medium · NCLEX-RN Basic Care and Comfort

The registered nurse is preparing to program a patient-controlled analgesia (PCA) pump with a new prefilled syringe of hydromorphone for a postoperative client.

According to high-alert medication safety guidelines, which process represents a true, valid independent double-check?

  1. A second nurse watches the administering nurse program the pump to ensure no programming steps are skipped.
  2. The administering nurse programs the pump, and a second nurse reviews the settings after they have already been submitted, as the next nursing response.
  3. Two nurses independently calculate the dose, verify the provider's order, confirm the client's identity, and verify pump settings before administration.
  4. The administering nurse calls out the dose and concentration to a second nurse, who verifies them verbally against the electronic record, for this client.

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