A nurse is preparing to administer lithium 300 mg by mouth every 8 hours. Available is lithium carbonate 150 mg per capsule. How many capsule(s) should the nurse administer per dose? capsule(s) (If needed, round the answer to the nearest whole number.)

Rationale:
A. Addressing client questions about medications after administration is not ideal because clients may need information before taking their medications to ensure understanding, adherence, and informed consent.

B. Crushing all medications for a client with difficulty swallowing is unsafe. Some medications are extended-release, enteric-coated, or otherwise formulated to prevent irritation or ensure proper absorption. Crushing these can alter their effectiveness or cause harm. Medications should only be crushed if verified as safe by a pharmacist or prescriber.

C. Performing medication calculations to verify the correct dosages is the correct action. Older adults are at higher risk for adverse drug events due to age-related changes in metabolism, renal and hepatic function, and polypharmacy. Accurate calculation ensures the client receives the correct dose, preventing toxicity or subtherapeutic effects.

D. Scanning prescribed medications before entering the client’s room is a helpful safety step for barcode-assisted medication administration, but it is not specifically focused on the older adult population or on verifying dose accuracy. It complements but does not replace careful dose calculation and assessment.

Rationale:

A. Providing education to the client before administration helps prevent medication errors. Educated clients can participate in their care, question unfamiliar medications, and alert the nurse if something seems incorrect. Client engagement adds an additional safety check.

B. Avoiding phone calls during medication preparation is correct. Interruptions are a major cause of medication errors. Limiting distractions during preparation improves focus and reduces the risk of incorrect dosing or selection.

C. Turning off the television or radio to reduce noise is appropriate. A quiet environment decreases distractions and improves concentration during medication preparation and administration, promoting safe practice.

D. Preparing medications for multiple clients at the same time is unsafe and increases the risk of mixing up medications. Medications should be prepared for one client at a time to reduce the risk of error.

E. Asking the client if they have any allergies is essential. Verifying allergies before administration prevents adverse drug reactions and is a critical safety step.

F. Verifying medication calculations are correct helps prevent dosage errors. Double-checking calculations ensures the correct amount of medication is administered, especially for high-alert medications.