Examkin

Question

Difficulty: MediumPharmacological Therapies

A practical nurse (PN) is reviewing the medication administration records and preparing for morning care. Which of the following planned actions by the PN are appropriate and safe? Select all that apply.

  1. Scanning the client's identification band and the medication package barcode before administering an oral dose of amlodipine.Answer
  2. Withholding a scheduled dose of digoxin for a client with an apical pulse of 54 beats/minute and notifying the registered nurse (RN).Answer
  3. C
    Administering a prescribed dose of intravenous (IV) push morphine sulfate to a client experiencing severe postoperative pain.
  4. D
    Administering a scheduled morning dose of warfarin to a client whose most recent international normalized ratio (INR) is 4.8.
  5. E
    Administering the measles, mumps, and rubella (MMR) vaccine to a pregnant client who is preparing for discharge.
  6. F
    Calculating a pediatric weight-based dose of oral acetaminophen using the child's weight in pounds instead of kilograms.

Answer

The appropriate and safe actions are scanning the client's identification band/medication barcode before giving amlodipine, and withholding digoxin for a heart rate below 60 beats/minute while notifying the RN.
The practical nurse must consistently verify two client identifiers and utilize barcode scanning when available to ensure medication safety. Additionally, the PN is expected to withhold digoxin and notify the supervising RN if the adult client's apical pulse falls below 60 beats/minute, as this is a primary indicator of potential digitalis toxicity or excessive therapeutic effect.

Step-by-Step Solution

1
Evaluate the scope of practice for the practical nurse regarding medication administration routes.
Identify that intravenous (IV) push medications are outside the standard PN scope of practice.
To ensure care is delegated appropriately and safely.
2
Analyze client clinical data against prescribed medications.
Determine that an apical pulse of 54 beats/minute warrants withholding digoxin, and an INR of 4.8 warrants withholding warfarin.
To prevent medication toxicity and adverse events such as hemorrhage.
3
Identify contraindications for scheduled immunizations.
Recognize that the live MMR vaccine is strictly contraindicated in pregnancy.
To prevent fetal harm and ensure maternal-child safety.
4
Review fundamental medication safety standards.
Confirm that barcode scanning is an expected safety measure and that pediatric dosages require precise weight conversion to kilograms.
To prevent medication administration and calculation errors.

Key Concept

Safe Medication Administration and Practical Nurse Scope of Practice
Rate this question

Topics

Pharmacological Therapies

More questions from this topic