An order is written for Demerol 500 mg IM q3-4h prn for pain. The nurs

An order is written for Demerol 500 mg IM q3-4h prn for pain. The nurse recognizes that this is significantly more than the usual therapeutic dose. The nurse should:

1. Give 50 mg IM as it was probably intended to be written
2. Refuse to give the medication and notify the nurse manager
3. Administer the medication and watch the client carefully
4. Call the prescriber to clarify the order

ANSWER

ANS: 4
The nurse should question the order if the written order is illegible, the dose seems unusually low or high, or the medication seems inappropriate for the client’s condition. The nurse should call the prescriber to clarify the order. The nurse cannot independently change physician’s orders. The nurse would have to call the prescriber and receive the order for the change. The nurse should first call the prescriber and clarify the order. If the prescriber does not change the order, the nurse may then refuse to give the medication and notify the nurse manager. The nurse could be held accountable for administering an ordered medication that is knowingly inappropriate for the cli-ent.