The nurse is preparing to administer medications to a 54-year old client. Which medications taken would be affected by the first-pass effect? (Select All that Apply.)

A) Report the incident immediately to your supervisor upon noticing: Reporting the incident is an important step, but it should come after assessing the client's condition. Immediate assessment of the client's vital signs and overall status takes precedence to address any potential immediate health impacts due to the medication error.

B) Gather reversal agents to administer to the client: Gathering reversal agents is a critical step if the medication administered poses an immediate risk and reversal is necessary. However, this action should follow an initial assessment of the client's condition to determine if reversal is needed.

C) Notify the client's provider immediately while present with the client: Notifying the provider is essential to receive guidance on how to manage the medication error. Nonetheless, the first priority should be to assess the client's condition to provide accurate information to the provider.

D) Assess the client's vital signs: The initial action should be to assess the client’s vital signs and overall condition to determine any immediate effects of the incorrect medication. This assessment helps in identifying if the client is experiencing any adverse reactions or complications, which will guide subsequent actions such as notifying the provider and administering reversal agents if needed.

A. This hospital might use a different manufacturer, but the medication is the same:
While it is possible that different manufacturers might produce pills of varying appearances, this response does not directly address the client's concern or involve them in verifying the medication. It's important for the nurse to first understand what the client is accustomed to before providing reassurance about the medication.

B. What does your usual pill look like?:
Asking the client to describe their usual pill is the best response. This approach allows the nurse to verify the medication in question by comparing it to the client’s known medication. It also reassures the client that their concerns are being taken seriously and provides an opportunity for the nurse to check if there has been an error or if the medication is indeed correct.

C. This is the medication prescribed by your provider:
While this statement is factual, it does not directly address the client’s concern about the appearance of the medication. It's important to involve the client in verifying the medication to ensure they are receiving the correct drug and to maintain their trust.

D. This pill is probably from a different lot number than yours at home:
This response assumes the issue is related to the lot number, which may not be the case. It does not involve the client in the verification process or address their specific concern about the appearance of the medication. Providing a more thorough and engaging response would be more appropriate.