A practical nurse (PN) realizes that an immediate-release oral antihypertensive medication was mistakenly administered to a client instead of the prescribed extended-release formulation. Arrange the PN's actions in the correct priority sequence from first to last.
- 1Assess the client's blood pressure, heart rate, and neurological status.
- 2Instruct the client to remain in bed and ensure the call light is within reach.
- 3Notify the primary healthcare provider and the nursing supervisor of the error.
- 4Document the administered medication and the client's clinical status in the health record.
- 5Complete an internal facility incident report detailing the event.
Answer
The correct sequence is to first assess the client's vital signs, then implement immediate safety precautions (bed rest), followed by notifying the healthcare provider, documenting the event in the medical record, and finally completing an internal incident report.
When managing a medication error, the practical nurse must prioritize direct client care and safety over administrative duties. The nursing process mandates assessing the client first to identify adverse reactions. Next, immediate safety interventions are implemented to prevent injury (e.g., falls). Once the client is safe, the nurse escalates the issue to the healthcare provider with the assessment data. Finally, clinical documentation is completed in the health record, followed by the separate, administrative incident report.
Step-by-Step Solution
Key Concept
Nursing Process and Error Management Prioritization