Chapter 9

The nurse is preparing an oral liquid medication for a patient. How does the usual procedure change when the volume of medication requires less than 5mL

Rather than pouring it into a medication cup, draw small volumes of liquid medications into a calibrated oral syringe

The primary health care provider has written a prescription for the nurse to administer medicine by intravenous piggyback (IVPB) to a patient. The IVPB system needs to be activated before administration. Arrange the steps in the correct sequence. 1. Snap the connection area between the intravenous bag and the vial. 2. Squeeze the fluid from the bag into the vial to allow the medication to dissolve. 3. Rotate the vial gently to ensure that all of the powder is dissolved. 4. Hold the IVPB apparatus by the vial and squeeze the bag. 5. Allow all of the fluid to enter the piggyback bag from the vial. 6. Make sure that all of the medication returns to the IVPB bag.

1, 2, 3, 4, 5, 6 To administer an IVPB medication, the nurse should snap the connection area between the intravenous infusion bag and the vial to activate the IVPB. Then, the fluid is gently squeezed from the infusion bag into the vial to allow the medication to dissolve. After a few minutes, the vial is rotated gently to ensure that all of the powder is dissolved. The IPVB apparatus is held and the bag is squeezed. The fluid then enters into the piggyback from the vial. The nurse should make sure that all of the medication returns to the IVPB bag.

Which method(s) should the nurse use to administer an oral tablet through a gastrostomy tube? Select all that apply. 1 Releasing the tubing after pouring the diluted medication 2 Flushing the tubing with 10 mL of warm water between each drug 3 Avoiding applying pressure to the tube with the bulb of the syringe 4 Diluting each tablet with 100 mL of cold water before administration 5 Carefully crushing the tablet into a fine powder and dissolving it in water

1, 2, 5 After pouring the diluted medications into the tube, the nurse should release the tubing; this helps the medication to flow by gravity into the patient. The nurse should flush the tubing with 10 mL of water between administration of each medication. The nurse should crush the tablets into a fine powder to prevent clogging of the tube by drug particles. The nurse should apply gentle pressure with the bulb of the syringe if the medication does not flow properly. To provide adequate dilution of the medications the nurse should use 15 to 30 mL of warm water.

A patient has been given a new inhaler that contains 100 doses of medication. The order specifies that the patient is to take one puff four times a day. How many days will this inhaler last before it becomes empty?

100 divided by 4-4puffs/day would equal 25 days

Which action(s) are correct in the administration of a liquid oral medication to a patient? Select all that apply. 1 Pouring unused medication back into the bottle 2 Placing the bottle's cap upside down on a paper 3 Holding the bottle with the label against the palm 4 Shaking the bottle vigorously before pouring the medicine 5 Holding the medicine cup at eye level when measuring the dose

2, 3, 5 When administering liquid medications to a patient, the bottle's cap must be placed upside down on a paper to prevent contamination by adherence of microbes and dust particles. The nurse should hold the bottle with the label against the palm to help prevent alterations to the label caused by spillage of the medicine. The medicine cup should be at eye level when measuring the dose. The nurse should pour any excess medication into a sink to avoid cross-contamination rather than pouring it back into the bottle. The bottle must be shaken gently, not vigorously, before pouring the medication for proper mixing of the medication.

A nurse assessing the response of a patient of the patient to a sublingual or intravenous push medication would evaluate the patient according to which time frame?

30 minutes

What is the maximum volume that can be administered by the intradermal route in one injection? 1 3 mL 2 5 mL 3 0.1 mL 4 0.5 mL

A drug given by the intradermal route enters into the outer layers of dermis, so very small amounts of the drug (0.01 to 0.1 mL) should be administered. Administering larger volumes such as 0.5, 3, and 5 mL can cause tissue necrosis and damage. A dose of 0.5 mL can be administered by the subcutaneous route; 3 mL of a drug can be administered by the intramuscular route.

The nurse is caring for a patient who has dysphagia and is prescribed an extended-release medication. Which intervention is correct when administering this medication to the patient? 1 The nurse does not administer the medication. 2 The nurse crushes the medication and mixes it in pudding. 3 The nurse administers the medication with a glass of water. 4 The nurse advises the patient to chew the medication well before swallowing.

