A nurse is assisting with the development of a nursing staff in-service about medication reconciliation. Which of the following instructions should the nurse recommend to include in the in-service?

Complete medication reconciliation when a client moves to a new room on the same unit.

Medication reconciliation should be completed whenever the nurse administers a medication.

Medication reconciliation can be delegated to an assistive personnel.

Include herbal supplements in the medication reconciliation.

Answer and Explanation

The Correct Answer is D

A. Complete medication reconciliation when a client moves to a new room on the same unit:

While it's important to update the client's information when they change rooms, this may not necessitate a full medication reconciliation. Medication reconciliation is typically more comprehensive and involves a thorough review of the client's entire medication regimen.

B. Medication reconciliation should be completed whenever the nurse administers a medication:

While it's important to verify medications before administration, a full medication reconciliation involves a broader review of the client's entire medication history and should not necessarily be done each time a single medication is administered.

C. Medication reconciliation can be delegated to an assistive personnel:

Medication reconciliation is a complex process that involves a thorough review of the client's medication history, and it is generally considered a nursing responsibility. Delegating this task to assistive personnel may compromise accuracy and completeness.

D. Include herbal supplements in the medication reconciliation:

This is the correct answer. Herbal supplements can interact with prescribed medications and may impact the client's overall health. Including them in the medication reconciliation process ensures a comprehensive assessment of the client's medication regimen.

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Correct Answer is C

Explanation

A. "The surgeon can obtain informed consent from the client's adult cousin."Informed consent must be obtained from a parent or legal guardian for a minor. An adult cousin does not have the legal authority to provide consent unless they are the legal guardian of the minor, which is not indicated in this scenario.

B. "The surgeon should delay surgery until he can obtain informed consent from a parent."Delaying surgery in an emergency situation could endanger the client's life or health. In such cases, waiting for parental consent is not advisable, and other legal mechanisms, such as implied consent, should be used to proceed with necessary treatment.

C. "The surgeon can proceed with the surgery by invoking implied consent."In emergency situations where the client is a minor and the parents or legal guardians are not available to provide consent, the principle of implied consent allows healthcare providers to perform life-saving procedures without explicit consent. The law recognizes that in emergencies, delaying treatment to obtain consent could result in harm, so the surgeon can proceed with the surgery.

D. "The client's pediatrician can obtain implied consent."The concept of implied consent is not something that can be "obtained" by another healthcare provider. It is a legal principle that allows healthcare providers to act in the best interest of the client during an emergency when consent cannot be obtained. The pediatrician does not have a role in obtaining or invoking implied consent in this context; it is the responsibility of the surgeon performing the emergency procedure.

A. The client's blood pressure was recorded at 0730 and 1130. B. The client's pain medication was administered twice during this shift. C. The client's enteral feeding bag needs to be changed at 2200. D. The client received a bath and backrub.

Correct Answer is A

Explanation

A. The client's blood pressure was recorded at 0730 and 1130.

In a change-of-shift report, it is important to communicate vital signs, especially changes in the client's condition. Recording the blood pressure at different times during the shift helps the oncoming nurse understand the client's cardiovascular status and identify trends or potential issues.

B. The client's pain medication was administered twice during this shift:

While medication administration is important information, specifying the number of times pain medication was administered may be less relevant in a brief change-of-shift report. It's more critical to communicate the client's pain level, response to medication, or any concerns related to pain management.

C. The client's enteral feeding bag needs to be changed at 2200:

While enteral feeding is an essential aspect of care, the timing of the feeding bag change may not be as crucial in a change-of-shift report. Instead, it would be more pertinent to communicate any issues related to the client's tolerance of feeding, any changes in feeding rate, or signs of intolerance.

D. The client received a bath and backrub:

Personal care activities, such as a bath and backrub, are essential components of nursing care, but they may be less critical in a change-of-shift report unless there are specific concerns related to the client's skin condition or overall well-being. More emphasis should be placed on clinical assessments and changes in the client's condition.

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