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The healthcare provider changes a client‟s medication prescription from IV to PO administration and double the dose. The nurse notes in the drug guide that the prescribed medication, when given orally, has a high first-pass effect and reduce bioavailability. What action should the nurse implement?

a-Continue to administer the medication via the IV route
b-Give half the prescribed oral dose until the provider is consulted.
c-Administer the medication via the oral route as prescribed.

1 Answer

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Final answer:

The nurse should administer the medication via the oral route as prescribed by the healthcare provider, as the doubled dose is likely an adjustment for the first-pass effect and reduced bioavailability associated with oral administration.

Step-by-step explanation:

The appropriate action the nurse should implement is c-Administer the medication via the oral route as prescribed. When a healthcare provider changes a medication prescription from IV to PO (by mouth) and doubles the dose, it typically indicates an adjustment for the first-pass effect, which is the metabolism of a drug that occurs before it reaches the systemic circulation, leading to reduced bioavailability when administered orally. IV administration bypasses this effect, which explains the higher plasma levels achieved through this route compared to oral administration. Therefore, even though the orally administered drug may have a high first-pass effect and reduced bioavailability, the provider has presumably accounted for that by doubling the oral dose. It is essential to follow the prescribed dosing and route unless there is a clear error or risk to patient safety that warrants immediate intervention and provider consultation.

In this scenario, giving half the prescribed oral dose or continuing with IV administration without consulting the provider could result in suboptimal therapy or disregard the provider's therapeutic plan. Conditions like gastrointestinal absorption and pharmacokinetics are crucial considerations, as drugs with high first-pass metabolism require higher oral doses to achieve therapeutic plasma levels. If the nurse has concerns about the changed prescription, it would be prudent to clarify with the healthcare provider while adhering to the new prescription unless otherwise advised.

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