The nurse selects routes for administering medication according to?

AIIMS Bhatinda NO - 2019

Fundamental of Nursing

Easy

Appeared in: AIIMS Bhatinda NO - 2019

Explanation

The prescriber's order is a legal and binding instruction that explicitly states the route by which a medication must be administered.
According to nursing fundamentals, a complete medication order must include seven parts, one of which is the route of administration.
The 'Rights of Medication Administration' include the 'Right Route,' which is determined by cross-referencing the medication administration record (MAR) with the original prescriber's order.
Nurses are legally responsible for the drugs they administer and must follow the prescriber's order unless it is suspected to be in error, in which case clarification is required.

Option A: Hospital policies provide a general framework for medication safety but do not dictate the specific route for an individual patient's prescription. The prescriber's order is patient-specific.
Option C: While the type of medication determines which routes are physically possible (e.g., some drugs cannot be given orally), the prescriber makes the final choice from the available options based on the patient's clinical needs.
Option D: Client size and muscle mass are critical for selecting the appropriate site and needle length for an intramuscular (IM) or subcutaneous injection, but they do not determine the overall route (e.g., oral vs. IM vs. IV).

Clinical Relevance

Nursing practice connection: Knowing Principles of Medication Administration helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Patient safety is paramount. Administering a medication via the wrong route can lead to ineffectiveness, adverse reactions, or even life-threatening events. Always verify the route in the prescriber's order.
A nurse acts as the final safety check. If a prescriber orders a medication via a route that is contraindicated (e.g., an oral tablet for a patient who is vomiting or unconscious), the nurse must withhold the medication and immediately contact the prescriber for a new order with an appropriate route.
What if? If a patient has a new peripherally inserted central catheter (PICC) line, but the order for their antibiotic remains 'IV peripheral line,' the nurse should contact the prescriber to confirm if the route should be updated to the new central line access, as this can impact administration protocols.

How to Approach the Question

First, identify the core of the question, which asks for the primary source of authority for selecting a medication route.
Analyze the options by placing them in a hierarchy of authority: a legal order, an institutional policy, a property of the drug, and a patient-specific physical factor.
Recognize that a prescriber's order is a direct, legal instruction tailored to an individual patient.
Compare this to the other options. Hospital policy is general, not specific. Medication type is a prerequisite for the order, not the order itself. Client size affects the technique of administration, not the choice of route.
Conclude that the prescriber's order is the highest and most direct authority that a nurse must follow.

Concept Tested & Keywords

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E6 Nursing Fundamentals Taylor p. 846-848

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