Chapter 20 - Prioritization, Delegation, and Assignment 100% All Verified A+

The nurse is caring for a patient newly diagnosed with hypertension. Blood pressure readings over the past 8 hours have been:08:00: 164/93 mm Hg12:00: 158/90 mm Hg16:00: 166/94 mm HgThe health care provider prescribes a no added salt diet and plans to start the patient on hydrochlorothiazide 25 mg. Which action is *most* important for the nurse to do before administering this drug? •Check the patient's serum potassium level •Review the patient's urine output for the past 24 hours •Instruct the unlicensed assistive personnel to check the patient's blood pressure •Check whether the patient is having abnormal heart rhythms - ANS-•Check the patient's serum potassium level •Hydrochlorothiazide is a thiazide diuretic often used to treat hypertension. An adverse effect of these diuretics is that when Na+ reabsorption is blocked by thiazide diuretics, this increases Na+ delivery to the cortical collecting duct and increases Na+ reabsorption in this segment of the nephron. Because Na+ reabsorption is coupled to K+ secretion in the cortical collecting duct, these drugs can lead to excessive K+ secretion and hypokalemia ([K+] in extracellular fluid is too low). The same is true of loop diuretics (e.g., furosemide). Thiazide and loop diuretics may be combined with potassium-sparing diuretics (e.g., spironolactone) to counteract this possibility. The other actions are also appropriate for this patient but are not as urgent. A patient is prescribed meloxicam for rheumatoid arthritis. This drug has a long half-life of 51 hours. Which prescription would the nurse be sure to clarify with the health care provider before giving the medication? •Meloxicam 7.5 to 15 mg/day •Meloxicam 15 mg/day before breakfast •Meloxicam 7.5 mg every 4 hours as needed for pain •Meloxicam 7.5 mg/day as needed - ANS-•Meloxicam 7.5 mg every 4 hours as needed for pain •A drug's plasma half-life depends on how quickly the drug is eliminated from the plasma. The half-life of a given medication is how long it takes for the body to get rid of half of the dose. If a drug with a long half-life is given too often or at short intervals, its level can become so high that it is toxic. The RN is a team leader working with an LPN/LVN and two unlicensed assistive personnel (UAP) to provide care for eight medical patients. Which action would be appropriate for the RN take with regard to nursing care provided by the LPN/LVN? •Delegate the performance of an abdominal dressing change to the LPN/LVN •Supervise and document the patient assessments completed by the LPN/LVN •Assign the LPN/LVN the administration of insulin to a patient with type 1 diabetes •Delegate checking and recording vital signs on all eight patients to the LPN/LVN - ANS-•Assign the LPN/LVN the administration of insulin to a patient with type 1 diabetes •LPN/LVNs are licensed and therefore responsible for their own practice. Their scope of practice includes administration of medications. The RN team leader is responsible for supervision as well as making assignments for LPN/LVNs (team leaders also make assignments for other RNs on the team). Delegation of checking and recording vital signs is appropriate for the UAPs. The LPN/LVN could perform the dressing change, but the RN would assign, not delegate, the task. A 14-year-old child was recently diagnosed with type 1 diabetes. The patient is prescribed 10 units of regular insulin and 15 units of NPH insulin each morning. How should the nurse instruct this patient to give herself the prescribed doses of insulin? CONTINUES...