A charge nurse is reviewing ethical principles with a group of staff nurses. Which of the following statements by a staff nurse indicates an understanding of ethical principles?

A. Shake the suspension well before each administration.

The medication label specifically states, "IMPORTANT: SHAKE WELL BEFORE EACH USE," and "THIS PRODUCT MUST BE SHAKEN WELL ESPECIALLY PRIOR TO INITIAL USE." This indicates the necessity of shaking the suspension before administration to ensure proper mixing of the medication.

B. Dilute the suspension with 38 mL water prior to initial use.

There is no indication on the label to dilute the suspension with water. The label emphasizes shaking well before use, but dilution is not mentioned.

C. Store the suspension in the refrigerator.

The storage instructions on the label state, "Store at 20° to 25°C (68° to 77° F) see USP controlled room temperature." Refrigeration is not mentioned, and it is not recommended to deviate from the specified storage conditions.

D. Discard the suspension 14 days after opening the bottle.

The label does not provide specific information about the shelf life after opening. Therefore, it is essential to follow the specific instructions on the label or refer to the package insert for complete prescribing information regarding the expiration or discard date after opening. The information on the label does not specify a 14-day limit.

A. Report the occurrence to the nursing supervisor:

While reporting the occurrence is important, verifying the DNR status takes precedence. The nurse needs to gather information and confirm whether the patient has a current DNR order before escalating the issue to a higher authority.

B. Complete an incident report stating the facts of the situation:

Completing an incident report is a part of the process, but it should not be the first action. The immediate concern is to determine if the patient has a valid DNR order. An incident report can be completed later to document the situation and any actions taken.

C. Verify the DNR prescription is current in the medical record.

Verifying the DNR (do-not-resuscitate) prescription is the first and most immediate action the nurse should take. It is crucial to confirm the current status of the DNR order to ensure that the healthcare team is following the patient's wishes. If the DNR is indeed valid and up-to-date, it means the resuscitation efforts, including CPR, were contrary to the patient's expressed wishes.

D. Request a meeting with the ethics committee:

Contacting the ethics committee may be necessary depending on the circumstances, but it is not the first step. Verifying the DNR status is an immediate action that can guide subsequent decisions. If there are ethical concerns or conflicts, involving the ethics committee can be considered after confirming the facts surrounding the DNR order.