RN Nursing · Medication Errors and Safe Practices · Practice question
A nurse receives an order for medication based on a child's weight from the primary care provider. The nurse notices that the prescribed dose is for a child weighing 10 pounds more than the weight of the child the medication is prescribed for. What should the nurse do?
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Recalculate the dose using the actual weight and give the new dose
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✓
Call the primary care provider and question the accuracy of the dose
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Ask the pharmacist about the weight difference and whether it is necessary to change the dose
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Notify the nurse manager and seek support to confront the healthcare provider about the dose
Answer & explanation
Correct: Call the primary care provider and question the accuracy of the dose
When a nurse identifies a potential medication error — in this case, a dose prescribed based on a weight 10 pounds greater than the child's actual weight — the appropriate first action is to contact the primary care provider and question the accuracy of the dose. Medication safety is a core nursing responsibility, and pediatric dosing is particularly sensitive to weight-based errors because children have a narrow therapeutic index and less physiologic reserve to tolerate overdose. Calling the provider directly is the most effective and time-efficient way to clarify whether the dose was intentional or erroneous and to obtain a corrected order if necessary. Recalculating the dose and independently administering a different amount than what was prescribed is outside the nurse's scope — the nurse cannot unilaterally change a prescribed dose without a new order. Consulting the pharmacist is a supportive step and can be valuable, but it does not replace direct communication with the prescriber who is responsible for the order. Notifying the nurse manager and seeking support to confront the provider adds unnecessary steps and delays resolution of a potential safety issue. The nurse's priority is patient safety, which is best achieved by promptly clarifying the discrepancy with the ordering provider before administering the medication.
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