Chapter 32 oral meds

What is an example of drug diversion? The nurse:

takes a medication from one client's container to use for another person.

The nurse has a prescription to administer 25 mg of furosemide IV to a client. The drug is supplied in a vial 40 mg/4 ml. How many milliliters will the nurse administer of the medication? Record your answer using one decimal place

2.5

The client has difficulty swallowing pills and requests to have the medication crushed and mixed in applesauce. The medication the nurse can choose to administer this way is one that is a:

scored tablet

An acute care facility follows the unit dose supply method to supply medication to the clients. What is meant by the unit dose supply method?

self-contained packets that hold one tablet or capsule for individual clients

A nurse is caring for a client who has been prescribed codeine, an opioid medication to relieve severe postoperative pain. Which responsibility does the nurse have to complete when handling opioid medications? Select all that apply.

Maintain an accurate account of the use of the medication, Record each medication used from the stock supply, Count each opioid medication at the change of each shift.

The client refuses a medication. Which is the best response from the nurse?

"What is the reason you do not want to take this medication?"

The prescribed medication is digoxin 250 mcg po now. The supplied drug is digoxin 0.125 mg tablets. How many tablets will the nurse administer? Record your answer using a whole number.

2

The health care provider prescribes ciprofloxacin 500 mg PO q12h for a pediatric client with bronchial pneumonia. The nurse has liquid ciprofloxacin 250 mg/10 mL on hand. How many milliliters would the nurse dispense? Record your answer using a whole number.

20

A nurse is caring for a client in the nursing unit when the physician, during the rounds, verbalizes a prescription for a medication. What appropriate action should the nurse take to ensure the accuracy of the verbal medication order?

Ask the physician to write out the order

A nurse is providing care for a client who has a history of dementia. Which method should the nurse use in order to determine the client's identity prior to medication administration?

Check the client's identification band.

The nurse is preparing to give medications to a client with anxiety. The order indicates that the client is to have bupropion, 7.5 mg by mouth twice daily. What is the appropriate nursing action?

Contact the health care provider for order clarification.

A nurse educator is reviewing information related to medication administration documentation with a group of graduate nurses. Which guideline for documenting will the nurse discuss with the group?

Document administration of the medication immediately after administering the drug

A nurse is taking care of a client who requests acetaminophen to help with a headache. The nurse checks to see if there is an order for acetaminophen and notices that the client is able to have 650 mg every 4 hours as needed for pain. What type of order is this considered?

PRN order

The client has continuous enteral feedings through a nasointestinal tube. The client has a thyroid medication that is to be taken on an empty stomach. What action does the nurse perform?

Stop the infusion for 30 minutes before and after administration of the thyroid medication

The nurse correlates the metric system as the most accurate method utilized to administer medications for which reason?

The dosage prescriptions of medications most often use this system as it is measured in 10s and can be easily converted between measurements

A community health nurse who provides care for numerous older adults is aware of the problem of polypharmacy among this population. Which individual is at greatest risk for polypharmacy

a woman whose prescribed medication regimen includes many different drugs

An oral medication is prescribed for the client with an enteral tube because of aspiration. Which form for administration would the nurse select as best?

liquid

A nurse is taking care of a 56-year-old man with end-stage liver disease. The nurse has a prescription to give 20 g of lactulose every 6 hours to treat the client's hepatic encephalopathy. On hand, the nurse has containers of lactulose that have 30 g in 45 ml. How many milliliters is the nurse going to administer every 6 hours to the client?

30 mL

The nurse is caring for a client who has a newly written prescription for "fluoxetine 20 mg by mouth daily for treatment of depression." The nurse is unfamiliar with this medication. What information should the nurse acquire prior to administration of this drug?

Contraindications of the drug.

The nurse is teaching a client how to take medications upon discharge. The client is alert and oriented but unable to articulate the teaching back to the nurse. What is the appropriate nursing action?

Give written instructions to the client and caregivers

The "rights" of medication administration help to ensure accuracy when administering medications. What are some of these rights? Select all that apply.

Medication, client, dosage, route

The nurse is preparing to administer the second dose of ordered antibiotics to a client and notes that the first dose of medication is still in the automated medication-dispensing system. The medication administration record (MAR) does not show that the initial dose was given. What is the appropriate nursing action?

Notify the health care provider

The nurse is reviewing a medication prescription for a client prior to administration and observes that the route of administration is not present in the prescription. What is the appropriate action by the nurse to address this omission?

Notify the health care provider to add the route and then administer the medication when complete.

What type of prescription would the health care provider most likely write to treat a client whose pain levels vary widely throughout the day?

PRN

A client has been prescribed a new medication that is costly and not fully covered by the client's insurance plan. What can the nurse suggest to the client to address the concern?

Request that the pharmacy partially fill the prescription to evaluate the drug's effectiveness before full purchase.

The nurse is administering an oral opioid medication to a client who reported pain. The client dropped the medication on the floor. What actions would the nurse take now? Select all that apply.

Search for the pill on the floor until the pill is found, Discard the pill in an appropriate container with a witnessing nurse present, Obtain another dose of the medication for the client.

Regarding medication administration, what must occur at the change of shifts?

The opioids for the division are counted.

The nurse has begun caring for a surgical client who has been ordered preoperative antibiotics prior to bowel surgery. While the nurse will adhere to all the principles of safe medication administration, which domain will the nurse pay particular attention toroute in this situation?

Time

Which nursing action best exemplifies proper drug-diversion prevention of client medications?

What is the reason you do not want to take this medication?"

A nurse has prepared an oral dose of acetaminophen for a client and the client has taken the medication while the nurse remained at the bedside. At what point should the nurse document the fact that the client took the medication as ordered?

as soon as the nurse is able to document this

Which order includes information that may be confusing and is recommended by The Joint Commission not to be used?

aspirin gr X po prn q4h prn moderate joint pain

The client cannot swallow and just had an enteral tube placed for feeding and medications. Medications will have to be in liquid form or crushed for administration. The client has the following medications prescribed. Which medication will the nurse withhold and consult with the health care provider?

oxycodone extended release tablet