The nurse cares for a client on total parenteral nutrition. What action should the nurse take to prevent complications associated with parenteral nutrition?

Rationale:
A. Verifying calculations with another nurse is an important safety step to ensure the correct dose is administered, especially for high-risk medications. However, this action focuses on dosage accuracy rather than whether the medication is appropriate for the client’s medical condition or therapeutic need. Correct calculation alone does not guarantee that the medication is indicated for the client’s current diagnosis.

B. Checking the label against the order ensures the nurse selects the right medication and dose and matches it to the prescription. This step is critical to prevent administration errors, but it does not provide information about whether the medication is indicated for the client’s condition or whether it is safe considering their medical history or concurrent medications.

C. Reviewing the client’s medical history is the most important action to ensure the medication is given for the right indication. By examining the client’s diagnoses, current symptoms, comorbidities, allergies, and other medications, the nurse can confirm that the prescribed medication is appropriate for the client’s needs. This step helps prevent giving a medication that is unnecessary, contraindicated, or potentially harmful. For example, administering a beta-blocker to a client with bradycardia or giving an NSAID to a client with renal impairment could cause serious complications if the indication and client history are not considered.

D. Confirming the name on the prescription ensures the right client receives the medication, which is essential for safety, but it does not verify that the medication is appropriate for the client’s health condition. Administering the correct drug to the wrong client or the correct drug to a client without proper indication can both result in adverse outcomes.

Rationale:

• Chest tightness is correct for Blank 1 because this symptom may indicate a potentially life-threatening condition such as cardiac or respiratory compromise. Using the ABC priority framework, physiological stability and possible airway, breathing, or circulation issues must be addressed first.
• Anxiety is correct for Blank 2 because once immediate physiological threats are assessed, psychological distress should be evaluated. Anxiety can contribute to physical symptoms and may worsen chest discomfort.
• No appetite is correct for Blank 3 because while important, it is not an immediate threat to physiological stability. Appetite changes can be addressed after ruling out serious causes of chest tightness and evaluating anxiety.