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Difficulty: MediumPharmacological Therapies

An unlicensed assistive personnel informs the registered nurse (RN) that a postoperative client is experiencing severe pain. The RN, who is occupied with a new admission, hands a filled syringe to the practical nurse (PN) and asks the PN to administer the intravenous (IV) push morphine to the client. Which statement by the PN is the most appropriate response?

  1. I am not permitted to administer intravenous push medications, and I cannot give a medication drawn up by someone else.Answer
  2. B
    I will give this medication right away to ensure the client's pain is managed promptly.
  3. C
    I can perform this task if you directly supervise me while I inject the medication.
  4. D
    I must verify the client's two identifiers against the syringe label before I proceed.

Answer

The practical nurse must decline the task, stating they cannot administer IV push medications or give a medication that was prepared by another nurse.
The correct response identifies two critical safety and legal boundaries. First, the administration of intravenous (IV) push medications is outside the legal scope of practice for a practical nurse in most jurisdictions, as it requires rapid RN-level assessment of the client's physiological response. Second, fundamental medication safety protocols dictate that a nurse must never administer a medication that was drawn up or prepared by another individual, as this compromises the ability to independently verify the rights of medication administration.

Step-by-Step Solution

1
Evaluate the delegated route of administration against the practical nurse scope of practice.
The administration of IV push medications requires rapid clinical assessment and is generally outside the standard practical nursing scope of practice.
Nurses must only accept assignments and perform tasks that fall within their legally defined scope to ensure client safety.
2
Evaluate the medication preparation safety principles.
The medication was drawn up by the RN, not the PN.
A fundamental principle of medication safety is that a nurse may only administer medications they have personally prepared in order to guarantee all 'rights' of administration.
3
Determine the most appropriate clinical response.
The PN must clearly and professionally refuse the delegation based on both the scope limitation and the safety violation.
Declining unsafe or out-of-scope delegations is a mandatory professional responsibility.

Key Concept

Scope of Practice and Medication Administration Safety
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Topics

Pharmacological Therapies

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