A patient with dysphagia may not be able to swallow a medication well and may not be able to drink a glass of water. An extended-release medication cannot be chewed or crushed. The safest course of action for the nurse is to hold the medication, call the primary health care provider, and ask for a different form of the medication.

The nurse is preparing to administer an IM medication using an airlock to prevent leakage of the medication into the subcutaneous space. Which amount of air should the nurse withdraw for the air lock?

A total of 0.2 mL of air should be withdrawn into the syringe to provide an airlock and prevent the leakage of medication back into the subcutaneous tissue.

Which action by the nurse is most correct when administering drugs via nasogastric tube?

allow the fluid to flow via gravity

The nurse is adding more than one medication to a solution. Which action is most important at this time?

Assess the two drugs for compatibility

The nurse is preparing to give an inradermal injection and will perform which action?

Avoid massaging the site

Which needle is required to administer oil-based medications by the intramuscular route? 1 8- to 10-gauge needle 2 12- to 14-gauge needle 3 18- to 25-gauge needle 4 30- to 34-gauge needle

Because oil-based medications are more viscous, 18- to 25-gauge needles are used to administer these medications by the intramuscular route; 12- to 14-gauge and 8- to 10-gauge needles are too large and can cause damage to the muscle because of their greater thickness and length, so they must not be used. A 30- to 34-gauge needle is too narrow and will make it difficult to withdraw the medication from the vial or ampule.

When giving a buccal medication to a patient, which action by the nurse is

Buccal medications are properly administered between the upper or lower molar teeth and the cheek. Caution the patient against swallowing, and do not administer with water. Medications given under the tongue are sublingually administered.

What should the nurse teach the patient to ensure the safe use of a medication by the buccal route? 1 "Mix the crushed medication in a small amount of soft food." 2 "Place the tablet under the tongue to promote drug absorption." 3 "Place the tablet between the lower molar teeth and the cheek." 4 "Make sure to take the tablet with a full 8-oz (240 mL) glass of water."

Buccal tablets are placed between the lower molar teeth and the cheek. This placement prevents the destruction of the drugs in the gastrointestinal tract and allows for rapid absorption into the bloodstream through the oral mucous membranes. Buccal tablets are allowed to dissolve in the buccal mucosa; they are not crushed and mixed with food. Sublingual tablets are placed under the tongue. A medication administered by the buccal route does not get swallowed. Therefore, drinking water is not necessary.

When giving a medication via intravenous push how will the the nurse correctly occlude the intravenous line?

By pitching or clamping the tubing just above the injection port

When administering nasal spray, which instruction by the nurse is appropriate?

Clear the nasal passages before receiving nasal spray. Blowing one's nose after receiving the medication will remove the medication from the nasal passages. The patient will receive the spray while inhaling through the open nostril and needs to remain in a supine position for 5 minutes afterward.

What is important for the nurse to teach the patient about the installation of nasal nasal drops?

Clear the nasal passages by blowing the nose gently before administering the medication

When giving medications, the nurse will use Standard Precautions, which include what action?

Discarding all syringes and needles in a puncture-resistant container.Standard Precautions include wearing clean gloves when there is potential exposure to a patient's blood or other body fluids; never recapping needles; never bending needles or syringes; and discarding all disposable syringes and needles in the appropriate puncture-resistant container.

A patient says he prefers to chew rather than swallow his pills. One of the pills has the abbreviation SR behind the name of the medication. The nurse needs to remember which correct instruction regarding how to give this medication?

Do not crush or break the tablet before administration. Sustained-release (SR) and enteric-coated tablets or capsules are forms of medications that must not be crushed before administration so as to protect the gastrointestinal lining or the medication itself. Do not break, dissolve, or crush these tablets before administering.

When administering ophthalmic eyedrops, the nurse will perform which action?

Drop the prescribed number of drops into the conjunctival sac. The eyedropper is held 1 to 2 cm above the conjunctival sac. The nurse should drop the prescribed number of drops into the conjunctival sac. Never apply eyedrops to the cornea. If the drops land on the outer eyelid margins (e.g., if the patient moved or blinked), the procedure should be repeated.

