A client recently had a myocardial infarction. Which medication would the nurse anticipate the provider prescribing?

A) "I know it is really busy but I do not have time to help you either. I have my own clients.": While it may be tempting to express frustration due to being busy, this response lacks professionalism and does not address the situation appropriately. As healthcare professionals, it is important to communicate effectively and collaborate with colleagues to ensure safe patient care, even when busy. Instead, the nurse should express the need to follow protocols while offering help in a safe manner.

B) "Are you sure the doctor ordered that much morphine? It seems like a lot to give all at once.": Although questioning the dosage is part of safe nursing practice, this response is unnecessary in this situation. If there is a concern about the prescribed amount of morphine, it should be verified with the healthcare provider. However, this question does not directly address the issue of administering the medication safely. It also does not ensure that the nurse is following correct protocols for preparing and administering medication.

C) "I can give your client their pain medications, but I need to draw up and prepare it myself.": This response is the most appropriate because it ensures the nurse is adhering to safe medication administration practices. The nurse should always prepare and administer medications themselves to verify the correct dosage, route, and patient. Allowing another nurse to prepare medication and administering it without proper verification can lead to medication errors. This response also shows willingness to help while maintaining safety standards.

D) "Sure thing, give me that syringe and I will give it for you while you are on break.": This response is inappropriate because it involves accepting medication from another nurse without verifying that the correct drug, dose, and preparation have been followed. It is unsafe to administer medications prepared by others without reviewing the medication and ensuring that everything is accurate. Nurses must always prepare and administer their own medications to prevent potential medication errors.

A) The drugs will compete for receptor sites: While it's true that highly protein-bound drugs can compete for binding sites on proteins (like albumin), the main issue with highly protein-bound drugs interacting is not related to competition for receptor sites. The primary concern is how the drugs displace each other from the protein-binding sites, which can increase the free (active) drug levels in the bloodstream. This can lead to a higher pharmacological effect, especially if the unbound drug concentration rises to a therapeutic or toxic level.

B) The client will have increased effects of both drugs: This is the correct answer. When two highly protein-bound drugs are administered together, they can displace each other from protein-binding sites. This displacement increases the amount of free (active) drug in circulation, which may intensify the pharmacologic effects of both drugs. For example, if one drug displaces the other from its protein-binding site, more of the free drug will be available to exert its effects. This can increase the risk of side effects, toxicity, or both.

C) The client will have decreased effects of both drugs: This is incorrect. The opposite is true—when two highly protein-bound drugs are given together, the displacement of one drug increases the amount of the free drug available, leading to a stronger effect, not a weaker one. Decreased effects would occur if the drug had no access to the target receptor or if it were metabolized or eliminated too quickly, which isn't the case in this scenario.

D) Both drugs are equally bound to protein: While both drugs may bind to protein, they do not necessarily bind equally. One drug might bind more strongly or more selectively to the protein than the other, which could lead to displacement of the weaker-bound drug. The important point is that their competition for protein-binding sites can lead to an increase in free (active) drug concentrations.