After administering a medication, the nurse notes that the client has itching and a runny nose. What is the nursing priority?
1. Document the findings
2. Assess vital signs
3. Notify the charge nurse
4. Monitor the client closely
3
Rationale 1:Upon discovering that a client is allergic to a product, it is the nurse's responsibility to first alert the charge nurse and patient's physician. Documentation is next as well as to apply labels to the chart and medication administration record to alert all healthcare personnel of the allergy. The client should be given an agency-approved allergy bracelet, and the pharmacist should also be told.
Rationale 2:Vital signs may or may not be assessed in this situation, and it would not be the next action of the nurse.
Rationale 3: On discovering that a client is allergic to a product, it is the nurse's responsibility to first alert the charge nurse and patient's physician.
Rationale 4:In this situation, the client is stable; however, the client would be monitored after notifying the charge nurse, physician, and pharmacist, and documenting information in the client's medical record.
Global Rationale: On discovering that a client is allergic to a product, it is the nurse's responsibility to first alert the charge nurse and patient's physician. Upon discovering that a client is allergic to a product, it is the nurse's responsibility to first alert the charge nurse and patient's physician. Documentation is next as well as to apply labels to the chart and medication administration record to alert all healthcare personnel of the allergy. The client should be given an agency-approved allergy bracelet, and the pharmacist should also be told. Vital signs may or may not be assessed in this situation, and it would not be the next action of the nurse. In this situation, the client is stable; however, the client would be monitored after notifying the charge nurse, physician, and pharmacist, and documenting information in the client's medical record.
You might also like to view...
The nurse assigned to an oncology unit reports that three of the patients with cancer do not have an appetite and have eaten little during the shift
What strategies can the nurse on the next shift use to increase her patients' appetites? Select all that apply. a. Offer frequent, smaller meals. b. Keep the patients' rooms neat and clean. c. Provide or assist with frequent oral hygiene. d. Increase liquid intake with meals. e. Serve foods with little aroma.
The amount of NaCl contained in 0.5 L of a 0.9% NaCl IV solution is ______________
a. 2.25 g b. 10 g c. 4.5 g d. 9 g
If a one-group pretest-posttest study uses subjects as their own controls, which is the study design?
a. Experimental b. Quasi-experimental c. Correlational d. Descriptive
The nurse is caring for a patient who has decreased mobility. Which intervention is a simple and cost-effective method for reducing the risks of stasis of pulmonary secretions and decreased chest wall expansion?
A) Antibiotics B) Frequent change of position C) Oxygen humidification D) Chest physiotherapy