Which dosage form may be given immediately after dissolving it in water? 1 Effervescent powders 2 Enteric-coated tablets 3 Sustained-release drugs 4 Long-acting medications

Effervescent powders can be dissolved in water and must be administered immediately for immediate action. Enteric-coated tablets must not be dissolved in water, because they will lose their action. Sustained-release drugs are intended for steady release into the bloodstream, so they must not be dissolved in water. Long-acting medications are administered to provide a longer drug effect. If they are dissolved in the water they are rapidly absorbed in the blood, which can lead to hepatic or renal toxicity.

The nurse is administering an IV push medication through an IV lock. After injecting the medication, which action will be taken next?

Flushing the lock. IV locks are to be flushed before and after each use; either heparin or saline flush is used, depending on the individual institution's policy. The other actions are not appropriate.

After administering eardrops, which action by the nurse is correct?

Gently massage the tragus of the ear.

Which interventions are correct regarding administration of ophthalmic medications?

Have the patient look upward while instilling the medication Instill the prescribed number of drops into the conjunctival sac Apply gentle pressure to the patient's nasolacrimal duct for 30 to 60 seconds after instilling the eyedrops

The nurse is administering a medication intravenously to a patient. Before administering the drug, the nurse finds an air bubble in the syringe and has 0.2 mL extra medicine in the syringe. What action should the nurse take before administering the medication? 1 The nurse should expel the excess drug into the sink. 2 The nurse should expel the drug back into the container. 3 The nurse should eject the air bubble by quickly pushing the plunger. 4 The nurse should withdraw the dose of the drug again in a new syringe.

If the nurse draws up an excess of a medication, the nurse should expel the medication into the sink. The nurse should not expel the medication into the container, because it can cause contamination. The nurse does not need to start the entire procedure over again, just expel the air bubble and the excess medication. The nurse should expel the air bubble by tapping the side of the syringe and slowly pushing the plunger.

A patient's primary intravenous infusion contains multivitamins. What action should the nurse take when infusing a medication via the piggyback route?

If the primary infusion contains multivitamins, the nurse should not backprime the fluids; multivitamins are incompatible with other intravenous solutions. The medication should not run concurrently with the infusion containing multivitamins or have the pharmacy mix the medication with the multivitamins, because they are not compatible. The nurse should not administer a drip medication by pushing it in rapidly, because this may cause side effects.

A 2-year-old child is to receive eardrops. The nurse is teaching the parent about giving the eardrops. Which statement reflects the proper technique for administering eardrops to this child?

In an infant or a child younger than 3 years of age, the ear canal is straightened by pulling the pinna down and back. In adults, the pinna is pulled up and outward. Pulling the lobe and administering eardrops without pulling on the ear lobe are not appropriate actions.

When planning to administer an intradermal medication, the nurse knows which location is the preferred site of injection on the forearm?

In general, 3 to 4 finger widths below the antecubital space and 1 hand width above the wrist is the preferred location on the forearm.

The nurse is preparing to give an aqueous intramuscular (IM) injection to an average-sized adult. Which actions are appropriate?

In general, aqueous medications can be given with a 22- to 27-gauge needle, and average needle lengths for adults range from 1 to inches. Insert the needle at a 90-degree angle. Checking for blood return is also part of the technique for IM injections to prevent inadvertent administration into the bloodstream. The ventrogluteal site is the preferred site for IM injections in adults. The dorsogluteal site is to be avoided because of proximity to nerves and blood vessels.

What is the appropriate site to administer an intradermal injection? 1 Just above the wrist 2 Just below the antecubital space 3 Two to four finger widths above the wrist 4 Three to four finger widths below the antecubital space

In general, three to four finger widths below the antecubital space and one hand width above the wrist is the preferred location on the forearm. The other locations are inappropriate.

A patient with asthma is to begin medication therapy using a metered-dose inhaler. What is an important reminder to include during teaching sessions with the

Inhale slowly while pressing down to release the medication.Position the inhaler to an open mouth, with the inhaler 1 to 2 inches away from the mouth, or attach a spacer to the mouthpiece of the inhaler, or place the mouthpiece in the mouth. To administer, press down on the inhaler to release the medication while inhaling slowly. Wait 1 to 2 minutes between puffs if a second puff of the same medication has been ordered.

