What is the safest action by the practical nurse regarding administration of medications to a patient with acute renal failure?

What is the safest action by the practical nurse regarding administration of medications to a patient with acute renal failure?

• A. Plan to administer lower doses of the medications due to the decreased ability of the kidneys to eliminate the drugs.
• B. Consider administering higher doses of the medications to promote more effective elimination of the drugs.
• C. Have his prescribed medications and doses reviewed by the prescriber and pharmacist prior to administering the drugs.
• D. Do not administer any medications that are known to be eliminated through the kidneys.

Answer: (C)

In acute renal failure, the kidneys can’t clear many drugs as effectively, so the safest approach is to have the prescribed medications and their doses reviewed by the prescriber and a pharmacist before giving them. This collaboration helps determine which drugs need dose adjustments, which should be avoided, and whether dosing intervals should be changed based on the patient’s current renal function. It also helps catch potential nephrotoxic drugs or dangerous interactions before they reach the patient, reducing the risk of toxicity or harm. Relying on lower doses by default isn’t always correct, and increasing doses to “promote elimination” could cause toxicity. Simply withholding all medications that are eliminated by the kidneys isn’t practical or safe, since many drugs can be used safely with proper adjustments. The key is a professional review to tailor therapy to the patient’s renal status.

In acute renal failure, the kidneys can’t clear many drugs as effectively, so the safest approach is to have the prescribed medications and their doses reviewed by the prescriber and a pharmacist before giving them. This collaboration helps determine which drugs need dose adjustments, which should be avoided, and whether dosing intervals should be changed based on the patient’s current renal function. It also helps catch potential nephrotoxic drugs or dangerous interactions before they reach the patient, reducing the risk of toxicity or harm.

Relying on lower doses by default isn’t always correct, and increasing doses to “promote elimination” could cause toxicity. Simply withholding all medications that are eliminated by the kidneys isn’t practical or safe, since many drugs can be used safely with proper adjustments. The key is a professional review to tailor therapy to the patient’s renal status.