RNSG 1219: Administer Medications

The nurse is teaching a parent how to administer ear drops to a 3-year-old client with an ear infection. What instructions should the nurse give the parent? "Have the child lie down with the affected ear facing the ceiling while administering the drops and then wait for 5 minutes after the drops are in." "Pull the child's pinna up and backward to straighten the ear canal before administration of the drops." "Keep the drops refrigerated until just before you administer and apply the drops onto a cotton ball then insert into the ear." "Administer the eardrops while holding the dropper 2 to 3 in (5 to 7.5 cm) above the ear canal."

"Have the child lie down with the affected ear facing the ceiling while administering the drops and then wait for 5 minutes after the drops are in." Rationale:The flow of the drops is facilitated by gravity and will be retained more efficiently by staying in the side-lying position for 5 minutes and preventing the medication from leaking out of the ear canal. The pressure of falling drops may injure the tympanic membrane and should not be held close to the ear canal. The medication should not be kept refrigerated but be administered as close to body temperature as possible. The pinna should be pulled up and backward only for an adult client.

The nurse teaches the client about home use of a transdermal medication patch for pain. The nurse evaluates the teaching as effective when the client makes which statement? "If the dose feels too high, I can cut the next patch in half to use." "I should place this patch over my back where the pain is worst." "The patch is replaced whenever I feel the medication effects diminishing." "I can't use my heating pad in the same area as the patch."

"I can't use my heating pad in the same area as the patch." Rationale:The client is correct that a heating pad or other heat source should not be used over the patch, because this may cause the medication to release too quickly into the system by speeding release and absorption rates. Transdermal medications provide prolonged systemic effects (12 hours to 7 days) to provide continual and controlled amounts of medication. Transdermal patches are not replaced on an as-needed basis; rather, they are replaced on the prescription schedule. The client should not cut the medication patch for any reason and should not double up patches. If a dose change is desired, the client must contact the health care provider. Transdermal medication is not a topical patch, so placing it over a perceived site of the pain does not increase the medication's effectiveness.

The nurse has educated the client on the use and reasons for using inhaled medications via a small-volume nebulizer. Which statements by the client indicate that education has been effective? Select all that apply. "Medication can be delivered through mouthpiece or mask." "Drops improve ventilation and oxygenation." "Fine mist is inhaled deep into the lower respiratory tract." "The nebulizer propels droplets into the nose." "Drops are introduced into the nostril by a dropper."

"Medication can be delivered through mouthpiece or mask.", "Drops improve ventilation and oxygenation.", "Fine mist is inhaled deep into the lower respiratory tract." Rationale:Medication is changed into a fine mist, so it can be inhaled deep into the lower respiratory tract. The medication is generally administered via a mouthpiece but can also be delivered with a mask for an adult who has difficulty using the mouthpiece. Usually drops are administered into the upper respiratory tract not the lower respiratory tract in which the small-volume nebulizer is used.

The nurse administers a dry powder dose inhaler to a client. The nurse stops and teaches the client when the client makes which statement? "I think the medication in these inhalers has gotten expensive." "I usually don't need help. I don't think you have to watch me." "I have used this inhaler once or twice a day for 2 or 3 years." "My allergies are not bothering me. I do not need the inhaler."

"My allergies are not bothering me. I do not need the inhaler." Rationale:When the client discusses the inhaler as though it is used on an as needed basis, the nurse must teach the client. Dry powder inhalers contain medications that control symptoms on a continual basis and are not effective on a symptomatic basis. It is fine that the client recalls that the use of the inhaler has changed over a multiyear period. The nurse can request an interdisciplinary follow up to address the client's potential issues with affording the medication. When the client tells the nurse not to watch, the nurse simply states that this is required, and no teaching on this point is necessary.

The client with chronic obstructive pulmonary disease uses an albuterol metered-dose inhaler at home. The client asks how to use the newly prescribed dry powder inhaler. What does the nurse explain to the client? "The dry powder inhaler only delivers medication when you inhale." "A dry powder inhaler can be used on a schedule or just as needed." "A dry powder inhaler will feel empty when it needs to be replaced." "The dry powder inhaler delivers puff of medication into the air."

