A nurse notices at the start of the shift that a patient's IV antibiotic scheduled to be given six hours ago is still hanging on the patient's IV pole. The pump is turned off and the tubing is not connected to the patient. The antibiotic is documented as given on the MAR by the previous nurse. What is the first thing the nurse should do? 


•The first action the nurse should take is to ensure the patient receives the ordered therapy by notifying the physician and seeking orders for the timing of the next dose of antibiotic. Antibiotics are most effective when there is a therapeutic level in the patient's system. The most important thing the nurse can do in this situation is to make sure that the physician is aware of the missed dose so that the antibiotic schedule can be adjusted if needed.

•After notifying the physician and adjusting the dosing schedule, the nurse should document physician notification, notify the charge nurse, and complete an incident report.

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