Question

a nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. which of the following actions should the nurse take first?

report the incident to the charge nurse.
notify the provider.
fill out an incident report.
check the clients blood glucose.

Explanation:

Analyze the clinical scenario

The scenario describes a medication administration error where a nurse administered metformin (an oral antidiabetic medication that lowers blood glucose levels) instead of metoclopramide (a prokinetic agent used to treat gastroesophageal reflux and gastroparesis). The question asks for the action the nurse should take first.

Apply the nursing process

Using the Nursing Assessment knowledge point, the nurse must prioritize client safety and assessment over administrative or reporting actions. Assessment is always the first step of the nursing process when a medication error occurs to determine the immediate physiological impact on the client.

Evaluate the physiological risk

Using the Insulin Administration and Diabetes Patient Education knowledge points, administering an oral hypoglycemic agent like metformin to a client who may not require it poses an immediate risk of hypoglycemia. Therefore, the nurse must assess the client's physiological status by checking their blood glucose level before taking reporting actions.

Compare the options

Using the Incident Reporting and Medication Error Documentation knowledge points

• "Report the incident to the charge nurse" and "Notify the provider" are necessary subsequent steps but are not performed before assessing the client.
• "Fill out an incident report" is an administrative task that is completed after the client is safe and stable.
• "Check the client's blood glucose" is the immediate assessment action required to ensure client safety.

Answer:

• Report the incident to the charge nurse.
• Notify the provider.
• Fill out an incident report.
• Check the client's blood glucose. (Correct answer)