Drug Level out of range

Also Consider:  Abnormal Lab Result

1. Take Vital Signs

• Temperature:

• Blood Pressure:

• Heart Rate: 

• Respiratory Rate:

• Oxygen Saturation:

2. Evaluate Symptoms and Signs

• Symptoms of the condition or disease being treated: ___

• If level is elevated, evaluate the drug’s symptoms of toxicity: ___

3. Take Action using SBAR Report:

• Presence of other, significant symptoms or signs of illness 

  • Refer to appropriate Situation-Specific Evaluation for the identified symptoms and signs.

• Immediately notify the medical staff & resident representative

  • Any drug level above or below therapeutic level with changes in condition for which the drug is prescribed, OR

  • Patient is having an adverse drug reaction with signs or symptoms of toxicity

• Notify medical staff & resident representative within the next 16 hours. 

  • Any drug level above or below therapeutic level AND  not in the patient’s usual range, prior to giving the next dose.

• Notify medical staff at the next regular rounds 

  • Any drug level above or below therapeutic level but in usual range for the patient 

4. Implement Management Plan

• Place on 24-hour report

• Review status and plan of care with designated representative

2025-04-26