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Difficulty: MediumPharmacological Therapies

A practical nurse is preparing to administer morning medications to a group of assigned clients. Which of the following actions by the nurse demonstrate safe pharmacological practice? Select all that apply.

  1. Verifying a client's identity by checking their identification band and asking them to state their full name and date of birth.Answer
  2. Withholding a scheduled dose of oral morphine for a client who has a resting respiratory rate of 10 breaths per minute and notifying the registered nurse.Answer
  3. C
    Administering an intravenous (IV) push dose of ondansetron to a client who is experiencing severe postoperative nausea.
  4. D
    Leaving a sealed unit-dose package of an oral antibiotic on the bedside table for a client who is currently in the restroom.
  5. Reviewing a client's most recent serum potassium level prior to administering a scheduled daily dose of oral digoxin.Answer
  6. F
    Administering a live attenuated influenza vaccine to a client who is currently receiving immunosuppressive corticosteroid therapy.

Answer

The correct actions are verifying identity with two unique identifiers, withholding the opioid for bradypnea (respiratory rate < 12), and checking the potassium level before giving digoxin.
Verifying identity with two unique identifiers, withholding opioids for respiratory depression (rate < 12), and monitoring potassium levels before digoxin administration all represent safe, within-scope pharmacological practices that protect the client from harm.

Step-by-Step Solution

1
Evaluate the action of verifying identity with two identifiers.
This action is correct and required.
It ensures the right medication is given to the right client, fulfilling a core right of medication administration.
2
Evaluate the action of withholding morphine for a respiratory rate of 10.
This action is a correct safety intervention.
Opioids depress the respiratory drive. A rate below 12 breaths per minute warrants withholding the drug and notifying the RN.
3
Evaluate the action of administering an IV push medication.
This action is inappropriate.
IV push administration falls outside the practical nurse's scope of practice, regardless of the severity of the client's symptoms.
4
Evaluate the action of leaving medication at the bedside.
This action violates safe medication administration rules.
The nurse cannot verify that the correct client took the medication at the scheduled time if it is left unattended.
5
Evaluate the action of reviewing the potassium level before digoxin administration.
This action is a correct and necessary precaution.
Low potassium levels can precipitate dangerous digoxin toxicity, making this a vital pre-administration data collection step.
6
Evaluate the action of giving a live vaccine to a client on corticosteroids.
This action is contraindicated.
Clients on immunosuppressive therapy cannot safely receive live attenuated vaccines due to the risk of active infection.

Key Concept

Safe Medication Administration and Scope of Practice
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Topics

Pharmacological Therapies

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