A prescription requires 300 mg to be given, but the concentration available is 150 mg/mL. How many mL should be administered?

Calculation:

Ordered Dose = 500 mg

Available Dose = 250 mg

Available Volume = 5 mL

Volume to administer = (Ordered Dose / Available Dose) × Available Volume

= (500 / 250) × 5

= 2 × 5

= 10 mL

Rationale:
A. Administer a counteracting medication: Administering another medication without provider orders can be unsafe and may worsen the patient’s condition. Intervention should follow provider instructions and established protocols.

B. Notify the healthcare provider and report the event to the FDA: The nurse must promptly inform the healthcare provider to ensure appropriate medical management of the adverse drug event. Reporting to the FDA’s MedWatch system also contributes to broader pharmacovigilance and patient safety by documenting potential drug-related risks.

C. Continue monitoring the patient and document the event in the medical record: While ongoing monitoring and documentation are essential, they are part of the overall response but do not replace notifying the provider and regulatory reporting, which are critical steps.

D. Immediately discontinue all medications: Stopping all medications indiscriminately can be dangerous, especially if the patient depends on essential therapies. Only the prescribing provider should adjust or discontinue medications based on assessment and clinical judgment.