Question

The nurse has a pre-op order to administer Valium (diazepam) \(10 \mathrm{mg}\) and Phenergan (promethazine) 25mg. The correct method of administering these medications is to: A. Administer the medications together in one syringe B. Administer the medications separately C. Administer the Valium, wait 5 minutes, and administer the Phenergan D. Question the order because they cannot be given to the same client

Short answer

Answer: The most appropriate method for administering Valium and Phenergan to a patient is to administer the medications separately. This ensures the correct dosage of each medication and eliminates the risks associated with mixing the medications.

Step-by-step solution

Evaluate each option

Let's evaluate each option in the exercise question: A. Administer the medications together in one syringe: Mixing two medications in one syringe should not be done unless it is explicitly allowed per recommendation or compatibility guidelines. Mixing medications can lead to chemical reactions, changing their effectiveness or causing harm to the patient. B. Administer the medications separately: This option seems the safest and most straightforward, as it ensures the correct dosage of each medication and eliminates the risks associated with mixing the medications. C. Administer the Valium, wait 5 minutes, and administer the Phenergan: This option is also plausible, but does not provide any clear clinical reason for waiting 5 minutes between administering both medications. Further evidence from guidelines and compatibility information should be sought before choosing this option. D. Question the order because they cannot be given to the same client: There is no clear indication in the exercise that this statement is valid. It could be true or false, but it appears irrelevant to the issue of the method of administration.

Refer to medication guidelines and compatibility

In order to make the best decision, refer to the manufacturer's guidelines and compatibility charts for Valium and Phenergan. Look for information on whether these medications can be mixed in the same syringe or if they need to be administered separately.

Choose the correct option based on the gathered information

Based on the gathered information and guidelines for each medication, choose the correct option. In general, option B, administering the medications separately, is most likely the safest option in the absence of clear compatibility guidelines.

Key concepts

Safe Medication Administration

When it comes to administering medications, safety is paramount. Safe medication administration involves several critical aspects, such as verifying patient information, double-checking medication orders, calculating the correct dosage, checking for medication interactions, and observing for adverse effects post-administration. Nurses must adhere to the 'Five Rights'—the right patient, the right drug, the right dose, the right route, and the right time—to prevent medication errors.

Before administering drugs like Valium (diazepam) and Phenergan (promethazine), a nurse should confirm the orders with any available resources, including the patient's medication chart and pharmacy guidelines. Understanding the chemical properties of these drugs is essential because it may determine whether the drugs can be safely combined or should be administered separately to avoid adverse reactions. For the NCLEX-PN Medication Administration, candidates should demonstrate an ability to apply these safety principles in hypothetical scenarios like the given exercise.

Nursing Pharmacology

Nursing pharmacology encompasses a nurse's comprehensive knowledge of drug action, drug classification, and medication management for patient care. This fundamental aspect of nursing ensures that healthcare providers understand not only how to administer medication safely but also the why behind it. Effective pharmacological knowledge includes understanding the biochemistry behind medications, potential side effects, therapeutic uses, and the physiologic response of the medication within the body.

With respect to the NCLEX-PN Medication Administration exercise, a nurse should understand the pharmacodynamics of diazepam and promethazine—how they act on the nervous system, their sedative properties, and the side effects. Equipped with this knowledge, the nurse can make informed decisions about administration methods, ensuring both safety and therapeutic efficacy.

Medication Compatibility

Medication compatibility is a crucial consideration in nursing pharmacology. Compatibility refers to whether two medications can be mixed together in the same syringe or infusion, which can involve physical, chemical, and therapeutic factors. Incompatible medications may form precipitates, degrade each other’s effectiveness, or result in increased toxicity or side effects.

In relation to the exercise provided, proper protocol would require the nurse to refer to compatibility charts or drug information databases when determining whether to mix Valium and Phenergan in one injection, administer them separately, or space their administration apart. If the compatibility information is not available or is unclear, the safest course is to administer medications separately, which aligns with answer B in the exercise. Remember, medication compatibility data is always evolving, and consultation with a pharmacist can provide additional guidance on the safest and most effective way to administer medications.