A physician orders 500 mg of a medication, but the available medication is labeled as 250 mg per tablet. Using dimensional analysis, how many tablets should the nurse administer?

Calculation:

Ordered Dose = 1.5 g

Available Dose = 500 mg

• Convert Ordered Dose to mg

Ordered Dose = 1.5 × 1000

= 1500 mg

Number of tablets = Ordered Dose / Available Dose

= 1500 / 500

= 3 tablets

Rationale:
A. Assess the patient's ability to swallow before administration: Evaluating the patient’s swallowing ability is the first and most important step to prevent choking, aspiration, or medication errors. This assessment guides whether modifications to the route or form are necessary.

B. Change the route to intravenous administration without consulting the provider: Altering the route without provider approval can be unsafe and may lead to incorrect dosing or adverse effects. Route changes require an order and clinical judgment.

C. Crush the medication and mix it with water or applesauce: Crushing may be appropriate for some medications, but not all (e.g., extended-release or enteric-coated forms). This action should only be taken after assessing swallowing ability and verifying the medication can safely be altered.

D. Administer the medication with a large glass of juice to ensure it is swallowed: Simply giving fluids does not address dysphagia risk and may not prevent aspiration. Proper assessment and potentially alternative administration strategies are needed for safety.