Mary K. Emerson is a patient at Felder Community Hospital. She was admitted last Thursday due to a diabetic episode and an upper respiratory infection that left her unresponsive at work. She was admitted to the ICU, and medical staff attempted to stabilize her condition. There were some problems with her care due to the wrong information being entered into the patient’s medication record in her chart. When the nursing staff was trying to update her medications from a previous episode, they chose Mary J. Emerson instead of the current patient, Mary K. Emerson. Mary J. Emerson was also a patient admitted around the same time to another unit. Mary K. was given penicillin for the upper respiratory infection but was found to have an extreme allergy, which sent her into acute respiratory distress. The penicillin was administered and documented on Mary J. Emerson’s chart before the clinical staff noticed the error.
As Mary remained in the ICU and drifted in and out of consciousness, clinical staff tried to make sure they remained on schedule with her medications. On two noted occasions, the scheduled dose of 30 units of insulin that was to be administered subcutaneously with meals was delayed during the shift. On a separate occasion, the nurse tech drew up 40 units to be administered intramuscularly instead of the prescribed subcutaneous route.
On the fifth day of her admission, Mary K. was exhausted from the testing and medication changes. When the nurse came in to administer her scheduled dose of insulin, she stated “Please, no more meds!”
A. Discuss the basic principles of pharmacology by doing the following:
1. Discuss the four stages of the drug cycle.
2. Discuss the physiological factors involved in drug absorption and drug distribution.
3. Discuss the difference between a side effect, a contraindication, and an adverse reaction to a medication.
a. Provide an example of a side effect, a contraindication, and an adverse reaction to a medication.
B. Using the scenario, discuss the seven drug rights when auditing documentation for a patient encounter by doing the following:
1. Identify the seven drug rights that were violated in the scenario.
a. Explain why the situations in the scenario are a violation of the seven drug rights.
2. Discuss the process an HIM professional would need to take to report the violations in the scenario to the appropriate party.
C. Explain the roles of OSHA, the FDA, and the DEA in enforcing the Controlled Substances Act.
D. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
