A nurse is reviewing the medication administration record for a client receiving continuous enteral nutrition via a nasogastric tube. The morning prescriptions include liquid acetaminophen, an immediate-release carvedilol tablet, and an extended-release nifedipine tablet. The provider's prescription states to crush all solid medications and administer them via the tube. Which action is the highest priority for the nurse to prevent a critical adverse event?
- Withhold the extended-release nifedipine and contact the healthcare provider to request a non-sustained-release alternative.Cevap
- BElevate the head of the client's bed to during and immediately after the medication administration.
- CPause the continuous enteral feeding for prior to administering the medications.
- DDelegate the administration of the liquid acetaminophen to the unlicensed assistive personnel (UAP).
Cevap
The nurse must withhold the extended-release nifedipine and contact the provider for an alternative prescription.
Extended-release (ER, XL, SR, CR) medications are specifically formulated to release their active ingredients slowly over an extended period. Crushing an extended-release antihypertensive like nifedipine destroys this controlled-release mechanism, causing a rapid 'dose dump.' This floods the systemic circulation with the medication, leading to profound, life-threatening hypotension and potential cardiovascular collapse. The nurse's highest priority is to recognize this prescribed medical error, withhold the medication, and collaborate with the provider for a safe alternative.
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Prevention of Medication Administration Errors: Contraindications for Crushing Medications
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