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Zorluk: ZorPharmacological Therapies

Following the change-of-shift report, a practical nurse reviews the electronic health record of an older adult client hospitalized for a heart failure exacerbation. The client's morning serum potassium result is 2.8 mEq/L2.8\text{ mEq/L} (2.8 mmol/L2.8\text{ mmol/L}). The active medication administration record includes scheduled oral furosemide, oral potassium chloride, and a new one-time order for intravenous (IV) push bumetanide. Which of the following actions should the practical nurse take? Select all that apply.

  1. Withhold the scheduled oral furosemide dose until the healthcare provider is consulted.Cevap
  2. Promptly communicate the morning serum potassium results to the supervising registered nurse.Cevap
  3. Auscultate the client's apical heart rate for one full minute to assess for irregular rhythms.Cevap
  4. D
    Administer the prescribed intravenous push dose of bumetanide to rapidly reduce fluid overload.
  5. E
    Confirm the client's identity by checking the bed and room number before administering the potassium chloride.
  6. F
    Give the oral furosemide as scheduled because the client is concurrently receiving a potassium supplement.

Cevap

The correct actions are to withhold the scheduled oral furosemide, communicate the critical potassium level to the registered nurse, and auscultate the apical heart rate for irregularities.
A serum potassium level of 2.8 mEq/L indicates severe hypokalemia. The practical nurse must prioritize client safety by withholding the potassium-wasting diuretic (furosemide), reporting the critical lab value to the registered nurse for prompt intervention, and monitoring the client for hypokalemia-induced cardiac complications by checking the apical pulse for irregularities.

Adım Adım Çözüm

1
Analyze the client's laboratory data.
The serum potassium level is 2.8 mEq/L, which indicates severe hypokalemia (normal reference range is typically 3.5-5.0 mEq/L).
Identifying abnormal laboratory values is essential before safely administering any medication.
2
Evaluate the prescribed medications in relation to the laboratory findings.
Furosemide is a potassium-wasting loop diuretic. Giving it would further deplete potassium levels.
Preventing medication-induced complications requires withholding contraindicated drugs when critical lab values are present.
3
Determine the practical nurse's scope of practice regarding the new IV orders.
The practical nurse identifies that administering IV push medications, such as bumetanide, is outside their scope of practice.
Ensuring safe delegation and assignment limits legal liability and protects the client from harm.
4
Formulate a safe plan of care based on the findings and scope of practice.
The nurse plans to hold the furosemide, report the critical potassium level to the registered nurse, and monitor the client's cardiac status by auscultating the apical pulse.
These actions align with the practical nurse's responsibilities for data collection, medication safety, and clinical escalation.

Anahtar Kavram

Medication safety, critical laboratory monitoring, and practical nursing scope of practice.
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Pharmacological Therapies

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