Diabetes and high blood pressure

You are assigned to administer medications to a client on the medical surgical floor. The client is 85 years old and has diabetes and high blood pressure and was admitted 2 days ago with difficulty speaking and swallowing. The provider wants to rule out if the client has had a stroke. The client’s allergies include penicillin and sulfa. The provider orders a swallowing study, an IV of normal saline at 30 mL/hr, NPO, HCTZ 25 mg po every day, and Humulin N insulin 15 U before breakfast. You as the student nurse prepare the medications and enter the client’s room. You introduce yourself to the client and explain that you are going to administer the client’s medications. You first prepare to administer the Humulin N at the IV port. The client asks why he is receiving the insulin in the IV when he states he always takes it in his abdomen at home. You stop and tell him you will check on this before you administer it. You hand him the HCTZ and tell him that this is his blood pressure pill. He takes it and swallows it with water. As soon as he swallows it he begins to cough and spits some of the water out but no pill is seen. You leave the client and state you will return after you check on the insulin. While you are checking on the insulin, the client calls out and requests you to come to his room. Upon entering the room, you notice the client has hives on his neck, arms, and hands. The client states he is itching and is still coughing since taking his BP pill. 1. Discuss the specific areas of the scope and science of nursing pharmacology that the student nurse failed to identify, assess, and evaluate in the given scenario. 2. What potential legal ramifications and client complications resulted from the student nurse’s actions? 3. What nursing pharmacology principles could have been implemented to provide safer client care?