Med math / pharm getting you down?

[Hannahbanana, BSN, MSN]

This just in:

Officials say a nursing home employee was neglectful when she gave a patient 20 times the amount of morphine he was prescribed, leading to his death.

According to a report filed by the Minnesota Department of Health (MDH), a nurse at the Minnesota Veterans Home admitted to giving a patient 100mg of morphine, as opposed to the 5mg he was prescribed, resulting in the patient's death. 

The report states that an employee asked the perpetrator to help give the patient morphine, as she was unsure what to do.

The perpetrator then drew up five 1ml full syringes and gave the liquid morphine to the patient, the report said. According to investigation records, the perpetrator said she thought she knew the order, "that 5mg was the same as 5ml and miscalculated the dose.”

………..

This is why your faculty hacks on you so hard for med math and pharmacology. When you hear somebody say, "it's all unit dose / controlled by the pump / in the Pyxis / set up by the pharmacist / etc., etc.” you can remember this one. (5cc does NOT equal 5 mg. …)

 

[Nurse Beth, MSN]

So the concentration was 20 mg/mL? Is that a common concentration for oral administration in nursing homes? 

[offlabel]

This is why your faculty hacks on you so hard for med math and pharmacology. When you hear somebody say, "it's all unit dose / controlled by the pump / in the Pyxis / set up by the pharmacist / etc., etc.” you can remember this one. (5cc does NOT equal 5 mg. …)

This kind of thing has nothing to do with being able to do the simple arithmetic of nursing medication administration. It has to do with being able to read. Same thing with the Vandy nurse giving vecuronium instead of versed. Says what it is and the concentration right on the label. No math required.

[feelix, RN]

Using common sense usually catches calculation errors. If you have to give an unusually high amount of any medication, step back. Take a deep breath, then take a fresh look at things.