Prioritizing Medication Administration: A Guide for Nurses in Urgent Situations

The nurse has received the a.m. shift report for clients on a pediatric unit. Which medication should the nurse administer first?1. The third dose of the aminoglycoside antibiotic to the child diagnosed withmethicillin-resistant Staphylococcus aureus (MRSA).2. The IVP steroid methylprednisolone (Solu-Medrol) to the child diagnosed withasthma.3. The sliding scale insulin to the child diagnosed with type 1 diabetes mellitus.4. The stimulant methylphenidate (Ritalin) to a child diagnosed with attentiondeficit-hyperactivity disorder (ADHD).

To determine which medication the nurse should administer first, the nurse should consider several factors such as the urgency of administration, the severity of the condition, and any specific instructions given in the facility’s policies or protocols

To determine which medication the nurse should administer first, the nurse should consider several factors such as the urgency of administration, the severity of the condition, and any specific instructions given in the facility’s policies or protocols.

In this case, it is important to prioritize the administration of medications based on the urgency of the condition and potential consequences of delaying administration. Let’s analyze each medication in this context:

1. The third dose of the aminoglycoside antibiotic to the child diagnosed with methicillin-resistant Staphylococcus aureus (MRSA):

MRSA is a serious and potentially life-threatening infection that is resistant to many common antibiotics. Administration of the antibiotic is crucial to ensuring effective treatment and preventing the spread of the infection. However, since this is the third dose, it suggests that there is already an established treatment plan in place, and a slight delay in administration may not have immediate severe consequences.

2. The IVP steroid methylprednisolone (Solu-Medrol) to the child diagnosed with asthma:

Asthma can be a chronic, but generally controllable condition. While steroids like methylprednisolone can help manage acute exacerbations, delaying the administration for a short period is unlikely to have severe immediate consequences, especially if the child’s symptoms are not severe at the moment.

3. The sliding scale insulin to the child diagnosed with type 1 diabetes mellitus:

Type 1 diabetes requires the regular administration of insulin to maintain blood glucose levels within a target range. Sliding scale insulin is used to adjust insulin doses based on the current blood glucose level. Delaying insulin administration can lead to uncontrolled blood sugar levels, which could cause acute complications such as diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS). These conditions can be serious and life-threatening, making the timely administration of insulin a priority.

4. The stimulant methylphenidate (Ritalin) to a child diagnosed with attention deficit-hyperactivity disorder (ADHD):

While Ritalin is an important medication for managing ADHD symptoms, delaying its administration for a short period is not likely to have immediate severe consequences. ADHD is a chronic condition, and missing one dose is not as critical as in the case of medication for urgent infections or diabetes management.

Based on the urgency and potential consequences, the nurse should prioritize the administration of the sliding scale insulin to the child diagnosed with type 1 diabetes mellitus. Ensuring the child receives their insulin on time is crucial for controlling blood sugar levels and preventing acute complications. After administering insulin, the nurse can proceed to administer the other medications in due order.

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