"The dry powder inhaler only delivers medication when you inhale." Rationale:A dry powder inhaler releases powder to the client when the client inhales, as opposed to metered-dose inhalers that release the medication once the mechanism has been triggered, whether the client is ready to inhale or not. Metered-dose inhalers can be used on a schedule or on an as needed basis; it is typically prescribed for a strict twice daily scheduling. A dry powder inhaler is filled with a specific number of doses or a new capsule or disc of medication is used for each dose.

The nurse is preparing to administer a nasal spray. Place the nurse's actions in order, from first to last. Use all options. Offer the client a tissue and ask the client to blow the nose. Compress the nasal spray while the client breathes in through the nose. Identify the client using two identifiers and verify any allergies. Remove the tip of the spray from the client's nostril and release the compression. Insert the tip of the nasal spray into one nostril and close the other nostril with a finger.

1. Identify the client using two identifiers and verify any allergies. 2. Offer the client a tissue and ask the client to blow the nose. 3. Insert the tip of the nasal spray into one nostril and close the other nostril with a finger. 4. Compress the nasal spray while the client breathes in through the nose. 5. Remove the tip of the spray from the client's nostril and release the compression.

A nurse has just administered a medication to client via nasal spray. The nurse instructs the client to refrain from blowing the nose for a minimum of how long? 1 minute 5 minutes 30 seconds 3 minutes

5 minutes Rationale:Once medication is administered via nasal spray, a client should be instructed to avoid blowing the nose for 5 to 10 minutes, depending on the medication. Doing so keeps the medication in contact with the mucous membranes of the nose.

The client is prescribed ear drops to be given in both ears. After administering the ear drops in one ear, how long would the nurse wait before administering the ear drops in the other ear? 5 minutes 15 minutes 20 minutes 10 minutes

5 minutes Rationale:When ear drops are to be administered in both ears, the nurse would wait 5 minutes after giving the ear drops in the first ear before administering the ear drops into the second ear. This avoids causing the medication to run out immediately after administration. Other times are longer than are needed between ears.

The nurse is administering an inhaled medication via a small-volume nebulizer to a client. What indicates that the medication is being administered correctly? A fine mist forms in the air. A cloud of powder appears between the canister and mouth. The client begins to cough forcefully. Air is felt coming through the tubing

A fine mist forms in the air. Rationale:The formation of a fine mist in the air indicates that the medication is being administered through a small-volume nebulizer. The fine mist carries the medication to the respiratory tissue for absorption. A cloud of powder may be seen when the canister of a metered-dose inhaler is depressed. Air coming through the tubing indicates that the oxygen source is functioning.

The nurse is preparing to administer a transdermal medication. How should the nurse proceed? Inject the medication into a body cavity. Inject the medication just below the dermis of the skin. Ask the client to swallow the medication. Apply the medication directly to the skin.

Apply the medication directly to the skin. Rationale:Transdermal medications are absorbed through the skin, typically from a patch, not injected or taken orally. Therefore, they should be applied directly to the skin. Injecting the medication below the dermis, asking the client to swallow the medication, or injecting the medication into a body cavity are incorrect.

When preparing to administer a second dose of a prescribed vaginal suppository, the client reports discomfort in the vaginal area. What should the nurse do next? Explain that this is expected effect of the medication. Notify the health care provider. Assess the vaginal area. Hold the second dose until the discomfort is relieved.

Assess the vaginal area. Rationale:When a client reports discomfort, further assessment is needed. The nurse should assess the vagina and vaginal canal for erythema, edema, drainage, or tenderness, and then notify the health care provider after the assessment is completed. The nurse does not know if the discomfort is expected until after assessment, and the nurse should assess the discomfort before deciding to hold the dose.

The client completes use of the dry powder inhaler. What action must the nurse perform after use of this medication? Assess the client's lung sounds. Obtain the client's blood glucose level. Assist the client to rinse out the mouth. Instruct the client about use of the medication.

Assist the client to rinse out the mouth. Rationale:The nurse assists the client to rinse out the mouth with water to prevent thrush, or candida infection. The nurse does not have to assess the client's lung sounds at this time but should have performed an assessment prior to administration. Systemic steroids can alter blood glucose levels, but inhaled steroids, such as are used in this type of inhaler, do not significantly alter glucose levels. Thus, the nurse does not need to obtain the glucose level. The nurse instructs the client about medication prior to administration, not after.

