The physician orders a brand name drug for the client. The hospital formulary substitutes the generic equivalent of the brand name drug, and the nurse administers the generic drug. Which statement(s) best represent(s) the nurse's action? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply
1. The nurse should have contacted the physician prior to administering the drug.
2. The nurse should have called the pharmacist to see if the drugs were bioequivalent.
3. The nurse used good judgment in administering the drug.
4. The nurse was correct; hospital policies allow for this.
5. The nurse should ask the client which brand of drug is used at home.
3,4
Rationale 1: It is not feasible for the nurse to contact the physician every time there is a generic substitution.
Rationale 2: The pharmacist should only fill the prescription with a bioequivalent drug from the approved formulary.
Rationale 3: The nurse used good judgment as hospital policies allow for generic substitution of certain drugs.
Rationale 4: Use of formularies and negative formularies support the hospital policies allowing substitution.
Rationale 5: In most cases, the client will not know which brand of medication is used at home. The brand used at home would be relevant only in very few medications.
Global Rationale: The nurse used good judgment as hospital policies allow for generic substitution of certain drugs. It is not feasible for the nurse to contact the physician every time there is a generic substitution. The pharmacist should only fill the prescription with a bioequivalent drug from the approved formulary. Use of formularies and negative formularies support the hospital policies allowing substitution.. In most cases, the client will not know which brand of medication is used at home. The brand used at home would be relevant only in very few medications.
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