Which nursing intervention is most appropriate when crushing oral medications to administer to a patient with dysphagia?

Keeping the drugs separate allows for accurate identification if a dose is spilled.

What suggestion should the nurse give the mother for administering a bitter-tasting medication to an infant? 1 "Mix the medication with a teaspoon of milk." 2 "Mix the medication with a teaspoon of jelly." 3 "Mix the medication with a teaspoon of honey." 4 "Mix the medication with a teaspoon of orange juice."

Medications that are bitter in taste can be mixed with sweet foods such as jelly, ice cream, or sherbet. Honey is not used, because it carries a risk of botulism in infants. The medications are not mixed with essential foods such as orange juice and milk, because the infant may develop an aversion to these foods.

how to assess for intrademral injections

Note ant lesions or discoloration of the forearm

how to assess for intramuscular injections

Note the integrity and size of the muscle and palpate for tenderness

how to assess for subcutaneous injections

Palpate for masses or tenderness and assess the amount of subcutaneous tissue

As a portion of the new nine rights of medication administration, the nurse knows to use two patient identifiers before administering medications. The nurse would be functioning according to the policy if which two identifiers are used?

Patient name and city of birth

Which position is correct when the nurse administers nasal drops for the frontal or maxillary sinuses?

Place a pillow under the patient's shoulders and tilt the head back.

The nurse is about to give a rectal suppository to a patient. Which technique would facilitate the administration and absorption of the rectal suppository?

Position the patient on his or her left side for rectal suppository insertion. The suppository is then lubricated with a small amount of water-soluble lubricant, not petroleum-based substances. The patient is told to take a deep breath and exhale through the mouth during insertion. Then the patient needs to remain lying on the left side for 15 to 20 minutes to allow absorption of the drug.

During the medication administering which will the nurse consider ti be a contraindication to the administration of rectal suppositories?

Rectal bleeding and diarrhea

The nurse is administering an intramuscular injection. After the needle enters the site, the nurse grasps the lower end of the syringe barrel with the non dominant hand and slowly pulls back on the plunger to aspirant the drug. Blood appears on the syringe. What is the best action?

Remove the needle and ensure that the site is not bleeding. Discard the medication and the syringe draw up new medication and repeat the procedure in a different location.

When administering a sublingual medication, which action should the nurse perform? 1 Wear gloves to place the tablet under the patient's tongue. 2 Have the patient swallow several times while the tablet dissolves. 3 Ask the patient to chew the medication so that it will absorb faster. 4 Instruct the patient to drink room-temperature water to enhance dissolution.

Standard Precautions require the wearing of gloves when placing a sublingual tablet under a patient's tongue. The patient should not chew a sublingual tablet and should not swallow or drink anything until the tablet is completely dissolved and absorbed.

When administering administering oral medications the nurse will follow which correct procedure?

Stay with the patient until until each medication has been swallowed.

The primary health care provider has written a prescription for a nurse to administer medicine to a patient by the subcutaneous route. The patient has a thin stature. At what angle is the needle is inserted in the skin? Record your answer using a whole number. ____ degree(s)

While administering medicine by the subcutaneous route, the needle is inserted at either a 45- or 90-degree angle. Subcutaneous injections deposit the drug into the loose connective tissue under the dermis. A 45-degree angle is used for thin patients because they have less fatty tissue. A 90-degree angle is used for an average-sized patient.

What is appropriate for the nurse to teach the patient about a sublingual medication? Select all that apply. 1 The patient takes the tablet with food. 2 The patient places the tablet under the tongue. 3 The patient swallows the tablet after 2 minutes. 4 The patient swallows after the drug is dissolved. 5 The patient drinks water after chewing the tablet.

Sublingual tablets must be placed under the tongue for rapid absorption of the drug into the bloodstream. The patient should not swallow the saliva until the drug is dissolved. The tablet must not be taken with food, because it affects the absorption of the drug and can cause a food-drug interaction. Swallowing the tablet without complete dissolution of the drug causes ineffective therapeutic action. Water and other fluids must not be taken until the tablet completely dissolves. The tablet should not be chewed, because chewing can cause gastrointestinal destruction.

