Final answer:
When a medication dose for an infant in a pediatric unit is in question, the nurse should verify the calculation, contact the pharmacy for clarification, check the chain of command policy, and document all actions taken. Direct administration without these checks is a risk to the patient's health.
Step-by-step explanation:
If a nurse calculates the medication dose for an infant on the pediatric unit and determines that the dose is twice what it should be, appropriate action must be taken to ensure the safety of the patient. Despite a pediatrician's instruction to administer the medication as ordered, the nurse has a professional responsibility to ensure proper dosing. Given the potential risks of administering an incorrect dose, the nurse should take the following steps:
- Verify the order and the calculation: Ensure that the dosage calculation is correct and that there is no misunderstanding regarding the order.
- Contact the pharmacy for clarification: Consulting with the pharmacy can provide an additional layer of check on dosage calculations and the appropriateness of the prescribed amount.
- Check the hospital or clinic's chain of command policy for such situations, which might involve escalating the issue to a nursing supervisor or a clinical director.
- Document all communications and actions: Keeping a record ensures transparency and accountability for actions taken.
Directly administering the medication as ordered without performing these checks could put the patient's health at significant risk, and giving the amount calculated to be correct without further verification could also lead to an error in patient care. Therefore, the nurse's next action should be to contact the pharmacy for clarification and to check the chain of command policy, notifying their nursing supervisor if necessary, to resolve the potentially unsafe medication order.