A nurse is preparing to administer esomeprazole 20 mg IV bolus in 100 mL 5% dextrose in water for a client who has peptic ulcer disease. Available is esomeprazole 40 mg/5 mL. How many milliliters should the nurse add to the 5% dextrose in water? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

A. Documenting communication with a provider in the progress notes of the client's medical record: Proper documentation of provider communication is standard nursing practice and does not constitute malpractice. It helps ensure continuity of care and legal protection.

B. Placing a yellow bracelet on a client who is at risk for falls: Implementing fall precautions, such as using a yellow wristband, is an appropriate safety measure and standard of care, not malpractice.

C. Administering potassium via IV bolus: Administering potassium as a rapid IV push is extremely dangerous and can cause cardiac arrest. This action violates the standard of care and constitutes malpractice due to potential harm to the client.

D. Leaving a nasogastric tube clamped after administering oral medication: A nasogastric (NG) tube is often clamped for a short period after administering medication to allow the medication to be absorbed. The nurse's action would only be considered negligent if they left the tube clamped for a prolonged period.

Rationale:

A. "I allow myself 10 minutes to finish each client's dressing change.": Assigning a fixed time to every procedure may not be realistic, as dressing change complexity and patient needs can vary. Overly rigid timing can compromise quality of care and flexibility in prioritizing tasks.

B. "I try to be working on at least three tasks at once so I can finish on time.": Multitasking in nursing can lead to errors, incomplete documentation, and compromised patient safety. Prioritizing and completing tasks sequentially is more effective for accuracy and quality care.

C. "I do not document my interventions in the electronic medical records until the end of each shift.": Delayed documentation increases the risk of errors, omissions, and inaccurate reporting. Timely documentation is essential for continuity of care and legal accuracy.

D. "I perform stat and time-critical care as soon as I receive the provider's prescriptions.": Addressing urgent and time-sensitive tasks immediately ensures that critical needs are met without delay. This reflects appropriate prioritization and effective time management.