ATI NCLEX style case scenario safety with acetaminophen Individual project Learning objectives Identify the nursing actions essential to administer acetaminophen safely 1 2 Describe the effects of an acetaminophen overdose 3 Explain what actions a nurse should take if an acetaminophen overdose occurs Instructions 1 After viewing the ATI video case study on Medication Administration Safety complete the following questions using the Frandsen Pennington pharm text or Davis Drug Guide 2 Cite your information in your answers Include a reference section in APA format Answers should be at least one to two paragraphs 3 Post your project in the Forums section of the Reggienet course 4 The assignment is worth 12 points Due Friday February 5th at 11 30pm Medication Administration Safety Scenario The nurse is caring for a client Mrs Goodman who has an elevated temperature The nurse administered acetaminophen to the client for an elevated temperature at 38 3 C 101 F 1 After reviewing the electronic medical record what potential safety concerns should the nurse be aware of prior to administering other medication s to Ms Goodman Medication errors commonly occur every day because of distraction lack of knowledge and not assessing the rights of medication administration When administering medications it is crucial to keep distractions at a minimum to avoid obtaining the incorrect medication incorrect dose incorrect route or incorrect patient Frandsen Pennington 2021 p 56 Nurses need to make sure the patient is receiving the correct medication the correct dose in the right route in the right time that is the correct patient receiving the medication that an assessment was made before administering the medication the right reason for giving the medication is still ongoing the right education was given to the patient the right documentation is taking place and the right response in the patient is taking place Frandsen Pennington 2021 p 34 Furthermore even though it is implied the nurse must make a total of three checks to make sure the right medication is being given The first check is done against the Pyxis the second check is done against the eMAR and the third check is done once again with the eMAR before administering This includes verifying the patient s identity with two verifications ex full name and date of birth Checking the dose is crucial to avoid overdose as well In addition the nurse must make sure she or he knows what the medication adverse effects are and keep an eye out to make sure the patient is not experiencing them They need to advocate for the patient if they notice that giving the medication right reason right assessment right time is incorrect and let the provider know that they are not going to give the medication if it would bring greater adverse effects to administer it This includes knowing the complications that can occur if a patient is receiving other medications Which include prescribed and over the counter medications and herbal medicine ATI 2021 If this is the case the nurse is going to assess the safety of administering acetaminophen 2 What are several effects of an acetaminophen overdose on the body The effects of acetaminophen overdose include fatal hepatotoxicity hepatic failure and acute renal failure Fatal hepatotoxicity being the main concern because metabolism of acetaminophen produces a toxic metabolite that is normally inactivated by combining with glutathione Then in overdose situations the glutathione is depleted and the toxic metabolite accumulates damaging the liver cells This might also lead to acute renal failure The early symptoms of toxicity are anorexia nausea vomiting diaphoresis within 12 24 hours after ingestion Then tests of liver function e g aspartate aminotransferase alanine aminotransferase bilirubin prothrombin time begin to show increased levels Later the manifestation will include jaundice and CNS stimulation with excitement and delirium Unfortunately then vascular collapse coma and death will follow Frandsen Pennington 2021 p 312 3 Describe several actions the nurse should take if the client displays manifestations of an acetaminophen overdose The first step includes notifying the provider and obtaining tests for liver function and plasma acetaminophen levels if the client displays manifestation of an acetaminophen overdose The tests of liver function e g aspartate aminotransferase alanine aminotransferase bilirubin prothrombin time begin to show increased levels if an overdose is present While plasma acetaminophen levels are preferably taken within 4 hours after ingestion and every 24 hours for several days Minimal hepatotoxicity is associated with plasma levels of less than 120 mcg mL at 4 hours after ingestion or less than 30 mcg mL at 12 hours after ingestion With blood levels greater than 300 mcg mL at 4 hours after ingestion about 90 of patients develop liver damage If the test proves there is an overdose gastric lavage is recommended within 4 hours after ingestion and activated charcoal can be given to inhibit absorption Frandsen Pennington 2021 p 312 Then the nurse should administer acetylcysteine Acetadote the antidote for acetaminophen overdose Vallerand Sanoski 2021 It may be given orally or intravenously within 8 32 hours of acetaminophen ingestion It works by supplying cysteine a precursor substance required for the synthesis of glutathione The synthesized glutathione combines with a toxic metabolite and decreases hepatotoxicity However it does not reverse damage that has already occurred Frandsen Pennington 2021 p 312 References Assessment Technologies Institute 2021 Medication administration Video Video Case Studies RN 2 0 https atitesting com Frandsen G Pennington S S 2020 Abrams clinical drug therapy Rationales for nursing practice 12th ed Philadelphia PA Wolters Kluwer Vallerand A H Sanoski C A 2021 Davis drug guide for nurses Philadelphia PA F A Davis Company Grading Rubric for ATI Projects Outcome Used proper citation format Shared responsibility Checked spelling grammar Included pharm texts Submitted on time Accurate and thorough responses to questions Criteria APA format Indicated role of each group member if group project 3 spelling grammar errors Included pharm texts in references Submitted by due date Addressed each question and supports with citation s Each part of question is addressed if has multiple questions One to two paragraphs written for each of the questions Note points will be deducted if criteria is