The nurse is administering a medication using a small-volume nebulizer. What should the nurse instruct the client to do? Tell the client to breathe normally. Place the mouthpiece about 1 to 2 in (2.5 to 5 cm) from the mouth. Depress the canister as the client begins to exhale slowly. Have the client inhale slowly and deeply through the mouth.

Have the client inhale slowly and deeply through the mouth. Rationale:When using a small-volume nebulizer to administer medications, the nurse would instruct the client to inhale slowly and deeply through the mouth to allow the aerosolized medication to come into contact with the respiratory tissue for absorption. The client would place the mouthpiece in the mouth, not 1 to 2 in (2.5 to 5 cm) away. The client depresses a canister when using a metered-dose inhaler, not a small-volume nebulizer. The client breathes normally through a spacer device before medication is administered using a metered-dose inhaler with a spacer.

After the client inhales a dose from a dry powder inhaler, which action does the nurse instruct the client to take next? Exhale the breath slowly and evenly. Hold breath for 5 to 10 seconds. Rinse mouth out with water and spit. Wait 1 minute before inhaling again.

Hold breath for 5 to 10 seconds. Rationale:After quickly inhaling the medication, the client holds his or her breath for up to 10 seconds before slowly exhaling again. If two puffs of medication are prescribed to complete the dose, the client waits for 1 to 5 minutes before inhaling again. After the dose is complete, the client rinses the mouth out to reduce the risk of oral fungal infection.

The nurse is caring for an adult client by inserting a rectal suppository. Which action would be most appropriate by the nurse? Insert the suppository to a depth of about 1 inch (2.5 cm). Lubricate the suppository and gloved finger. Insert the suppository's flat end first. Encourage the client to remain still for about 30 minutes.

Lubricate the suppository and gloved finger. Rationale:When inserting a suppository, the nurse would lubricate the suppository and the gloved index finger to help reduce friction and promote client comfort. The rounded end of the suppository is inserted first, to a depth of approximately 3 to 4 inches (7.5 to 10 cm) to ensure that the suppository is beyond the internal sphincter. The client should remain still for approximately 5 minutes to promote absorption of the suppository.

Which actions by the nurse are appropriate when administering a vaginal cream? Select all that apply. Perform perineal care cleansing from just above the vaginal orifice downward. Insert the vaginal applicator directing it downward and backward. Keep the plunger applicator fully depressed until removed from the client. Assist the client to a sitting position after insertion of the cream. Put on sterile gloves after completing preparation of the applicator and perineal care.

Perform perineal care cleansing from just above the vaginal orifice downward., Insert the vaginal applicator directing it downward and backward., Keep the plunger applicator fully depressed until removed from the client. Rationale:Correct actions when administering a vaginal cream include performing perineal care by spreading the labia and cleansing with a disposable cloth from above the vaginal orifice downward toward the sacrum, inserting the vaginal applicator directing it downward and backward (this follows the normal contour of the vagina), and the applicator should be kept fully depressed until it is removed completely from the vaginal canal. There is no need for the use of sterile gloves for this procedure, and the client should be requested to remain in the supine position for a minimum of 5 to 10 minutes after insertion to allow time for the medication to be absorbed in the vaginal cavity and to prevent the medication from leaking from the vaginal orifice.

After administering ear drops to a client, how does the nurse ensure the medication is delivered completely? Ensure the dropper does not touch the ear during administration. Straighten the ear canal during administration. Place the client's head to the side prior to administration. Place gentle pressure on the tragus after administration.

Place gentle pressure on the tragus after administration. Rationale:The nurse applies gentle pressure to the tragus after administering ear drops to move the medication from the canal toward the tympanic membrane. A cotton ball, if inserted, would also help prevent the medication from leaking out of the ear. Pulling the pinna up and back and position the client's head correctly is proper technique but does not assist the medication in getting to the eardrum. Not allowing the dropper to touch the ear reduces the risk of contamination of the dropper but has nothing to do with the tragus.

