Examkin

Question

Difficulty: MediumPharmacological Therapies

A practical nurse is assigned to care for a client who is prescribed oral levofloxacin, subcutaneous regular insulin, and an intravenous (IV) push dose of ondansetron. The client's morning laboratory results reveal a serum potassium level of 2.9 mEq/L2.9\text{ mEq/L}. Which of the following actions are appropriate for the practical nurse to take? Select all that apply.

  1. Request that the registered nurse administer the intravenous push ondansetron.Answer
  2. B
    Administer the intravenous push ondansetron slowly over 22 minutes to prevent adverse effects.
  3. Report the morning serum potassium result to the registered nurse or healthcare provider immediately.Answer
  4. D
    Administer the subcutaneous regular insulin as scheduled because it does not affect the potassium level.
  5. Verify the client's identity using two distinct identifiers prior to any medication administration.Answer
  6. F
    Scan the client's identification band immediately after the client has swallowed the oral medication.

Answer

The appropriate actions are to request the registered nurse to administer the IV push medication, report the critical potassium level immediately, and verify the client's identity using two identifiers prior to any administration.
The correct actions prioritize client safety and adhere to the practical nurse scope of practice. Requesting the registered nurse to administer the IV push medication is correct because IV push administration requires advanced clinical judgment outside the practical nurse's scope. Reporting the serum potassium level of 2.9 mEq/L2.9\text{ mEq/L} is correct because this is a critical value (normal is 3.5 to 5.0 mEq/L3.5\text{ to }5.0\text{ mEq/L}) requiring prompt intervention, and administering the scheduled insulin would worsen this hypokalemia. Verifying the client's identity using two distinct identifiers prior to administration is a fundamental standard of medication safety.

Step-by-Step Solution

1
Analyze the practical nurse scope of practice regarding the prescribed medication routes.
The practical nurse can administer oral and subcutaneous medications, but intravenous (IV) push medications require a registered nurse.
To ensure care is delegated and provided within legal and safety boundaries.
2
Evaluate the provided morning laboratory results.
The serum potassium level is 2.9 mEq/L2.9\text{ mEq/L}, which indicates significant hypokalemia (normal range: 3.5 to 5.0 mEq/L3.5\text{ to }5.0\text{ mEq/L}).
To identify any contraindications or need for immediate medical intervention before giving scheduled medications.
3
Assess the relationship between the prescribed medications and the abnormal laboratory value.
Regular insulin causes potassium to shift into cells, which would dangerously exacerbate the client's hypokalemia. The medication must be withheld and the lab value reported.
To prevent iatrogenic harm from medication administration.
4
Apply standard medication administration safety principles.
Two distinct client identifiers must always be verified before, not after, administering any medication.
To adhere to the standard rights of medication administration and prevent errors.

Key Concept

Delegation, Scope of Practice, and Medication Safety
Rate this question

Topics

Pharmacological Therapies

More questions from this topic