A practical nurse is caring for a client who is scheduled to receive a prescribed dose of oral azithromycin. The morning diagnostic reports indicate a serum potassium level of 3.1 mEq/L (3.1 mmol/L) and a newly prolonged QT interval on the electrocardiogram. Which action should the practical nurse take?
- Withhold the azithromycin and immediately report the clinical findings to the registered nurse.Answer
- BAdminister the medication as prescribed and note the potassium level in the end-of-shift report.
- CAdminister an intravenous potassium bolus to correct the deficit before giving the azithromycin.
- DBypass the electronic barcode scanning process to expedite the administration of the prescribed antibiotic.
Answer
The practical nurse should withhold the azithromycin and immediately report the clinical findings to the registered nurse.
Azithromycin is a macrolide antibiotic that carries a known risk of prolonging the QT interval. This client already has a newly prolonged QT interval and concurrent hypokalemia (potassium level of 3.1 mEq/L). The combination of hypokalemia and a QT-prolonging medication drastically increases the risk of developing a lethal ventricular arrhythmia, such as torsades de pointes. The most appropriate action within the practical nursing scope of practice is to prioritize client safety by withholding the medication and immediately communicating these critical findings to the supervising registered nurse or healthcare provider.
Step-by-Step Solution
Key Concept
Safe medication administration requires the practical nurse to evaluate pertinent laboratory values and diagnostic results prior to giving a drug, withholding medications that pose an immediate risk of adverse effects, and promptly escalating these findings to the registered nurse.