medium · NCLEX-RN management
The pharmacy notifies the progressive care unit that there is a critical national shortage of intravenous diltiazem, with only two vials remaining in stock. The RN is caring for a client with stable atrial fibrillation receiving a continuous diltiazem infusion at a rate of 5 mg/hr, and a newly admitted client with unstable atrial fibrillation with rapid ventricular response (heart rate 162/min, blood pressure 88/54 mmHg).
Which action should the RN take?
- Administer half-doses of IV diltiazem to both clients to ensure equitable distribution of the scarce resource, at this point in care, as the next nursing response.
- Prepare to transition the stable client to oral diltiazem as ordered by the provider and reserve the remaining IV diltiazem for the newly admitted unstable client.
- Reduce the infusion rate of the stable client by half to conserve the remaining supply for the new client, in this situation, for the clinical situation described.
- Withhold diltiazem from both clients until the pharmacy obtains an alternative calcium channel blocker.
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