After administering an inhaled medication via a small-volume nebulizer, which action should the nurse have the client do? Perform deep-breathing and coughing exercises. Blow the nose forcefully. Rinse and gargle with tap water. Remain still for approximately 5 minutes.

Rinse and gargle with tap water. Rationale:After administering an inhaled medication, the nurse would instruct the client to gargle and rinse the mouth with tap water to help remove any medication residue. It is not necessary for the client to perform deep-breathing and coughing exercises after receiving inhaled medications. Remaining still for 5 minutes would be appropriate if a suppository was given, not an inhaled medication. The medications are administered by way of inhalation through the mouth; therefore, blowing the nose would be inappropriate.

After administering an inhaled medication via a metered-dose inhaler, the nurse asks the client to take which action? Spit out excess medication. Rinse and gargle with water. Take in a deep breath. Clear the throat forcefully.

Rinse and gargle with water. Rationale:Some inhaled medications can cause dry mouth and other side effects. Rinsing and gargling helps to remove any medication remaining in the mouth, helps prevent side effects, and minimize the risk of candidiasis associated with inhaled agents. The client does not need to take in an additional deep breath after the medication is administered nor have a reason to clear the throat. Inhaled medications do not leave any sort of excess for the client to spit out.

What instruction will the nurse include in discharge teaching for a client who is prescribed a vaginal suppository? Remain upright for at least 30 minutes after insertion. Store this medication in its original container in the refrigerator. Use petroleum jelly as a lubricant for insertion. A small tampon may be used to prevent staining of undergarments

Store this medication in its original container in the refrigerator. Rationale:The nurse should instruct the client to store the suppositories in their original container in the refrigerator. The client should use a water-based lubricant, not a petroleum jelly lubricant. To promote absorption of the medication the client should remain supine for at least 5 to 10 minutes after insertion. To prevent the staining of undergarments, the client should be instructed to use a perineal pad, not a tampon, because the tampon may absorb the medication.

Which client position will best aid the nurse in insertion of a vaginal cream? Side lying position with top leg bent forward Supine position with legs bent at the knees Prone position with knees bent and hips elevated High Fowler's position with feet elevated on pillows

Supine position with legs bent at the knees Rationale:The client should be positioned lying on the back (supine) with the knees flexed. This position provides the easiest access to the vaginal canal and helps to retain the medication in the canal. No other position provides the easiest nor best access to the vaginal canal.

The nurse is inserting a medication via a rectal suppository to a client. What would the nurse instruct the client to do? Use panting breaths. Hold the breath. Take slow, deep breaths. Inhale for a count of 10.

Take slow, deep breaths. Rationale:When inserting a rectal suppository, the nurse would instruct the client to take slow, deep breaths to help relax the anal sphincter and reduce discomfort. Instructing the client to hold the breath, pant, or inhale for a count of 10 would be inappropriate and could add to the client's discomfort.

The nurse administers a dry powder inhaler to a client. The client takes this medication at home. What action does the nurse take? Ask the client to use the normally prescribed inhalers from home. Instruct the client on differences between home and in-hospital inhalers. Teach the client how to use the inhaler using step-by-step instructions. Have the client use the inhaler while the nurse prepares other medications.

Teach the client how to use the inhaler using step-by-step instructions. Rationale:Even though the client uses the medication at home, the nurse instructs the client about use of the medication. Teaching is a continuous process and there is always more to learn. The nurse should observe the client using the inhaler to ensure that it is done correctly. Home medications can only be used under specific circumstances, which include the nurse having possession of those home medications for distribution to the client. The dry powder inhaler mechanisms are the same for the medication used at home and the one used in the hospital.

The nurse has instructed the client in the use of a metered-dose inhaler. Which instruction should the nurse include in the client education? Explain the need to wait 30 seconds before taking a second dose of medication. Train the client to monitor the respiratory rate for 1 minute after taking the medication. Tell the client to exhale immediately after inhaling the medication. Teach the client to push the top of the medication canister while taking a deep breath.

Teach the client to push the top of the medication canister while taking a deep breath. Rationale:The client should be instructed to push the top of the canister while taking a deep breath. The client should wait 2 minutes before taking a second dose of medication, not 30 seconds. The client should monitor the pulse rate, not the respiratory rate, a because some medications can cause tachycardia. After inhaling, the client should hold the breath for as long as possible, and then exhale through pursed lips.

