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Difficulty: MediumPharmacological Therapies

A practical nurse (PN) is reviewing their client assignments and preparing to administer medications on a medical-surgical unit. Which of the following planned actions by the PN demonstrate safe pharmacological practice? Select all that apply.

  1. A
    Administering an initial dose of intravenous (IV) push morphine for a client experiencing severe postoperative pain.
  2. B
    Administering the live attenuated measles, mumps, and rubella (MMR) vaccine to a client who is currently pregnant.
  3. Asking an alert client to state their full name and date of birth while comparing it to the medication administration record.Answer
  4. D
    Identifying a sleeping client by checking the room and bed assignment number before administering a scheduled antibiotic.
  5. E
    Rounding a calculated pediatric liquid medication dose of 2.4 mL up to 3.0 mL to make it easier to draw into the syringe.
  6. Withholding a scheduled oral beta-blocker and notifying the registered nurse when the client's apical heart rate is 50 beats per minute.Answer

Answer

The correct actions are verifying the client's identity using their full name and date of birth, and withholding the beta-blocker for a heart rate of 50 beats per minute.
Safe pharmacological practice requires strict adherence to the rights of medication administration and operating within the legal scope of practice. Using two distinct, unique identifiers (like name and date of birth) ensures the medication is given to the correct individual. Additionally, assessing critical vital signs, such as an apical pulse, before administering medications like beta-blockers and withholding the dose if the heart rate is too low prevents dangerous adverse cardiac effects.

Step-by-Step Solution

1
Analyze each planned medication administration action against the practical nurse scope of practice and general pharmacological safety standards.
Identified that checking two standard identifiers (name and date of birth) and withholding a beta-blocker for bradycardia are appropriate and safe nursing actions.
These actions directly uphold the rights of medication administration and ensure patient safety by preventing errors and adverse drug events.
2
Evaluate the remaining actions for safety and scope of practice violations.
Identified that IV push administration, giving live vaccines to pregnant clients, using room numbers for identification, and improperly rounding pediatric doses are all unsafe or out of scope.
Recognizing unsafe practices prevents patient harm and ensures adherence to legal guidelines and facility policies regarding safe medication administration.

Key Concept

Safe Medication Administration and PN Scope of Practice
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Topics

Pharmacological Therapies

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