A nurse is preparing to administer digoxin orally to a client. Identify the sequence of steps the nurse should take.
(Move the steps placing them in the order of performance. Use all the steps.)
Remove the medication from the dispensing system.
Compare the client's wristband to the medication administration record.
Open the medication package.
Document administration of the medication.
The Correct Answer is A,B,C,D
Choice A rationale:
The first step is to remove the medication from the dispensing system. This ensures that the nurse has the right medication and dose for the client. The nurse should also check the label of the medication against the medication administration record (MAR) at this point. Choice B rationale:
The second step is to compare the client's wristband to the MAR. This verifies the client's identity and prevents medication errors. The nurse should use two identifiers, such as name and date of birth, to confirm the client's identity.
Choice C rationale:
The third step is to open the medication package. This prepares the medication for administration and prevents contamination. The nurse should also check the expiration date of the medication before opening it.
Choice D rationale:
The fourth step is to document administration of the medication. This completes the medication administration process and provides a record of the client's care. The nurse should document the medication name, dose, route, time, and any relevant observations or outcomes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
IV bolus administration of potassium is not appropriate due to the risk of cardiac arrhythmias.
Choice B rationale:
The formulation of potassium (potassium chloride) is appropriate for IV administration.
Choice C rationale:
Potassium chloride is typically diluted in normal saline (0.9% sodium chloride) for IV administration, not dextrose.
Choice D rationale:
The prescribed infusion rate of 30 mEq of potassium chloride over 30 minutes is too rapid and could lead to adverse effects, such as cardiac arrhythmias. The nurse should clarify the prescription and discuss a slower infusion rate with the provider.
Correct Answer is D
Explanation
Choice A rationale:
Taking an HMG-CoA reductase inhibitor (statin) is not directly related to digoxin toxicity.
Choice B rationale:
Having a prolapsed mitral valve is not a known risk factor for digoxin toxicity.
Choice C rationale:
Having a history of COPD is not directly associated with digoxin toxicity.
Choice D rationale:
High-ceiling diuretics (loop diuretics) can lead to electrolyte imbalances, such as hypokalemia, which can increase the risk of digoxin toxicity. Potassium plays a role in the effects of digoxin on the heart, and low levels can potentiate toxicity.
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