The nurse is administering prescribed eye drops to a client. What action would cause the nurse to stop the administration? The drops fall into the lower conjunctival sac. The dropper touches the client's eyelid. The client looks upward at the ceiling. The client blinks while administering the eye drops.

The dropper touches the client's eyelid. Rationale:If the dropper touches the client's eyelid, the nurse should stop the administration because the dropper has become contaminated. If the client blinks while trying to instill the drops, the nurse should help the client relax and then try again, encouraging the client to focus upward. The drops are instilled into the lower conjunctival sac.

What should the nurse ask the client to do before inserting a vaginal cream medication? Use a pH-balanced douche to prepare the environment. Void to empty the bladder to lessen discomfort. Apply a vaginal moisturizer to lubricate the area. Shower using an antibacterial soap to sterilize the area.

Void to empty the bladder to lessen discomfort. Rationale:Before administering a vaginal cream, the client should be asked to void to empty the bladder. This helps to minimize pressure and discomfort during administration. Although perineal care should be done to prevent contamination of the vaginal orifice, there is no need for the client to shower with an antibacterial soap or to use a douche. A water-based lubricant is applied to the applicator, so there is no need for a vaginal moisturizer, and a moisturizer may decrease absorption of the medication.

The new nurse places a transdermal medication patch on a client. The preceptor stops the new nurse for which action? Wears gloves to remove old patch. Applies patch to flank skin. Presses the patch onto the skin. Writes date on medication patch.

Writes date on medication patch. Rationale:Dating the patch is ideally done on a separate piece of tape near the skin, not on the patch itself, because this action can interfere with medication delivery. When removing or applying a patch, gloves should be worn to protect the nurse from touching the medication on the patch. A new site that is clean, dry, and intact, free of hair, irritation, and skin breakdown should be used each time, with the old patch being removed before a new one is applied. The patch is firmly pressed against the skin to ensure good contact.

The nurse is caring for a client for whom the health care provider has prescribed a metered-dose inhaler medication and the client expresses concern about possible side effects. Which systemic effects would the nurse advise the client may occur with this medication? Select all the apply. palpitations irritation of mucous membranes orthopnea tachypnea tachycardia

palpitations, irritation of mucous membranes, tachycardia Rationale:Some respiratory medications may cause unwanted systemic effects such as tachycardia, palpitations, or irritation of the mucous membranes of the respiratory tract. Orthopnea and tachypnea are not systemic effects of inhaled medications.

The nurse is preparing to administer a transdermal medication. Which placement is appropriate? posteriorly on the shoulder anteriorly over the sternum inner aspect of the forearm site of the client's discomfort

posteriorly on the shoulder Rationale:A transdermal patch should be applied to an area of skin that is clean, dry, intact, and free of hair. The shoulder is usually a good area for these reasons. A fatty area is best for transdermal medication absorption. The inner aspect of the forearm is the correct placement for an intradermal medication, such as a tuberculin or allergy testing. The site of the client's discomfort may be appropriate for topical medications. Anteriorly over the sternum is correct placement for a telemetry lead.

When administering a rectal suppository, in which position would the nurse position the client? supine semi-Fowler's prone side-lying

side-lying Rationale:When administering a rectal suppository, the nurse would position the client in the side-lying position to facilitate access to the anal area. The supine, semi-Fowler's, or prone position would be inappropriate for this procedure.

The nurse is preparing to administer ear drops to an adult client. In what direction would the nurse position the pinna? outward, away from the nose laterally toward the skull base up and back down and forward

up and back Rationale:When administering eardrops to an adult, the nurse would pull the pinna up and back to straighten the ear canal properly. Moving the pinna laterally toward the skull base, down and forward, or outward will not help position the pinna for accurate ear drop administration.

The nurse is preparing to administer ear drops to a 2-year-old client. The nurse would pull the pinna in which direction? laterally toward the skull base down and backward outward, away from the nose up and back

down and backward Rationale:The pinna should be pulled down and backward to straighten the ear canal of a child younger than age 3. The pinna should only be pulled up and backward to straighten the ear canal of an adult or child older than age 3. The pinna should not be pulled laterally toward the skull base nor outward, away from the nose.

