The physician orders Zithromax 500 mg IVPB every 24 hours.

The medication is supplied in 500 mg/250 mL to infuse over 90 minutes.

Calculate the flow rate in milliliters per hour.

(ROUND TO WHOLE NUMBER: LABEL CORRECTLY TO RECEIVE CREDIT)

Choice A rationale

"Right medication" refers to ensuring that the drug administered is precisely the one prescribed by the healthcare provider. This involves verifying the medication name, strength, and formulation against the order. In this scenario, the issue is not the medication itself, but rather the timing of its administration, making this choice incorrect.

Choice B rationale

"Right route" pertains to administering the medication via the prescribed pathway (e.g., oral, intravenous, subcutaneous). This ensures that the drug reaches the systemic circulation or target site effectively. The scenario explicitly states "oral guaifenesin," indicating the route was correct; the error lies in the timing.

Choice C rationale

"Right time" is a crucial aspect of medication administration, ensuring that the drug is given at the prescribed frequency and within the specified time window. Administering a medication 2 hours after its scheduled dose constitutes a deviation from the ordered time, potentially affecting its therapeutic efficacy or peak plasma concentration.

Choice D rationale

"Right dose" involves verifying that the amount of medication given is precisely what was ordered, preventing under-dosing or over-dosing. The scenario does not indicate any error in the quantity of guaifenesin administered, only the timing of its delivery. Therefore, this choice is not applicable to the described problem.

Choice A rationale

Administering medication without verifying the order, especially when the patient expresses concern about a change in appearance, is a breach of medication safety principles. The patient's concern highlights a potential discrepancy, and simply explaining a possible change without confirmation is unprofessional and dangerous.

Choice B rationale

This action is incorrect and dangerous. The patient stated she always takes a yellow pill, but the nurse is preparing to administer a blue tablet. Telling her the action of a "red tablet" is confusing, indicates a potential misunderstanding of the medication, and demonstrates a failure to address the patient's valid concern about the color discrepancy.

Choice C rationale

When a patient questions a medication, especially regarding its appearance, it is imperative to withhold the drug and recheck the medication administration record (MAR) against the physician's original order. This verifies that the correct medication, dose, and form are being administered, preventing potential medication errors and ensuring patient safety.

Choice D rationale

Administering the medication and making a mental note to check later is unsafe practice. A patient's concern about medication is a critical alert. Ignoring it and administering the drug first could lead to serious adverse effects if a medication error has occurred. Verification must precede administration.