A client who is admitted for primary hypothyroidism has early signs of myxedema coma.
In assessing the client, in which sequence should the nurse complete these actions? (Rank the first action at the top with the remainder in descending order.).

Medication administration is a process that involves prescribing, dispensing, and giving medications to patients. It is a critical and complex task that requires accuracy, safety, and adherence to the rights of medication administration, such as the right patient, right drug, right dose, right route, right time, right documentation, and right response.

When a male client tells the practical nurse (PN) that the pill he has been taking at home is a different color and size than the one the PN is trying to give him now, this may indicate a potential medication error or discrepancy. A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm. A medication discrepancy is any difference between the current and previous medication regimens of a patient.

The PN should respond to the client's concern by telling him that the PN will verify that the dispensed medication is the valid prescription. This means that the PN will check the medication label, the medication order, and the medication administration record (MAR) to confirm that the medication given to the client matches the one prescribed by the healthcare provider. The PN will also compare the dispensed medication with a drug reference guide or a picture of the medication to ensure that it is the correct drug and dosage form. The PN will also report any suspected errors or discrepancies to the healthcare provider or the pharmacy for clarification or correction.

Options A, B, and D are incorrect answers, as they do not reflect the appropriate or responsible actions for the PN to take when faced with a possible medication error or discrepancy.

Option A is incorrect because explaining that the healthcare provider probably prescribed a different medication while he is hospitalized is not true or helpful, as it does not verify or resolve the issue.

Option B is incorrect because telling the client that he is probably confused since being hospitalized tends to disorient clients is rude and dismissive, as it does not acknowledge or address the client's concern.

Option D is incorrect because explaining that the pharmacy often substitutes generic equivalents for more expensive brands is not accurate or relevant, as it does not verify or resolve the issue.

Choice A rationale:

Verapamil is a calcium channel blocker and is expected to decrease heart rate by inhibiting calcium influx into cardiac cells, particularly in the SA (sinoatrial) node, where it can slow down the heart's electrical impulses.

Choice B rationale:

Increased contractility is not an expected outcome of verapamil use. In fact, verapamil's main action is to decrease myocardial contractility, making it useful for treating conditions like angina and atrial fibrillation.

Choice C rationale:

Verapamil is known to dilate coronary arteries, which can improve blood flow to the heart muscle and relieve symptoms of angina.

Choice D rationale:

Reduced blood pressure is an expected outcome of verapamil use due to its vasodilatory effects on peripheral blood vessels. This can be beneficial in treating hypertension and angina.

Choice E rationale:

Relieved chest pain is an expected outcome of verapamil use, particularly in the case of variant angina (Prinzmetal's angina), as it helps to relax coronary arteries and reduce coronary artery spasm, which is a common cause of chest pain in this condition.