Examkin

Soru

Zorluk: ZorAccident, Error, and Injury Prevention

A nursing supervisor is conducting safety rounds on a medical-surgical unit. Which observation represents a critical breach in safety protocols that requires the supervisor's immediate intervention to prevent client injury?

  1. A registered nurse administering an intravenous (IV) push dose of phenytoin directly into the Y-site of a continuous 5% dextrose in water (D5W) infusion.Cevap
  2. B
    Staff members donning standard surgical masks prior to entering the private room of a client admitted with suspected meningococcal meningitis.
  3. C
    Bilateral soft wrist restraints secured to the movable portion of the bed frame for a client with agitated delirium, following the documented failure of a continuous sitter.
  4. D
    An unlicensed assistive personnel (UAP) ambulating a stable 2-day postoperative client in the hallway, with instructions to immediately report any client complaints of dizziness.

Cevap

The observation requiring immediate intervention is the administration of IV push phenytoin into a continuous D5W infusion.
The administration of phenytoin into a dextrose solution is a critical error. Phenytoin is highly incompatible with D5W and will rapidly precipitate (crystallize) in the tubing, creating a severe risk of an embolism if it enters the client's bloodstream. The supervisor must intervene immediately to stop the administration, flush the line with 0.9% sodium chloride (normal saline), and prevent client injury.

Adım Adım Çözüm

1
Analyze the supervisor's goal.
The supervisor must identify an active safety hazard that violates accident, error, and injury prevention principles and could cause immediate harm to a client.
This establishes the criteria for selecting the correct option: identifying the unsafe practice among safe practices.
2
Evaluate the medication administration scenario.
Phenytoin precipitates when mixed with dextrose. Administering it into a D5W line creates an immediate risk of embolus.
Understanding IV compatibility is a critical component of medical error mitigation and injury prevention.
3
Evaluate the remaining clinical scenarios for hidden safety errors.
The use of surgical masks for meningitis (Droplet Precautions), securing restraints to the movable bed frame, and delegating ambulation of a stable post-op client to a UAP are all safe and evidence-based nursing actions.
Differentiating between actual errors and safe practices prevents unnecessary intervention and confirms the correct hazard.

Anahtar Kavram

Prevention of Medication Errors and Intravenous Incompatibilities
Tahmini Süre:1m 15s
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Konular

Accident, Error, and Injury Prevention

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