Skills Chapter 21

Several patients have been prescribed inhalation medications. The nurse is aware that a spacer will be beneficial for which patient?

An elderly patient who uses a metered-dose inhaler

The nurse is preparing to administer an eye ointment to the patient. Which action by the nurse is appropriate?

Apply a thin ribbon evenly along the inner edge of the lower eyelid.

The nurse receives orders on several patients for oral medications. The nurse will question the order on patients with which conditions? (Select all that apply.) A: History of asthma and difficulty breathing B: Inability to swallow food C: Decreased level of consciousness D: Use of gastric suction

B, C, D

The nurse is to administer several medications to a patient via a nasogastric (NG) tube. What should the nurse do first?

Check for placement of the NG tube.

What should the nurse do to assist a patient who is having difficulty swallowing tablets?

Crush the medications and administer with a small amount of food.

The nurse is preparing to administer a pediatric dose of liquid medication to an infant. Which action by the nurse is appropriate?

Gently shake the multi-dose bottle before pouring the medication.

How should the nurse position the patient to administer nose drops to the maxillary sinus?

Head tilted back over the edge of the bed and turned toward the side to be treated

The nurse is teaching a mother how to administer nasal drops to her infant. What should be included in the teaching plan?

Infants should receive nose drops 20 to 30 minutes before feedings.

The nurse is preparing to administer a rectal suppository to a patient. The patient should be assisted to which position for insertion of the rectal suppository?

Left Sims' position

The nurse is teaching a patient how to use a metered-dose inhaler without a spacer. Which action by the patient demonstrates correct use of the device?

Positioning the mouthpiece in front of the mouth while not touching the lips

The nurse is preparing to give sublingual nitroglycerin to a patient complaining of chest pain. The nurse instructs the patient not to swallow the medication. Why is this instruction important?

The effects of the medication will be nullified if swallowed.

The nurse is preparing oral medications for administration. Which action by the nurse is appropriate?

Using a cutting device to cut scored tablets

The patient is receiving vaginal suppositories for a vaginal infection. Which assessment finding by the nurse indicates a desired outcome of the treatment?

Vaginal discharge the same color of the medication is noted.

A nurse is preparing to administer eardrops to an adult patient. Which action should be taken by the nurse?

Warm the medication to room temperature using warm water.

Medications in the form of drops or ointments will have the word ________________ on the container to identify them as eye medications.

ophthalmic

The easiest and most desirable way to administer medications is via the _________ route.

oral

The nurse is teaching a patient how to use a topical medication. Which statement indicates an understanding of the procedure?

"If my skin is irritated, I will cleanse it using water only."

Handheld devices that deliver inhaled medication in a fine powder to penetrate lung airways are known as ___________.

dry powder inhalers (DPIs)

Handheld devices that disperse medications through an aerosol spray or mist to penetrate lung airways are known as ___________.

metered-dose inhalers (MDIs)

The nurse is preparing several topical medications for a patient. The nurse identifies which of the following as ways to administer a topical medication? (Select all that apply.) A: Administering through an enteral tube placed in the jejunum B: Inhaling an aerosol spray into the lungs C: Spraying a mist into the nose D: Dissolving a medication under the tongue

B, C, D

The patient is to receive three different medications via a nasogastric tube. What is the total amount of water the nurse should prepare to administer?

30 to start, 30 after 1st med, 30 after 2nd med, 30 after 3rd med. 120 total. Their answer: 90 mL of water Rationale: 30 mL of water is administered before the medications, 15 to 30 mL of water is administered after each of the first two medications, and 30 to 60 mL is administered after the third medication, so 90 to 150 mL of water is needed.

The nurse is teaching a patient with asthma about using a metered-dose inhaler to administer albuterol. Which statements should the nurse include in the teaching plan? (Select all that apply.) A: This medication can produce systemic effects such as tachycardia and tremors. B: After inhaling the medication, hold your breath for about 10 seconds. C: After inhaling the medication and holding your breath, exhale slowly through an open mouth. D: After the last dose, do not rinse your mouth or drink any water for at least 1 hour.

A, B

The nurse is preparing to administer a medication. Which of the following is the most critical to assess before medication administration?

Allergy history

The nurse is caring for four patients who require medications at 0900. Which action by the nurse adheres to the six rights of medication administration?

Give the prescribed anticonvulsant between 0830 and 0930.

The nurse is preparing to administer aspirin to a patient via an enteral feeding tube. Which form is appropriate for the nurse to administer?

Liquid aspirin

The nurse is preparing a medication for a small child. The medication comes in pill or liquid form, but the liquid preparation has a bitter taste. Which action by the nurse is most appropriate?

Mix the liquid in applesauce.

The nurse administers eardrops in the patient's left ear. Which of the following positions is appropriate after instillation of the drops?

Right lateral

The patient is unable to sit upright for medication administration. The nurse should assist the patient to which position to decrease the risk for aspiration?

Side-lying

A patient is experiencing a systemic effect from eyedrops. Which assessment finding by the nurse is indicative of this?

Elevated pulse and blood pressure

The patient has eyedrops ordered daily to both eyes. Which action by the nurse is appropriate when administering the medication?

Hold the eyedropper about 1 to 2 cm above the eye.

The nurse is administering a buccal medication. Which instruction should be given to the patient?

Hold the medication against the cheek membranes.

The patient has a bronchodilator and an inhaled steroid scheduled for the same time. What teaching should the nurse provide to the patient about administering these medications?

Inhale the bronchodilator, wait 2 to 5 minutes, then inhale the steroid.

The nurse is preparing to administer a rectal suppository to an adult patient. Which action should be taken by the nurse?

Instruct the patient to remain lying flat or on the side for 5 minutes after insertion of the suppository.

The nurse is applying a new nitroglycerin transdermal patch. Which action by the nurse is appropriate?

Instructing the patient to avoid heat sources over the patch

The nurse is administering a beta-adrenergic medication via a small-volume nebulizer. Which assessment finding requires the nurse to withhold the medication immediately?

Irregular pulse with light-headedness

The nurse is preparing to administer a medication via a jejunostomy tube to a patient who is receiving continuous tube feedings. The medication needs to be given on an empty stomach and comes only in tablet form. What action should the nurse take first?

Stop the feeding 30 minutes before medication administration.

The patient is prescribed an ophthalmic medication via an intraocular disc. Which action by the nurse is appropriate when administering the medication?

Place the disc in the conjunctival sac.

When preparing to administer medication via a nasogastric tube, the nurse aspirates 275 mL of gastric residual. What is the first action the nurse should take?

Return the aspirate and withhold the medication Rationale: Return aspirated contents to the stomach unless a single volume exceeds 500 mL or two measurements taken 1 hour apart each exceed 250 mL. When gastric residual is greater than 250 mL, the medication is withheld and the residual is rechecked in 1 hour. Large-volume aspirates indicate delayed gastric emptying and place the patient at risk for aspiration. Additional fluid would not be administered if the patient had a large residual. Use of suction would require an order from the health care provider.

The nurse is preparing to administer medications to a patient with an enteral tube. The nurse can safely give the medications through which types of enteral tube? (Select all that apply.) A: Nasogastric feeding tube B: Percutaneous endoscopic gastrostomy tube C: Jejunostomy tube D: Nasogastric decompression tube

A, B, C