Which prescribed medication can the nurse instruct the client to crush if needed?

A) Ask the client what prescribed medications are taken at home: While obtaining information about the client's home medications is important, this action does not address the specific issue of the unclear order. It is not an appropriate substitute for clarifying the medication order that the nurse is having difficulty transcribing.

B) Contact the prescriber to clarify the order: This is the best action for the nurse to take. If the nurse is unsure about the order due to illegible handwriting, the safest and most effective way to clarify the order is to directly contact the prescriber. This ensures that the nurse administers the correct medication and dose, reducing the risk of medication errors.

C) Wait until the prescriber makes rounds again to clarify the order: Waiting for the prescriber to make rounds is not an appropriate or timely solution. Medication administration should not be delayed due to unclear orders, as it could lead to treatment delays or potential harm to the patient. Immediate clarification is necessary.

D) Ask a colleague what the order says: While consulting a colleague might be helpful, it is not the most reliable or safe course of action. The nurse should not rely on others to interpret unclear orders, as there may be different interpretations or misunderstandings. Contacting the prescriber directly ensures the order is clarified accurately and safely.

A) Low albumin: This factor has the most impact on the pharmacokinetic phase of distribution. Albumin is a key protein in the blood that binds to many medications. When albumin levels are low, fewer drug molecules will be bound, leading to an increased concentration of free (unbound) drug in the bloodstream. This can result in enhanced drug effects or toxicity, as the unbound drug is pharmacologically active and more readily able to cross cell membranes.

B) Renal disease: While renal disease can impact drug elimination and excretion, it does not have as direct an effect on the distribution phase of pharmacokinetics. Renal function primarily affects the clearance of drugs from the body rather than how the drug is distributed within the tissues.

C) Hepatic disease: Hepatic disease can affect the metabolism of drugs and their clearance, but it does not directly affect the distribution phase. While the liver is involved in metabolizing drugs, it is the ability to clear or process the drug that is most influenced, rather than its distribution to tissues.

D) An elevated gastric pH: Elevated gastric pH (which can occur with antacid use or in certain conditions) can affect the absorption of some medications but has minimal direct impact on the distribution phase of pharmacokinetics. Distribution is primarily concerned with how a drug moves from the bloodstream into tissues, and this is more influenced by factors like blood flow, protein binding, and the drug's lipophilicity, rather than the pH of the stomach.