Med admin

What can the nurse do to help the patient relax the anal sphincter before administering a rectal suppository?

Ask the patient to take slow, deep breaths through the mouth.

The patient asks why the nurse applies the drops in the conjunctival sac. What is the nurse's best response to the patient's question?

"Applying drops to the conjunctival sac provides even distribution of medication across the eye

The patient is concerned that there may be systemic effects from a medication given by the nonparenteral route. Which statement would be the best response by the nurse?

"Even though medications are absorbed more slowly through the skin, it is possible to have systemic effects if the medication concentrations are high."

The nurse is instructing the patient on how to insert a vaginal suppository. Which statement if made by the patient indicates further instruction is needed? (Select all that apply.)

"I should warm the suppository to body temperature by putting it under warm running water while it is still in the wrapper." "I should insert the rounded end of the suppository along the side wall of the vagina approximately 1 inch or 2.5 cm (approximately to the first knuckle of the index finger)."

The mother of a 10-year-old child calls the doctor's office stating that she just administered ear drops to her child and the child is crying, stating that the ear hurts worse than it did before the ear drops were applied. What should the nurse tell the mother?

"I will notify the health care provider. It is possible the eardrum may have ruptured.

For which patient would a transdermal patch be the preferred type of medication administration?

A patient with liver disease.

At what temperature should the solution be when ear drops are instilled?

Body temperature

Which symptoms indicate overuse of MDIs? (Select all that apply.

Cardiac dysrhythmias Tachycardia Restlessness

What should the nurse do to maximize the effectiveness of medicated lotions and/or ointment

First wash area with nondrying soap and water

The patient complains of burning after the administration of a nonparenteral medication. By which route would you most likely expect this response

Instillation onto the eye

What is the primary danger associated with occluding the ear canal with the ear dropper during the administration of ear drops?

It can create too much pressure within the canal with subsequent injury to the eardrum

hat is the purpose of massaging the tragus of the ear after ear drop instillation?

It helps move the medication inward.

A patient has been hospitalized for several days after a motor vehicle accident. The patient has several fractured bones and has cuts and scratches across the chest area. Where should you apply the fentanyl (Duragesic) patch to treat the patient's pain?

On the upper back in an area that is free of hair

How far should the nurse insert a rectal suppository in an adult? (Select all that apply.)

Past the internal anal sphincter Approximately 10 cm (4 inches)

The hospice nurse comes to the home of a patient with terminal cancer. She discovers several fentanyl (Duragesic) pain patches on the patient's body. What should the nurse do first?

Remove the patches except for the most recent and provide patient teaching

The nurse is going to administer eye drops into the eye of a confused elderly patient. What safety precautions should the nurse take?

Rest hand holding the eye dropper on the patient's forehead and hold the eye dropper 1 to 2 cm (0.4 to 0.8 inches) above the conjunctival sac.

You are planning to teach a patient about using an MDI without a spacer device. What are some points you should include in the teaching plan? (Select all that apply.)

Show the patient how the canister fits into the inhaler. Warn the patient about overuse of the inhaler, including drug side effects. Instruct the patient how to time inhalation with the depression of the medication canister. Instruct the patient to shake the canister before administration

What position should the patient assume for insertion of a rectal suppository

Sims'

The nurse is instilling eye drops into a patient's eye. The nurse checks the patient's identification, performs hand hygiene, and applies gloves. The nurse follows the 6 rights of medication administration. The nurse asks the patient to tilt the head back and look up. The nurse holds the patient's eye open by pushing up on the skin of the upper orbit, and with the free hand, instills the drops of medication onto the patient's cornea at a distance of 2.5 to 5 cm (1 to 2 inches). The nurse applies gentle pressure to the lacrimal duct and asks the patient to close the eyes gently. The nurse discards the gloves and performs hand hygiene, and documents the procedure. What actions by the nurse, if any, were incorrect? (Select all that apply.)

The method used to hold the patient's eye open. Using the free hand to instill the drops at a distance of 2.5 to 5 cm (1 to 2 inches). Applying the eye drops onto the patient's cornea.

The nurse is going to administer eye ointment in the newborn's eyes. Which action by the nurse is the correct procedure?

The nurse applies a ribbon of ointment along the lower eyelid on the conjunctiva from inner to outer canthus.

The nurse is administering eye medication. Which nursing action requires further intervention by the nurse? (Select all that apply.)

The patient blinks and the eye drop falls on the outer lid after instillation. The nurse applies the ointment along the inner edge of the lower eyelid from the outer to inner canthus.

When should the patient depress the canister when using an MDI?

The patient should depress the canister simultaneously with slow inhalation

Which situations may be contraindications for the oral route of medication administration? (Select all that apply.)

The patient who is confused and unwilling to cooperate The patient who has a nasogastric tube connected to wall suction The patient who is NPO (nothing by mouth) The patient who is unconscious

The nurse is going to insert a rectal suppository. The nurse provides privacy, performs hand hygiene, dons gloves, places the patient in the Sims' position, drapes the patient appropriately, and removes the suppository from its wrapper. The nurse tells the patient to take a few slow, deep breaths, and the nurse inserts the blunt end into the patient's rectum until it is unable to be seen. The nurse removes the gloves, performs hand hygiene, and assists the patient onto the back with the head elevated to the level of comfort. What steps, if any, are missing and/or did the nurse perform incorrectly? (Select all that apply.)

The suppository was inserted without additional lubricant. The blunt end of the suppository was inserted into the patient's rectum. The suppository was inserted into the patient's rectum until it was unable to be visualized. The patient was assisted onto the back with the head elevated.

The nurse is going to instill ear drops in a 7-year-old child. In which direction should the nurse pull the pinna of the ear

Up and back

A patient is demonstrating the use of an MDI (without a spacer device). The patient removes the mouthpiece cover and shakes the inhaler. The patient takes a deep breath and exhales, places the mouthpiece of the inhaler in the mouth, and depresses the canister while inhaling. The patient holds the breath for approximately 10 seconds and exhales with canister in mouth. The patient shakes the canister again and repeats the procedure in approximately 10 seconds. The patient replaces the mouthpiece cover when finished administering puffs. What steps did the patient eliminate or require further teaching? (Select all that apply.)

Used the wrong method of exhalation after using the MDI. Repeated the procedure in 10 seconds. Replaced the mouthpiece cover when finished administering puffs.

A nurse understands the importance of providing culturally competent care. Which action by the nurse fails to take possible cultural differences into consideration?

When admitting a patient, the nurse asks only about prescribed medications

You don clean gloves and measure the antianginal ointment onto dosage paper according to health care provider's orders. You rub the ointment off the paper directly onto the female patient's skin of the anterior chest and cover the area of ointment with plastic wrap and tape. You discard the gloves and perform hand hygiene. Which steps of the procedure were incorrect and/or missing? (Select all that apply.)

You did not remove the previous dosage paper. You rubbed the ointment off the paper. You did not write the date, time, and initials on the paper wrapper.

Which patient is at lowest risk for a systemic effect from a topical agent? A patient who

is very mobile and receiving a drug in low concentration.

A patient is being admitted to the hospital to receive intravenous (IV) antibiotics. What type of medication administration is an IV antibiotic

parenteral

What additional instruction should you include for the patient who is receiving steroids via an MDI? The patient:

should rinse the mouth after use of the MDI.