A nurse is administering an antibiotic to a competent elderly client at midnight. The client refuses to take meds stating 'I already took my pills before I went to sleep'. What is the PRN best action?

• A. Check with previous documentation to be certain that the time of administration was not changed by previous shift
• B. Administer the antibiotic anyway
• C. Document refusal
• D. Call the physician to obtain a new order

Answer: (A)

Verifying the medication record and any changes in dosing time is the first safety step when a patient questions whether a med has been given. Shift handoffs can alter the scheduled administration time, so administering at midnight without checking could result in a double dose or a missed dose. By checking the previous shift’s documentation, you confirm whether the time was changed, whether the dose was already given, or whether it’s still due. This keeps the care plan accurate and protects the patient from dosing errors. If the record shows the dose was already given, you wouldn’t administer again and would document the finding; if it’s still due, you proceed according to the patient’s consent and the MAR. The key idea is to confirm the current status in the record before taking further action.