Which schedule of controlled substances has no accepted medical use in the U.S. and carries the highest potential for abuse?

When a medication error occurs, the nurse's first priority is patient safety. The nurse must immediately assess the patient for adverse effects and notify the healthcare provider (prescriber) to initiate any necessary interventions. Prompt action helps minimize potential harm, ensures timely treatment, and supports the process of error reporting and quality improvement in medication safety.

Rationale for correct answer:

2. The first action is to assess the patient for adverse effects and notify the prescriber promptly so that timely interventions, such as administering an antidote or adjusting therapy, can prevent or reduce harm. Patient assessment ensures that any immediate risks are addressed.

Rationale for incorrect answer:

1. Completing an incident report is an important part of the medication error process but is not the first priority. Immediate patient safety takes precedence over documentation, which is completed later.

3. Documentation of the error in the patient’s chart is required for transparency and continuity of care but should occur after the nurse ensures the patient’s safety and informs the healthcare provider.

4. Informing the nursing supervisor is part of the reporting process but does not address the urgent need to evaluate and manage the patient’s condition immediately following the error.

Take-home points:

• The nurse’s first priority after a medication error is to assess the patient and notify the prescriber.
• Immediate action can reduce harm and guide timely interventions.
• Reporting and documentation follow after patient safety is addressed.

Gentamicin is an aminoglycoside antibiotic used to treat serious infections, but it carries a risk of ototoxicity, especially with prolonged use or high serum levels. Hearing loss, tinnitus, or balance disturbances, are early signs of toxicity. Early detection and reporting of auditory changes are essential to prevent permanent damage and adjust therapy as needed.

Rationale for correct answer:

2. Gentamicin carries a well-known risk of ototoxicity, which can result in hearing loss, tinnitus, or balance disturbances. Nurses should monitor hearing and report any auditory changes to prevent permanent damage.

Rationale for incorrect answer:

1. Hypertension is not a common adverse effect of gentamicin. This antibiotic is more likely to affect the kidneys and the auditory system rather than blood pressure regulation.

3. Hyperglycemia is unrelated to gentamicin use. Blood sugar disturbances are not typically associated with aminoglycoside antibiotics like gentamicin.

4. Constipation is not a common side effect of gentamicin therapy. Gastrointestinal effects are possible but ototoxicity and nephrotoxicity are the most significant concerns.

Take-home points:

• Gentamicin can cause ototoxicity, so clients must be monitored for hearing loss or tinnitus.
• Early detection of auditory changes helps prevent permanent hearing damage.
• Hearing and renal function are the primary concerns with gentamicin, not blood pressure or glucose.