The nurse plans to administer the adult client’s prescriptions which are metoprolol, hydrochlorothiazide, enoxaparin and atorvastatin.

The current laboratory values are; Serum potassium 5.2 mmol/L, Platelet Count 98,000/mm, Serum cholesterol 250 mg/dL and Serum Creatinine 1.2 mg/dL.
Which medication should the nurse hold and notify the prescriber?

I give the client his medications when the wife is grocery shopping. This statement would require the nurse to re-evaluate and correct the plan of care because home health aides are not allowed to administer medications in most states. Home health aides can only provide medication reminders, help put the medication into the hands of the user, or assist with self-administration of certain forms of medications.

Giving medications to the client without supervision or delegation by a registered nurse or physician is a violation of the scope of practice and could harm the client.

Choice A is wrong because removing throw rugs from the client’s walking path is a safety measure that can prevent falls and injuries for a client with Alzheimer’s disease.

Choice B is wrong because documenting activities with the client before leaving for the day is a professional responsibility that ensures continuity of care and accountability.

Choice C is wrong because contacting the nurse if there are any questions about the plan of care is a sign of good communication and collaboration that can enhance the quality of care for the client.

A. Administer oxygen. This is the first priority because oxygen can help prevent further sickling of red blood cells and improve tissue perfusion.

B. Start IV fluids. This is the second priority because hydration can reduce blood viscosity and prevent vaso-occlusion.

C. Administer pain medication. This is the third priority because pain is a common and distressing symptom of sickle cell crisis and should be treated with opioids around the clock.

D. Draw lab work. This is the last priority because lab work can help monitor the severity of the crisis and the need for blood transfusions, but it does not directly relieve the patient’s symptoms or prevent complications.