Update Graded A+
HISTORY
A 58-year-old female admitted for reduction of a fractured left femur reports insomnia. She
claims she is currently experiencing difficulty falling asleep and has had this problem "on and
off" prior to her admission. After consulting with her physician, he prescribes zolpidem
(Ambien).
ASSESSMENT
The patient's medication order reads:
Today's date, 1100
Zolpidem (Ambien) 5-10 mg PO HS for sleep PRN
D. Harden, MD.
To minimize the risk of a medication error, you must
A. call the physician to double check the order
B. check the patient's chart for medication allergies
C. observe the patient's "six rights." A - Incorrect. It is not necessary to double check every
order with the provider.
B - Incorrect. Checking the chart or asking the patient about any known or suspected
medication allergies will help minimize the risk of an adverse reaction, but it does not address
the issue of medication errors.
C - Correct. By observing the six rights, you are acting responsibly when preparing and
administering medication to your patient.
, HISTORY
A 58-year-old female admitted for reduction of a fractured left femur reports insomnia. She
claims she is currently experiencing difficulty falling asleep and has had this problem "on and
off" prior to her admission. After consulting with her physician, he prescribes zolpidem
(Ambien).
ASSESSMENT
The patient's medication order reads:
Today's date, 1100
Zolpidem (Ambien) 5-10 mg PO HS for sleep PRN
D. Harden, MD.
When you administer this medication, you should
A. give the patient 10 mg of zolpidem at bedtime
B. provide the patient with 5 mg of zolpidem each night
C. give the patient an oral dose of zolpidem at bedtime at the patient's request A - Incorrect.
While the patient may receive up to 10 mg of zolpidem at bedtime, you should first administer
5 mg and assess the effectiveness of the lower dose for treating the patient's insomnia. If it
appears that the patient is still having difficulty falling asleep, you can give her an additional 5
mg. As a general principle, administer the lowest dose that will achieve the desired effect.
B - Incorrect. The order reads, "PRN," which means that the patient should have input into the
need to take the medication. You should not "automatically" administer the medication each
night.
C - Correct. The abbreviation "PO" (per os) refers to the oral medication route while "HS" refers
to the patient's hour of sleep (bedtime). "PRN" (pro re nata) is an acceptable abbreviation for
when the patient expresses a need or when necessary.