Which medicine is administered using the Z-track method? 1 Heparin 2 Phenytoin 3 Hydroxyzine 4 Nitroglycerin

The Z-track method is used for injections of irritating substances such as hydroxyzine and iron dextran. The technique reduces pain, irritation, and staining at the injection site. Heparin is not given by this route because it may cause tissue damage. Heparin is administered subcutaneously or intravenously. Phenytoin is not administered by this method. It is administered by intravenous piggyback. Nitroglycerin is administered by the sublingual route.

Which are the appropriate landmarks for an IM injection into the dorsogluteal region?

The dorsogluteal region is no longer recommended for injection; a different site should be selected. The dorsogluteal injection site is no longer recommended for injections because of the close proximity to the sciatic nerve and major blood vessels. Injury to the sciatic nerve from an injection may cause partial paralysis of the leg. The dorsogluteal site is not to be used for IM injections.

After administering an intradermal (ID) injection for a skin test, the nurse notices a small bleb at the injection site. The best action for the nurse to take at this time is to:

The formation of a small bleb is expected after an ID injection for skin testing. Do nothing.

How should the nurse administer a dose of tetanus toxoid intramuscularly to an adult patient? 1 The deltoid site 2 The antecubital site 3 The dorsogluteal site 4 The ventrogluteal site

The nurse should administer tetanus toxoid at the ventrogluteal site, because it is the preferred site for administering intramuscular injections. It is considered the safest of all sites because the muscle is deep and away from major blood vessels and nerves. The deltoid site is not the first choice for administering intramuscular injections, because the muscle may not be well developed in some adults. Moreover the site carries a risk for nerve injury because the axillary nerve lies beneath the deltoid muscle. The antecubital site is used for phlebotomy, not for intramuscular injections. The nurse should avoid administering tetanus toxoid at the dorsogluteal site because of the close proximity to the sciatic nerve and major blood vessels to the site of injection.

A patient is prescribed oral (PO) digoxin. What intervention is essential before administering this medication? 1 The nurse prepares an intradermal injection. 2 The nurse assesses the patient's blood glucose level. 3 The nurse attaches the patient to an electrocardiogram. 4 The nurse assesses the patient's apical pulse for 60 seconds.

The nurse should check the patient's apical pulse for 60 seconds before administering medications such as digoxin because it has a low therapeutic index. The medication is prescribed PO, and an intradermal injection is not appropriate. There is no need for the nurse to assess blood glucose level or attach an electrocardiogram.

What should the nurse teach a patient about administering a suppository? 1 "You can immediately get up after inserting the suppositories." 2 "You should lie on your right side while administering the medication." 3 "You should remove the outer wrappings from the drug before insertion." 4 "You can divide the suppositories into equal portions for a smaller dose."

The nurse should give appropriate instructions if the patient wants to self-administer a suppository. The nurse should instruct the patient to remove the wrappings from the suppositories before inserting them into the rectum. After inserting the suppository the patient must remain in the side-lying position for 15 to 20 minutes until the medication is absorbed into the blood. The patient must be lying on the left side with the right leg drawn up (Sims' position). The suppository cannot be divided into equal portions, because the active ingredient is not equally distributed in the suppository base.

What should the nurse do when withdrawing medication from a multidose vial? 1 The nurse should wipe the cap before withdrawing medication. 2 The nurse should use a sharp needle for withdrawing the medication. 3 The nurse should write the date and time the vial was opened on the label. 4 The nurse should inject saline into the vial before withdrawing the medication.

The nurse should mark the date and time of opening and the date of discard on a multidose vial. This helps to prevent the administration of expired medicine. The nurse should not wipe the cap, because the vial is accessed under the cap. The nurse should use a blunt-tipped needle for withdrawing the medication. It helps to reduce the chances of injury. The nurse should not inject saline into the ampule, because it can cause the contents to overflow and a loss of the drug.

