Nursing Prioritization Delegation Assignment Q 30

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Which of these medication orders for a patient with a pulmonary embolism is more important to clarify with the prescribing physician before administration?

  

     A. Warfarin (Coumadin) 1.0 mg by mouth (PO)

     B. Morphine sulfate 2 to 4 mg IV

     C. Cephalexin (Keflex) 250 mg PO

     D. Heparin infusion at 900 units/hr

    

    

Correct Answer: A. Warfarin (Coumadin) 1.0 mg by mouth (PO)

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Medication safety guidelines indicate that the use of a trailing zero is not appropriate when writing medication orders because the order can easily be mistaken for a larger dose, such as 10 mg. The order should be clarified before administration. The other orders are appropriate, based on the patient’s diagnosis.

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Option B: FDA-approved usage of morphine sulfate includes moderate to severe pain that may be acute or chronic. Most commonly used in pain management, morphine provides major relief to patients afflicted with pain.

Option C: Cephalexin is an FDA-approved antibiotic. Cephalexin is a first-generation cephalosporin utilized in the treatment of urinary tract infections, respiratory infections, and other bacterial infections. Cephalexin is also commonly used in treating streptococcal and staphylococcal skin infections.

Option D: Unfractionated heparin is an anticoagulant indicated for both the prevention and treatment of thrombotic events such as deep vein thrombosis (DVT) and pulmonary embolism (PE) as well as atrial fibrillation (AF). Heparin is also used to prevent excess coagulation during procedures such as cardiac surgery, extracorporeal circulation, or dialysis, including continuous renal replacement therapy.

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