A nurse is caring for a client who has refused medications. Which of the following actions should the nurse take? (Select all that apply.)

Document the client's statement in the medical record.

Reinforce teaching about the purposes of the medications.

Tell the client they can take their medications later in the day.

Record non administration in the client's medication administration record.

Inform the pharmacy the client's medications will be wasted.

Answer and Explanation

Correct Answer : A,B,D

A.   Document the client's statement in the medical record. Accurate documentation is essential to provide a complete record of the client's care and decisions.
B.   Reinforce teaching about the purposes of the medications. Providing information can help the client make informed decisions and reconsider their refusal.
C.   Tell the client they can take their medications later in the day. This may not be appropriate, depending on the medication schedule and therapeutic requirements.
D.   Record non-administration in the client's medication administration record (MAR). This ensures an accurate medication history and alerts other providers to the missed dose.
E.   Inform the pharmacy the client's medications will be wasted. Medications are not automatically wasted upon refusal; they can often be returned or rescheduled.

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Correct Answer is D

Explanation

A. Examine personal values: Understanding personal biases is important, but this is not the initial step in ethical decision-making.
B. Agree on a desired outcome: Reaching a consensus is essential but should come after gathering the necessary information.
C. Create a plan of action: Developing a plan is premature without gathering facts and understanding the situation.
D. Collect the relevant facts: Gathering all relevant information is the first step to understanding the ethical dilemma and determining an appropriate response.

A. The medication administration record indicates the client received pain medication 12 hr ago. B. The client reports a pain level of 7 on a scale from 0 to 10. C. The client's pulse rate and blood pressure have decreased. D. The client is restless and grimaces with movement. E. The client's family tells the nurse the client is in pain.

Correct Answer is ["A","B","C","D"]

Explanation

A. The medication administration record indicates the client received pain medication 12 hr ago. This is important to prevent overmedication and assess if the dosing schedule allows another administration.
B. The client reports a pain level of 7 on a scale from 0 to 10. Pain rating is a critical factor in deciding whether to administer PRN pain medication.
C. The client's pulse rate and blood pressure have decreased. Vital sign changes may indicate sedation or hemodynamic instability, which could contraindicate additional pain medication.
D. The client is restless and grimaces with movement. Nonverbal cues of pain are essential considerations, especially if the client is unable to communicate effectively.
E. The client's family tells the nurse the client is in pain. While family input can be valuable, pain assessment should be based on the client's report or nurse observations.

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A nurse is caring for a client who has refused medications. Which of the following actions should the nurse take? (Select all that apply.)

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