistant tells you that Mrs. Carter isvery lethargic and unresponsive. You suddenly realize that you gaveMrs. Aleen’s 1100 medications to Mrs. Carter.
|
|
Critical Reflection: To promote safe nursingpractice in medication administration when caring for multiplepatients, identify nursing actions:
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Answer:
1, Report:Mrs. Allen 67 years old patient with type 1 diabetes andhypertension. patient with right heel pressure ulcer, on bedrestwith the right leg elevated. wet to dry dressing change at 10 am.Vs stable and BP 170/108 on medications.Mrs. carter 73years old patient admitted with dehydration 3 daysago. discharge today. Iv site redness presents while removing thesaline lock. she is stable ad vital signs are normal.Flow chart:Mr. Allen7.30 am humulin N 26NSQ QAMTenormin 25mg PO dailyfusrosimide 20mg po BIDCeftazidine 0.5g IV PB Q8hTemazepam 30mg PO bedtimeMrs. carterPrazosin 1mg po QAMMultivitamin 1 PO QAMFollowup:Mrs. AllenThe patient is on pressure sore need dressing and patient pressureand sugar level to be monitoring before medication.Mrs. carterThe patient needs discharge education and followup advice formedication continuation.Plan of care in the next 3hoursMrs. Allen11.00 am -Tenormin 25mg PO11.00 am furosemide 20mg POwound care at 10.00 amMrs. carter9.00am -prazosin 1mg PO9.00 am -multivitamin 1 tab POAs soon as the error identified to accept the truth and error.disclose the error immediately to collegues, doctor, risk manager,supervisor and patient and apologies to them.The benefit of the report in error prevention is disclosure andreporting the documentation in the patient’s record. error reportdocumentation in the patient chart should include the type oferror, time and data, error disclosure, adverse condition of thepatient or type of harm due to this error.Practice safe medication practice with adequate skills,decision-making process, clinical judgment to promote patientsafety. check patient allergy condition before administration,follow the policy for the patient identification, check the patientname, dose, medication indication, and calculation beforeadministering medication, avoid overcrowd and tension and rapidadministration of medication, make interaction with the patientbefore medication administration, use checklist, report near miss,error and adverse reaction. get supervisor support if any queryregarding medication.
"Our Prices Start at $11.99. As Our First Client, Use Coupon Code GET15 to claim 15% Discount This Month!!"
