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Zorluk: OrtaPharmacological Therapies

A practical nurse (PN) enters the room of an elderly client to administer a scheduled dose of oral morphine for chronic back pain. The PN notes that the client, who is typically alert and oriented, is now acutely confused, lethargic, and struggling to stay awake. Which of the following is the most appropriate action for the PN to take?

  1. A
    Administer the medication as prescribed, attributing the confusion to expected age-related cognitive changes.
  2. B
    Prioritize the client's chronic pain management and administer the morphine while monitoring their respiratory rate.
  3. Withhold the medication and immediately report the client's change in mental status to the registered nurse.Cevap
  4. D
    Verify the client's identity using the name posted on the room door due to the client's lethargy, then administer the medication.

Cevap

Withhold the medication and immediately report the client's change in mental status to the registered nurse.
The correct answer identifies that the client is experiencing an acute change in neurological status (lethargy and confusion). Because morphine is an opioid analgesic that can cause central nervous system and respiratory depression, giving the medication could be dangerous. The most appropriate action within the practical nurse (PN) scope of practice is to withhold the medication and immediately notify the registered nurse (RN) so a comprehensive assessment can be performed.

Adım Adım Çözüm

1
Assess the client's current status and compare it to their baseline.
The client is experiencing acute confusion and lethargy, which represents a significant change from their typically alert baseline.
Identifying acute changes in a client's condition is a critical component of safe medication administration.
2
Determine the safety of administering the scheduled medication.
Morphine is a central nervous system depressant. Administering it to a lethargic and confused client increases the risk of severe respiratory depression and worsening mental status.
Opioids can exacerbate hypoxia and central nervous system depression.
3
Select the appropriate action within the practical nurse scope of practice.
The PN must withhold the dose and promptly escalate the finding to the registered nurse (RN) for further assessment and intervention.
An acute change in condition requires an RN-level assessment to determine the underlying cause before proceeding.

Anahtar Kavram

Monitoring for adverse pharmacological effects and adhering to the practical nurse scope of practice regarding acute changes in client condition.
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Pharmacological Therapies

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