Chapter 51 individual considerations of medication administration

1. A nurse is caring for a client who takes several medications. The client states, "I fast for several days each week to control my weight." The nurse should instruct the client that fasting increases the risk for medication toxicity due to what physiological factor?

1. When taking actions, the nurse should instruct that inadequate nutrition, such as from intermittent fasting, can decrease the level of plasma albumin, which decreases the protein-binding response of medications. This causes an increase in level of medication and increases the risk for medication toxicity. @ NCLEX® Connection: Physiological Adaptation, Pathophysiology

2. A nurse is teaching a class about physiological factors that can alter how a medication can affect infants and older adults. Sort the following physiological factors into either infants or older adults. A. High body water content B. High percentage of body fat C. Increased blood flow to skin D. Decreased total body water

2. INFANTS: A, C; OLDER ADULTS: B, D When taking actions, the nurse should instruct that pharmacokinetic factors that alter how a medication affects infants include high body water content, increased blood flow to skin which can increase absorption of topical medications, and immature liver. The nurse should instruct that pharmacokinetic factors that alter how a medication affects older adults include decreased total body water, higher percentage of body fat, and decreased liver enzymes. The nurse should provide the lowest medication dose possible to infants and older adults, and carefully monitor for adverse effects, to reduce the risk of toxicity. © NCLEX® Connection: Health Promotion and Maintenance, Developmental Stages and Transitions

3. A nurse is teaching an older adult client about medication self-administration. Which of the following instructions should the nurse include? (Select all that apply.) A. Adjust doses to daily weight. B. Place pills in daily pill holders. C. Set up a daily calendar with medication reminders. D. Ask a relative to assist as needed. E. Request child-resistant caps on medication containers.

3. B. CORRECT: When taking actions, the nurse should instruct the client to place pills in a daily pill holder, to promote adherence to medication regimen. C. CORRECT: When taking actions, the nurse should instruct the client to set up a daily calendar as a reminder to take medications, to promote adherence to medication regimen. D. CORRECT: When taking actions, the nurse should instruct the client to ask a relative to assist as needed, to promote adherence to medication regimen. @ NCLEX® Connection: Pharmacological and Parenteral Therapies, Medication Administration

4. A nurse is teaching a client who is in the first trimester of pregnancy about medications. What instructions should the nurse include in the teaching?

4. When taking actions, the nurse should instruct that pregnancy is a contraindication for live-virus vaccines, including rubella, due to possible teratogenic effects. Most medications, including over-the-counter, are potentially harmful to the fetus. The client should avoid any medications unless prescribed by the provider. Nutritional supplements that include iron are prescribed during pregnancy to support the health of the mother and fetus. Providers can prescribe medications to treat nausea and other discomforts of pregnancy. © NCLEX® Connection: Health Promotion and Maintenance, Developmental Stages and Transitions

5. A nurse is teaching a client who is lactating about taking medications. Which of the following instructions should the nurse include? A. Drink 8 oz of milk with each dose of medication. B. Use sustained-release medications. C. Take medications right after breastfeeding. D. Pump breast milk and freeze it prior to feeding.

5. C. CORRECT: When taking actions, the nurse should instruct the client to take medications immediately after breastfeeding to minimize medication concentration in the next feeding. This action reduces the risk of harm to the infant. C NCLEX® Connection: Health Promotion and Maintenance, Developmental Stages and Transitions