1. SAFETY AND INFECTION CONTROL

a. ACCIDENT/ERROR/INJURY PREVENTION

i. SAFE MEDICATION ADMINISTRATION AND ERROR REDUCTION:

ADMINISTERING PHENYTOIN

1. Undesirable interaction is giving omeprazole, a proton pump

inhibitor, concurrently with phenytoin, an anticonvulsant. This can

increase the serum level of phenytoin. Obtain a complete

medication history, and be knowledgeable of clinically significant

interactions. Be aware that medications can also interact

beneficially or harmfully with food and with herbal and dietary

supplements

ii. ANTIBIOTICS AFFECTING THE BACTERIAL CELL WALL:

PRIORITY FINDING AFTER A PENICILLIN INJECTION

1. Instruct clients to take penicillin V, amoxicillin, and

amoxicillin-clavulanate with meals. Tell them to take all others

with 8 oz of water 1 hr before or 2 hr after meals. Instruct clients to

report any signs of an allergic response such as dyspnea, a skin

rash, itching, and hives. Give IM injections cautiously to avoid

injecting into a nerve or an artery. Advise clients to complete the

entire course of therapy, even if symptoms resolve. Advise client to

use an additional contraceptive method when taking penicillin’s.

iii. REPORTING OF INCIDENT/EVENT/IRREGULAR

OCCURRENCE/VARIANCE

1. SAFE MEDICATION ADMINISTRATION AND ERROR

REDUCTION: PRIORITY ACTION FOR INCORRECT

MEDICATION DOSAGE

a. Use a unit-dose system to decrease errors. If not available,

calculate the correct medication dose. Check a drug

reference to ensure the dose is within the usual range.

When performing medication calculations or conversions,

have another qualified nurse check the calculated dose.

Prepare medication dosages using standard measurement

devices, such as graduated cups or syringes. Some

medication dosages require a second verifier or witness,

such as some cytotoxic medications. Automated medication

dispensing systems use a machine to control the dispensing

of medications.