To ensure an accurate and proper “med pass,” the nurse must adhere to the Ten Rights of Medication Administration. The third right, the right dose requires an accurate nurse to calculate the appropriate amount of medication to be given. The dose equals the strength of the medication multiplied by the amount. Again, the nurse must complete the routine checks (tip #28) prior to administering any medication. The pharmacy is also responsible for recognizing dose issues when reviewing the orders. Errors may be made if a nurse gave only one tablet, when the dose required two. Some meds are ordered with special instructions, for example, if a blood pressure or a blood sugar falls below a known range, the dose would need to be held. A call to the physician may also be required. A dose may need to be calculated based on the laboratory result, such as administering an amount of insulin, based on the blood sugar level. Facilities may have a policy requiring a second nurse to double check another nurse when he/she is drawing up certain medication in a syringe, such as insulin. Nurses must also determine if the dose ordered is appropriate for the resident, especially if the resident had a change in condition. If the nurse notes a discrepancy or inappropriateness in the dose, this must also be reported to the physician. These steps must be followed to ensure safe administration of the right dose. This is basic training, usually taught to nursing students before they ever actually pass medication to residents. If there is any doubt about a medication that a nurse gives to your loved one, ask the nurse to confirm if it is the correct medication and/or if it was actually ordered.