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Difficulty: MediumPharmacological Therapies

While coordinating care on a busy inpatient unit, a practical nurse performs several medication-related tasks throughout the shift. Which of the following actions reflect adherence to established pharmacological safety standards and the appropriate scope of practice? Select all that apply.

  1. Verifying a client's most recent serum potassium level prior to dispensing an oral loop diuretic.Answer
  2. B
    Administering an intravenous push dose of hydromorphone for a client experiencing acute severe pain.
  3. Withholding a scheduled dose of metoprolol and notifying the registered nurse when the client's apical pulse is 48 beats per minute.Answer
  4. D
    Confirming a client's identity by matching their room number to the medication record instead of asking for a date of birth.
  5. Asking a client to state their full name and comparing it with their identification band prior to handing them their pills.Answer
  6. F
    Providing a routine influenza immunization without first verifying if the client has a history of severe allergic reactions.

Answer

The actions that demonstrate safe pharmacological practice are: verifying the potassium level before giving a loop diuretic, withholding metoprolol for a low heart rate and notifying the RN, and having the client state their name while checking their identification band.
Safe pharmacological therapy requires the practical nurse to operate within their defined scope of practice while strictly adhering to safety checks. This includes verifying relevant lab values (like potassium for diuretics), checking vital signs and knowing when to withhold medication (like heart rate for beta-blockers), and strictly using two acceptable patient identifiers (like asking the client to state their name and checking the ID band).

Step-by-Step Solution

1
Evaluate each action against the 'rights of medication administration' and safety protocols.
Checking identifiers (name/ID band) and verifying relevant lab values (potassium) align with the rights of medication administration.
Standard safety protocols require two active identifiers and pre-administration assessment of pertinent labs.
2
Determine if each action falls within the legal scope of practice for a practical nurse.
Withholding medication for abnormal vitals and reporting to the RN is within scope. Administering IV push medications is out of scope.
Practical nurses must recognize when to hold a medication based on vital sign parameters but are restricted from performing IV push administrations in most jurisdictions.
3
Assess pre-administration screening practices.
Failing to check for allergies before giving a vaccine is a major safety violation.
Immunization protocols mandate allergy screening to prevent anaphylactic reactions.

Key Concept

Medication Safety and Practical Nurse Scope of Practice
Estimated Time:1m 30s
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Topics

Pharmacological Therapies

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