The nurse is preparing to administer an intramuscular medication using an air lock to prevent leakage of the medication into the subcutaneous space. Which amount of air should the nurse withdraw for the air lock? 1 0.05 mL 2 0.1 mL 3 0.2 mL 4 0.3 mL

The nurse should withdraw 0.2 mL of air into the syringe to provide an airlock and prevent leakage of medication back into the subcutaneous tissue.

In which position is it most appropriate to place a patient when administering medications via a nasogastric tube? 1 Supine 2 Left side 3 Semi-Flowers or Fowler's position 4 Trendelenburg position

The patient should be positioned in a semi-Fowler's or Fowler's position during and after administration of medications via a nasogastric tube to reduce the risk of aspiration. The other positions do not reduce the risk of aspiration.

Which position is MOST appropriate for the nurse to position a patient when administering medications via a nasogastric (NG) tube?

The patient should be positioned in a semi-Fowler's or Fowler's position during and after administration of medications via an NG tube to reduce the risk of aspiration.

A patient is to receive a penicillin intramuscular (IM) injection in the ventrogluteal site. The nurse will use which angle for the needle insertion?

The proper angle for IM injections is 90 degrees.

The nurse is giving an intradermal (ID) injection and will choose which syringe for this injection?

The proper size syringe for ID injection is 1-mL tuberculin. The other syringes pictured are incorrect. Insulin syringes (marked in units) are not used for intradermal injections.

The nurse needs to administer insulin subcutaneously to an obese patient. Which is the proper technique for this injection?

The proper technique for a subcutaneous injection for an obese patient is to pinch the skin at the site and inject the needle to below the skin fold at a 90-degree angle.

Which injection technique will the nurse use when administering a medication subcutaneously?

The proper technique for subcutaneous injections involves the use of a 1/2- to 5/8-inch, 25-gauge needle at a 45- or 90-degree angle of insertion depending on patient size. Aspiration is not done with anticoagulants and insulin. The landmark for the vastus lateralis is one handbreadth below the greater trochanter and above the knee on the outer aspect of the thigh.

The nurse has an order to administer an intramuscular (IM) immunization to a 2-month-old child. Which site is considered the best choice for this injection?

The vastus lateralis is the preferred site of injection of drugs such as immunizations for infants. The other sites are not appropriate for infants. The ventrogluteal site is the preferred site for adults and children. The deltoid site is used only for the administration of immunizations to toddlers, older children, and adults (not infants) and only for small volumes of medication. The dorsogluteal site is no longer recommended because of the possibility of nerve injury.

The nurse is giving medications through a percutaneous endoscopic gastrostomy (PEG) tube. Which technique is correct?

Using the barrel of the syringe, allowing the medication to flow via gravity into the tube.For PEG tubes (and nasogastric tubes), medications are poured into the barrel of the syringe with the piston removed, and the medication is allowed to flow via gravity into the tube. Fluid must never be forced into the tube. The tubing is to be flushed with 30 mL of tap water (not saline) to ensure that the medication is cleared from the tube after the medication has been given. A 3-mL syringe is too small for this procedure.

When administering a sublingual medication, which action will the nurse perform?

Wear gloves to place the tablet under the patient's tongue. Standard precautions require the wearing of gloves when placing a tablet under a patient's tongue. The patient should not chew a sublingual tablet and should not drink or swallow until the tablet is completely dissolved and absorbed.

What action should the nurse take to prevent aspiration when administering a medication via a nasogastric tube? 1 Administer the medication as quickly as possible. 2 Have the patient cough while the medication is infusing. 3 Suggest the patient remain supine for 10 minutes after administration. 4 Elevate the head of the bed for 30 minutes after administering the medication.

When administering medication by a nasogastric tube, the patient must be in the semi-Fowler's or high Fowler's position. The patient's head must be kept in this position for a minimum of 30 minutes after medication infusion to help prevent aspiration. Administering the medication too quickly is a risk for aspiration. Coughing does not help to prevent aspiration. The patient is most likely to aspirate in the supine position

A patient is receiving eyedrops that contain a beta-blocker medication. The nurse will use what method to reduce systemic effects after administering the eyedrops?

