Psychotic Disorders no. 4023

Psychotic Disorders no. 4023

QUESTION: A client's medication order reads, "Thioridazine (Mellaril) 200 mg P.O. q.i.d. and 100 mg P.O. p.r.n." The nurse should:

✘O a.) administer the medication as prescribed.
✓O b.) question the physician about the order.
✘O c.) administer the order for 200 mg P.O. q.i.d. but not for 100 mg P.O. p.r.n.
✘O d.) administer the medication as prescribed but observe the client closely for adverse effects.

RATIONALE

RATIONALE: The nurse must question this order immediately. Thioridazine (Mellaril) has an absolute dosage ceiling of 800 mg/day. Any dosage above this level places the client at high risk for toxic pigmentary retinopathy, which can't be reversed. As written, the order allows for administering more than the maximum 800 mg/day; it should be corrected immediately, before the client's health is jeopardized.
NURSING PROCESS STEP: Implementation
CLIENT NEEDS CATEGORY: Physiological integrity
CLIENT NEEDS SUBCATEGORY: Pharmacological and parenteral therapies
COGNITIVE LEVEL: Knowledge