What instructions should the nurse give a client following the administration of prescribed eye drops? Select all that apply. "Allow the drops to flow into the other eye." "Damage may occur if you touch the dropper to the eye." "Wash your hands before and after you use the eye drops." "Apply gentle pressure to the inner canthus hourly." "Do not rub the medicated eye(s)."

"Damage may occur if you touch the dropper to the eye.", "Wash your hands before and after you use the eye drops.", "Do not rub the medicated eye(s)." Rationale:The client should always wash hands before and after using the eye drops. Damage could occur to the cornea if the dropper touches the eye. If the drops are allowed to flow into the other eye, it can cause cross-contamination and an infection could occur. There is no need to apply gentle pressure to the inner canthus hourly, only after administration to prevent medication from flowing into the lacrimal duct.

The nurse caring for a client has just inserted a rectal suppository. What is the best instruction by the nurse at this time? "You can go home now." "Sit up and hold it as long as you can." "You may go to the bathroom as soon as you feel the urge." "Remain in horizontal position for 10 to 20 minutes."

"Remain in horizontal position for 10 to 20 minutes." Rationale:The client should stay in lateral position for 10 to 20 minutes to keep the suppository in place and facilitate absorption. Going to the bathroom as soon as the client feels the urge does not allow the suppository to be absorbed into the mucous membranes of the rectum. Sitting up may displace the suppository and push it farther out of the rectum. The nurse will want to see what kind of result the suppository has had on the client, so the nurse would not send the client home.

Prior to the nurse administering eye drops to the client, what should the nurse do? Ask the client to blink several times. Tell the client to rub the eye. Clean the eyelids of any loose eyelashes. Have the client focus downward toward the dropper.

Clean the eyelids of any loose eyelashes. Rationale:When administering eye drops, the nurse would clean the eyelids of any eyelashes so that they do not fall into the eye and cause discomfort for the client. The client should look up at the ceiling and focus on something. After the drops are given, the client should close the eyes gently and wipe away any excess fluid. The client should be instructed not to rub the eyes.

The nurse has educated a client about the use of a prescribed metered-dose inhaler. What actions should the client learn to perform prior to inhaling the metered dose? Select all that apply. Cough and deep breathe 5 times. Cough up respiratory tract secretions. Blow the nose. Drink 8 oz of water. Rinse the mouth.

Cough up respiratory tract secretions., Blow the nose. Rationale:The nurse should encourage the client to blow the nose and cough up respiratory secretions, because these actions clear excess secretions from the respiratory tract and allow the medication to reach the mucous membranes. The client should rinse the mouth after administration of the metered-dose inhaler. Drinking 8 oz of water and breathing deeply 5 times are unnecessary actions prior to administering a metered-dose inhaler.

The nurse will be administering an inhaled medication via a small-volume nebulizer to a client. What would the nurse have the client do first? Remain still for approximately 5 minutes. Rinse and gargle with tap water. Perform deep-breathing and coughing exercises. Encourage client to blow the nose and cough up secretions.

Encourage client to blow the nose and cough up secretions. Rationale:Encouraging the client to blow the nose and cough up secretions clears excess secretions from the respiratory tract and permits the medication to reach the mucous membrane. The client would rinse and gargle with water only after administration. The client does not need to remain still for 5 minutes, or to perform deep-breathing and coughing exercises.

The nurse has just completed administering a nasal spray to a client. What should the nurse do next? Assess the client's nose for any drainage. Evaluate client for medication effectiveness. Evaluate client for level of discomfort. Assess the client for any allergies.

Evaluate client for medication effectiveness. Rationale:After administering a medication, in this case a nasal spray, the nurse should evaluate for effectiveness, therapeutic effect, or adverse reactions. Assessing for allergies and assessing the client's nose should be done before administering the nasal spray. The nurse would evaluate for level of discomfort after implementing an intervention to relieve discomfort or pain, which is not the purpose of a nasal spray.

