Med error advice

[LynnG]

So, I graduated in July as an LPN. Last night was the first night on my unit alone for a 12 hour shift. I work at a long term care facility. I had 2 patients with nausea in which I gave one some crackers and water and it seemed to help and another Zofran because it was PRN. I think I did okay with that, but I did have some guidance from the RN working with me. Anyways, at the end of my shift, about 30 minutes. A patient has a call light on and when I come in she tells me she is short of breath. For some reason, I didn't think about assessing.. jus treating. She is a COPD patient and is already on 3L of oxygen. My first thought was to see if she had any PRN breathing treatments. She only had scheduled.. and to my stupidity.. I thought about getting in trouble of making a med error if I gave a scheduled med. I gave a PRN med Albuterol which said it's use was for "chest tightness", It said "one puff". I knew albuterol was a bronchodilator and could help her breathe better. I gave it to her and she asked me if she could have two puffs and I didn't stop her because I knew she needed help breathing. After that, she said she was fine and could breathe. I didn't even think to call the doctor... now that I'm at home. I thought of all the things that I SHOULD have done that were SOOOO obvious. I feel like I failed her and my company. SOB is nothing to play around with. I am wondering if everything is okay now.. or if something bad happened after I left.

[Esme12, ASN, BSN, RN]

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Albuterol is the appropriate med for this and 2 puffs is the usual dose. I am sure that the "chest tightness meant difficulty breathing kind of "tightness" but the order needs to be clarified. You probably should have called the MD with the second puff to clarify the order but I wouldn't beat yourself up....((HUGS))