When administering ophthalmic drugs that may cause systemic effects, one's finger should be protected by a clean tissue or glove and gentle pressure applied to the patient's nasolacrimal duct for 30 to 60 seconds. The other actions are not appropriate.

When adding medications to a bag of intravenous (IV) fluid, the nurse will use which method to mix the solution?

When medications are added to IV fluid containers, the medication and the IV solution are mixed by holding the bag or bottle and turning it end-to-end, mixing it gently. Shaking vigorously is not appropriate; inverting the bag just once or simply allowing the bag to stand for 10 minutes may not be sufficient to mix the medication into the fluid.

Which statement by a patient indicates an understanding of how to clean a nebulizer at home? 1 "Avoid washing the parts with soapy water." 2 "Scrub the nebulizer parts with a stiff brush." 3 "Rinse out the nebulizer parts one time per week." 4 "Soak the nebulizer parts in a solution of vinegar and water."Which statement by a patient indicates an understanding of how to clean a nebulizer at home? 1 "Avoid washing the parts with soapy water." 2 "Scrub the nebulizer parts with a stiff brush." 3 "Rinse out the nebulizer parts one time per week." 4 "Soak the nebulizer parts in a solution of vinegar and water."

When using a nebulizer at home, precautions should be taken to prevent the growth of microbes in the nebulizer. Patients should be taught to soak the nebulizer parts in a solution of vinegar and water once a week. The concentration of vinegar to water should be four parts water to one part white vinegar. The nebulizer parts should soak in this solution for 30 minutes; then the patient should rinse them thoroughly with clear, warm water and allow them to air dry. The nebulizer parts should be rinsed after each use with warm, clear water and air dried. Soapy water should be used daily to wash the nebulizer parts to keep them clean. Scrubbing with a stiff brush may provide areas for microbes to grow

Which interventions are correct in the administration of eye drops? Select all that apply. 1 Assisting the patient to a sitting position 2 Holding the eye dropper 1 to 2 cm above the cornea 3 Removing the secretions from the outer to the inner canthus 4 Repeating the procedure if the drops are deposited on the outer lid margins

While administering eye drops, the secretions in the eye should always be removed from the inner to the outer canthus. This helps prevent infection in the eye. The patient should be assisted to a supine or sitting position, and the patient's head should be tilted back slightly to administer the eye medication. The eye medication dropper should be held 1 to 2 cm above the conjunctival sac. The eye drops should never be applied to the cornea. If the eye medication drops are deposited on the outer lid margins, the procedure should be repeated.

What is the appropriate method to remove a medication from an ampule? 1 The top portion of the ampule should be tapped slowly. 2 Gauze must not be placed around the neck of the ampule. 3 The tip of the needle must not come in contact with the rim of the ampule. 4 A filter needle must not be used for removing the medication from the ampule.

While taking the medication from the ampule, the nurse should not touch the tip of the needle to the rim of the ampule, because it may contain minute glass particles. A small gauze pad or dry alcohol swab must be placed around the neck of the ampule to protect the hand from broken glass. The ampule's cap contains a small amount of the drug, so it must be tapped quickly and lightly. Some glass particles may be present inside the ampule after breaking it, so a filter needle must be used for removing the medication from the ampule.

The nurse is measuring 4 mL of a liquid cough elixir for a child. Which method is most appropriate?

Withdrawing the elixir from the container using a calibrated oral syringe.Small doses of liquid medications must be withdrawn using a calibrated oral syringe. A hypodermic syringe or a syringe with a needle or syringe cap must not be used. If hypodermic syringes are used, the drug may be inadvertently given parenterally, or the syringe cap or needle, if not removed from the syringe, may become dislodged and accidentally aspirated by the patient when the syringe plunger is pressed. The other methods are not accurate for small volumes.

The prochloperzine (Compazine) retal suppository is twice the strength of what has actually been ordered. Which is the the nurses best action?

call the physican for clarification

The nurse will apply a transdermal patch to a side that is

non hairy

When giving sublingual medications the nurse recalls that medications given by this route have which advantage?

they are immediately absorbed

The nurse is preparing to give a Z-track intramuscular injection. This technique indicated in which situation?

with medications that are known to be irritating, painful, or staining to tissues