What instruction will the nurse include when teaching a client how to administer nasal drops? Hold the dropper just above the nostril to administer the drops. Tilt the head forward and blow the nose after administering the drops. Administer drops when in a supine position to improve absorption. Breathe in deeply through the nose when administering the drops.

Hold the dropper just above the nostril to administer the drops. Rationale:The client should be instructed to hold the dropper about 1/3 of an inch (about 3/4 of a centimeter) just above the nostril to administer the drops. The dropper should not be placed inside the nostril to help prevent contamination of the dropper. The nurse should teach the client to get into an upright position and tilt the head backward to administer the drops. The client should be instructed to breathe through the mouth and not the nose. After instilling the drops, the client should remain in position with head tilted back for about 5 minutes to prevent the medication from escaping.

The nurse is preparing to apply a new transdermal patch to a client's chest. What would the nurse do first? Remove the old patch from the client's skin. Remove the new patch from its protective covering. Wash the area of the old patch with soap and water. Initial and write the date and time on the label of the new patch.

Remove the old patch from the client's skin. Rationale:When applying a new transdermal patch, the nurse would first remove the old patch from the client's skin and then gently wash the area with soap and water to remove all traces of medication in that area. Then the nurse would remove the new patch from its protective covering, and initial and write the date and time on the label side of the new patch.

The nurse is teaching the client how to correctly use a metered-dose inhaler. Which client action displays understanding of the education? holding the inhaler 2 cm (0.75 inches) away from the mouth administering 2 puffs rapidly, between breaths exhaling immediately after administering a puff refraining from shaking the canister before puffs

holding the inhaler 2 cm (0.75 inches) away from the mouth Rationale:The nurse should teach the client to hold the metered-dose inhaler 2 cm (0.75 inches) away from the mouth, hold the breath for 5 to 10 seconds after inhalation, then slowly exhale through pursed lips. The client should shake the canister before each puff and wait 2 minutes between puffs.

The nurse is preparing to administer eye drops to a client. What purposes are commonly associated with instilling medications via eye drops? Select all that apply. infection treatment pupil dilation allergy testing pupil constriction control of intraocular pressure

infection treatment, pupil dilation, pupil constriction, control of intraocular pressure Rationale:Eye drops are instilled for their local effects, such as for pupil dilation or constriction when examining the eye, for infection treatment, or for controlling intraocular pressure (for clients with glaucoma). Allergy testing is typically performed via intradermal injections.

The nurse is administering eye drops to a client. Where should the nurse place the drops? lower conjunctival sac inner canthus outer eyelid margin cornea

lower conjunctival sac Rationale:When administering eye drops, the nurse would place the eye drops into the lower conjunctival sac. After administration, the nurse would apply pressure to the inner canthus to prevent the eye drops from entering the tear duct. The drops should not be placed onto the cornea or outer eyelid margin.

The nurse is preparing to administer a rectal suppository to an adult client. How many inches (or centimeters) should the nurse plan to insert the suppository? 3 inches (7.5 cm) 2 inches (5 cm) 5 inches (12.5 cm) 1 inch (2.5 cm)

3 inches (7.5 cm) Rationale:A rectal suppository must make contact with the rectal mucosa for absorption to occur, so it should be inserted about 3 to 4 inches (7.5 to 10vcm). Inserting the suppository 1 or 2 inches (2.5 to 5 cm) will not make contact with the rectal mucosa and inserting it 5 inches (12.5 cm) could affect the client's comfort level.

The nurse is teaching a client how to use nasal spray. What will the nurse include in the teaching plan? Select all that apply. Blow the nose 1 minute after administering the spray. Insert the tip of the nose piece into one nostril. Tilt the head slightly forward. Sit up comfortably in the bed. Hold the breath for a few seconds after administering the spray.

Insert the tip of the nose piece into one nostril., Sit up comfortably in the bed., Hold the breath for a few seconds after administering the spray. Rationale:The nurse will teach the client to sit up and tilt the head slightly back, not forward. The client will blow the nose before administering the spray to help clear the nasal passage ways. Then insert the tip of the nose piece into one nostril while closing off the other nostril. Next, the client will administer the spray and then hold the breath for a few seconds to allow the medication to remain in contact with the mucosa. The client should not blow the nose for 5 to 10 minutes after administration of a nose spray.