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Zorluk: ZorPharmacological Therapies

An interdisciplinary care team has established a treatment plan for a client admitted with acute decompensated heart failure and atrial fibrillation. The pharmacological prescriptions include a continuous intravenous heparin infusion, intravenous push furosemide, oral spironolactone, and topical nitroglycerin ointment. Which medication administration action should the practical nurse identify as being within their scope of practice?

  1. A
    Titrate the continuous intravenous heparin infusion rate according to the hospital protocol and the morning activated partial thromboplastin time.
  2. B
    Administer the prescribed intravenous push furosemide slowly over two minutes to minimize the risk of ototoxicity.
  3. C
    Bypass the electronic barcode scanning of the client's identification band before giving the spironolactone if the nurse just completed their initial shift assessment.
  4. Apply the topical nitroglycerin ointment to a hairless area of the chest using a dose-measuring applicator while wearing clean gloves.Cevap

Cevap

The practical nurse should safely apply the topical nitroglycerin ointment to the client using a dose-measuring applicator while wearing clean gloves.
Applying topical medications, such as nitroglycerin ointment, is a foundational skill within the practical nurse scope of practice. Using a dose-measuring applicator ensures correct dosing, and wearing clean gloves is a critical safety measure to prevent the nurse from absorbing the medication and experiencing adverse effects like hypotension and a severe headache.

Adım Adım Çözüm

1
Evaluate the order for the continuous intravenous heparin infusion.
Determine that titrating this infusion is outside the practical nurse scope.
Titrating high-alert continuous infusions based on laboratory results requires the advanced clinical judgment of a registered nurse.
2
Evaluate the order for intravenous push furosemide.
Determine that administering intravenous push medications is not permitted for the practical nurse.
Intravenous push medications carry high risks, act rapidly, and require immediate registered nurse assessment.
3
Evaluate the medication verification scenario regarding the oral spironolactone.
Determine that bypassing barcode scanning violates safe medication administration principles.
Two client identifiers must be verified before every single medication administration to prevent errors.
4
Evaluate the order for the topical nitroglycerin ointment.
Determine that applying topical medications is a safe, standard procedure for the practical nurse.
Wearing gloves is a critical safety step to prevent unintended self-administration and systemic vasodilation in the nurse.

Anahtar Kavram

Practical Nurse Scope of Practice in Pharmacological Therapies
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