A nurse is reviewing a client medication record

QUESTION

A nurse is reviewing a client medication record. The nurse should identify that which of the following prescription requires further clarification. A-Albuterol metered dose inhaler 2 inhalations every 4 to 6 hr PRN for bronchospasm B-Clozapine 25 mg PO daily C-Flunisolide 80 mcg inhalation twice daily D-Haloperidol .5 mg PO 2 times each day

ANSWER

The nurse, while reviewing a client’s medication record, should identify that the prescription requiring further clarification is option B: “Clozapine 25 mg PO daily.”

Here’s why:

1. Albuterol metered dose inhaler (Option A): This prescription is clear and concise. It specifies the medication (Albuterol), the route (inhaler), the dosage (2 inhalations), and the frequency (every 4 to 6 hours PRN for bronchospasm). There is no ambiguity, and it aligns with common practice for managing bronchospasm.

2. Flunisolide 80 mcg inhalation (Option C): Similar to Option A, this prescription is clear and specific. It mentions the medication (Flunisolide), the dosage (80 mcg inhalation), and the frequency (twice daily). It is not in need of further clarification.

3. Haloperidol 0.5 mg PO (Option D): This prescription is also straightforward. It includes the medication (Haloperidol), the dosage (0.5 mg), the route (PO, which stands for “by mouth”), and the frequency (2 times each day). It is not ambiguous and conforms to standard medication orders.

However, Option B, “Clozapine 25 mg PO daily,” raises a concern:

The prescription mentions the medication (Clozapine), the dosage (25 mg), and the route (PO, or “by mouth”). It specifies that it should be taken “daily,” which implies once a day.

The reason for concern

Clozapine is a potent antipsychotic medication typically prescribed to individuals with specific mental health conditions, such as schizophrenia. The dosing and monitoring requirements for clozapine are quite strict due to potential side effects, including severe blood-related issues. It often requires a gradual titration to the target dose.

Given the complexities associated with clozapine therapy, the prescription “Clozapine 25 mg PO daily” raises questions:

1. Is this the starting dose, or is the patient already titrated to this dosage?
2. Is the prescriber aware of the strict monitoring requirements for clozapine, including regular blood tests?
3. Should there be a plan for dose titration, and if so, what is it?

To ensure patient safety and appropriate medication management, the nurse should seek clarification from the prescriber regarding the details of the clozapine prescription. This is crucial to ensure that the medication is administered safely and effectively, considering the unique requirements associated with clozapine therapy.