You are a new nurse about to give an elderly woman her medications. You have placed the tablets in a pill cup for easy administration. You check her blood pressure and it is low at 90/52, so she can't take her blood pressure medication. What mistake have you made?
A. Opening the seals of the medications before taking patient's blood pressure
B. Taking the blood pressure before administering the medication
C. Taking the blood pressure with the patient lying down
D. Forgetting to bring juice to give with the medications
Answer (2)
In this scenario, the mistake likely made was 'Opening the seals of the medications before taking the patient's blood pressure.'
Here's a step-by-step explanation of why this is the correct answer:
Patient Assessment: It's crucial to assess the patient's vital signs, including blood pressure, before administering medications, especially if they include blood pressure medications. This helps determine if it's safe to proceed with the medication as prescribed.
Medication Preparation: By opening the seals of the medication before checking the blood pressure, you prematurely prepared for administration without full assurance that it was safe or appropriate. If the blood pressure is too low, as in this case (90/52 mmHg), administering further blood pressure-lowering medication could exacerbate the situation, potentially leading to dizziness, fainting, or worse complications.
Decision-making: Checking the blood pressure first ensures that you make informed and safe decisions about whether it's appropriate to administer the medication based on the patient’s current condition.
Best Practice: As part of safe medication administration practices, always assess and confirm the patient's current state, including reviewing vital signs and patient's history, before preparing medications. This prevents waste of medication and reduces the risk of administering inappropriate treatments.
The other options present less critical mistakes in this context:
Taking the blood pressure before administering the medication: This is a correct step, not a mistake, as it helps ensure safe administration.
Taking the blood pressure with the patient lying down: While it's common to take it sitting, lying down can be appropriate, especially in clinical settings.
Forgetting to bring juice to give with the medications: While juice might be important for certain medications to aid swallowing or mask taste, it is not the critical mistake in terms of assessing medication safety based on vital signs.
The mistake made was 'Opening the seals of the medications before taking the patient’s blood pressure.' It is crucial to check the patient's blood pressure before administering medications, particularly those that could lower blood pressure further. This practice helps ensure the safety and appropriateness of medication administration based on the patient's current condition.
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