A practical nurse (PN) and a registered nurse (RN) are co-assigned to care for a client wi… — NCLEX-PN

A practical nurse (PN) and a registered nurse (RN) are co-assigned to care for a client with acute heart failure. The primary healthcare provider prescribes furosemide $40\text{ mg}$ intravenous (IV) push stat. The RN prepares the medication in a syringe, hands it to the PN, and says, "The client's potassium is $3.8\text{ mEq/L}$ . Can you push this while I admit a new client?" What is the most appropriate action by the PN?

A
Decline the delegated task, as a serum potassium level of $3.8\text{ mEq/L}$ is critically low and requires withholding the furosemide.
B
Accept the delegated task, provided the PN can independently verify the medication vial and client identifiers prior to administration.
Decline the delegated task, as administering medications via the IV push route is outside the standard scope of practice for a PN.Answer
D
Accept the syringe and administer the medication immediately, as the RN has already verified the client's identity and laboratory data.

Answer

The correct action is to decline the delegated task because administering medications via the IV push route is outside the standard scope of practice for a practical nurse.

The standard scope of practice for a practical nurse (PN) does not include the administration of intravenous (IV) push medications. This specific task requires the advanced assessment skills, pharmacological knowledge, and clinical judgment of a registered nurse (RN) to evaluate for immediate therapeutic or adverse reactions during the rapid administration into the bloodstream. Additionally, fundamental medication safety principles dictate that a nurse must never administer a medication drawn up by another individual, as doing so bypasses essential independent verification steps.

Step-by-Step Solution

Analyze the requested route of medication administration.

The prescription is for an intravenous (IV) push medication.

The route of administration determines whether the task falls within the practical nurse's legal scope of practice.

Evaluate the client's laboratory data.

The client's serum potassium level is

3.8\text{ mEq/L}

, which is within the normal reference range of

3.5

5.0\text{ mEq/L}

Loop diuretics like furosemide can cause hypokalemia, making it essential to verify baseline potassium before administration.

Apply the legal scope of practice and medication administration safety standards.

The PN must decline the task because IV push medications are outside the standard scope of practice, and it is unsafe to administer a medication drawn up by another nurse.

Nurses are accountable for working within their authorized scope and adhering to the rights of medication administration to ensure client safety.

Key Concept

LPN/LVN Scope of Practice and Medication Administration Safety

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