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Zorluk: ZorChemical and Other Dependencies / Substance Use Disorders

A charge nurse on an inpatient clinical unit observes a staff registered nurse (RN) returning from a scheduled break. The staff RN is exhibiting an unsteady gait, slurred speech, and noticeably constricted pupils. Over the past several weeks, the charge nurse has noted that this specific RN frequently volunteers to administer intravenous pain medications for other nurses' clients. Which of the following is the priority action for the charge nurse to take?

  1. Relieve the staff RN of all client care responsibilities immediately and escort them to the nursing supervisor.Cevap
  2. B
    Approach the staff RN privately to empathetically inquire if they are experiencing a substance use relapse.
  3. C
    Delegate the staff RN's remaining medication administrations to an unlicensed assistive personnel while auditing the narcotic cabinet.
  4. D
    Document the observed physical findings in a confidential incident report and monitor the RN closely for the rest of the shift.

Cevap

The priority action is to immediately relieve the impaired staff RN of all client care responsibilities and escort them to nursing administration.
When a nurse exhibits signs of acute intoxication or impairment, such as constricted pupils, slurred speech, and ataxia, they pose an immediate and severe risk to client safety. The absolute highest priority is to remove the impaired professional from the clinical setting to prevent client harm. Once the nurse is removed, the charge nurse must involve nursing administration, such as the nursing supervisor, to manage the substance use violation according to facility policy.

Adım Adım Çözüm

1
Analyze the clinical presentation of the staff RN.
The combination of constricted pupils, slurred speech, ataxia, and a history of volunteering to give narcotics strongly indicates opioid intoxication and potential drug diversion.
Recognizing the signs of chemical dependency in peers is a critical professional responsibility.
2
Determine the highest priority need based on the assessment.
An actively impaired nurse providing direct care poses a severe, immediate threat to client safety.
According to Maslow's hierarchy and basic safety principles, protecting clients from immediate physical harm takes precedence over all other actions.
3
Select the intervention that immediately mitigates the safety risk.
Removing the nurse from the unit and involving the nursing supervisor ensures clients are protected and facility protocols for suspected substance use are followed.
Administrative intervention is required to manage workplace impairment safely and legally.

Anahtar Kavram

Impaired Professional and Workplace Substance Use Disorders
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Konular

Chemical and Other Dependencies / Substance Use Disorders

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