Under standing orders, when should you contact medical control for dose adjustment?

• A. When the patient age or weight is outside the covered range
• B. When there is a language barrier
• C. When the patient is asleep
• D. Only if the patient requests

Answer: (A)

Dosing under standing orders relies on defined age and weight ranges. When a patient’s age or weight falls outside those covered ranges, you must contact medical control to obtain approval for a dose adjustment. This ensures safe and appropriate dosing because pharmacologic effects and needed quantities can change with extreme ages or body sizes, and the standing order lacks guidance for those scenarios. Medical control can provide a tailored dose or alternative plan based on the situation, taking into account factors like safety margins and practical considerations.

Language barriers, sleep, or a patient’s request do not by themselves mandate dose adjustments under standing orders. You follow the protocol for dosing within the covered ranges, and escalate to medical control for deviations or clarifications as needed, rather than adjusting doses based on those other factors.