The home care nurse is reviewing the patient's prescribed medications. The patient reports he doesn't take his antihypertensive (blood pressure) medication anymore. What is the best response by the nurse?
"You could create problems for your family if you don't manage your health."
"You could possibly suffer a stroke if you don't manage your blood pressure"
"Have you had your blood pressure checked since discontinuing this medication?"
"What is the reason you are no longer taking the blood pressure medication?"
The Correct Answer is D
A) "You could create problems for your family if you don't manage your health.": While this statement highlights the potential impact on family, it may not effectively address the patient's concerns or motivations. This response could come across as judgmental rather than supportive.
B) "You could possibly suffer a stroke if you don't manage your blood pressure.": Although this response underscores the seriousness of uncontrolled hypertension, it might induce fear without encouraging a constructive dialogue about the patient's reasons for discontinuing the medication.
C) "Have you had your blood pressure checked since discontinuing this medication?": This question is relevant but does not directly address the patient's decision to stop taking the medication. It misses an opportunity to explore the underlying reasons behind the patient's choice.
D) "What is the reason you are no longer taking the blood pressure medication?": This response is the most effective because it opens a dialogue for the patient to express his feelings or concerns about the medication. Understanding the patient's perspective allows the nurse to provide better education and support tailored to the patient's needs, potentially addressing any misconceptions or side effects that may have influenced the decision.
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Correct Answer is ["A","B","D"]
Explanation
A) Notify the health care provider: It is essential to inform the healthcare provider if a
patient refuses a medication. This allows for a reassessment of the patient's treatment plan and ensures that any necessary follow-up or adjustments can be made based on the patient's refusal.
B) Determine the reason for refusal: Understanding why a patient refuses medication is crucial. It may be due to side effects, lack of understanding, personal beliefs, or concerns about the medication. Gathering this information can help the nurse address the patient’s concerns and educate them appropriately.
C) Administer the dose when the next dose is due: Administering a medication that the patient has refused would violate their rights and could be considered coercive. The patient has the right to refuse treatment, and the nurse should respect that decision rather than attempt to administer it later without consent.
D) Document the reason for refusal in the patient's health record: Accurate documentation is vital in healthcare. Recording the patient's refusal and the reason for it in their health record ensures continuity of care and provides information for other healthcare team members regarding the patient's preferences and concerns.
E) Mix it in a small amount of their food: This action is inappropriate and unethical. Coercively administering medication without the patient's consent undermines their autonomy and trust in the healthcare system. The nurse should always respect the patient’s right to refuse medication.
Correct Answer is D
Explanation
A) 2: Administering 2 mL of Compazine would provide a total dose of 10 mg (since the concentration is 5 mg/mL), which exceeds the ordered dose of 2.5 mg. This option is incorrect as it would administer too much medication.
B) 1.5: This option suggests giving 1.5 mL, which would equate to 7.5 mg (1.5 mL x 5 mg/mL). This dosage also exceeds the ordered 2.5 mg and is therefore not appropriate.
C) 1: Administering 1 mL would deliver 5 mg of Compazine. This amount is higher than the prescribed 2.5 mg and is not the correct dose.
D) 0.5: This option is correct. Administering 0.5 mL of Compazine would provide a dose of 2.5 mg (0.5 mL x 5 mg/mL). This matches the ordered dosage perfectly, ensuring that the patient receives the correct amount of medication.