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Difficulty: MediumPharmacological Therapies

While providing care on a busy medical-surgical unit, a practical nurse performs several actions related to medication administration. Which of the following actions demonstrate adherence to safe pharmacological principles and the practical nurse scope of practice? Select all that apply.

  1. Declining a provider's order to administer a stat dose of intravenous push furosemide to a client with heart failure.Answer
  2. B
    Accepting a delegated task to formulate the initial educational plan for a client starting oral anticoagulants.
  3. C
    Bypassing the electronic barcode scanner because a client is asleep and visually confirming the name on the wristband instead.
  4. Withholding a scheduled oral antihypertensive medication when the client's systolic blood pressure is below the prescribed hold parameter.Answer
  5. E
    Estimating a pediatric client's weight in kilograms to calculate a liquid medication dosage rather than obtaining a current scale measurement.
  6. F
    Administering a prescribed live virus vaccine to a client who currently takes daily immunosuppressant medications.

Answer

The safe and appropriate actions are declining to administer an intravenous push medication and withholding an antihypertensive medication when the blood pressure is below the hold parameter.
Practical nurses promote client safety and practice within their legal scope when they decline to perform tasks requiring RN-level certification (such as administering intravenous push medications) and when they appropriately withhold scheduled medications based on objective assessment data that falls outside safe or prescribed parameters.

Step-by-Step Solution

1
Evaluate each action against the practical nurse scope of practice.
Declining intravenous push medications is correct as this route requires RN-level monitoring and assessment. Formulating initial teaching plans is incorrect as it is strictly an RN responsibility.
The practical nurse must understand the legal boundaries of their license and appropriately decline tasks outside their scope to ensure client safety.
2
Evaluate the remaining actions against fundamental medication administration safety principles.
Withholding medication for out-of-range vital signs is correct. Bypassing barcode scanners, estimating pediatric weights, and giving live vaccines to immunosuppressed clients are all severe safety violations.
Strict adherence to the rights of medication administration, precise dosage calculations, and recognizing drug contraindications prevents severe adverse events.

Key Concept

Safe Pharmacological Practices and Practical Nurse Scope of Practice
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Topics

Pharmacological Therapies

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