Ch.29 Medications PrepU

When the client demonstrates a rash 30 minutes after she has taken a dose of penicillin, the nurse recognizes that the client is likely demonstrating which type of drug reaction?

Allergy Explanation: Allergic reactions result from an immunologic response to a substance to which the client is sensitized.

A client is to take Demerol 35 mg IM. You have Demerol 50 mg per cc. How many cc will you administer?

0.7 cc Explanation: The nurse will administer Demerol 35 mg or 0.7 cc.

(see full question) A nurse needs to administer an intradermal tuberculin skin test injection to a client. Which of the following is the most suitable angle when administering an intradermal injection?

10-degree angle Explanation: When administering an intradermal injection, the nurse should hold the syringe almost parallel to the skin at a 10-degree angle with the bevel pointing upward. This facilitates delivering the medication between the layers of the skin and advances the needle to the desired depth. A nurse administers a subcutaneous injection at a 45-degree angle or a 90-degree angle to reach the subcutaneous level of tissue, depending on the length of the needle. The nurse will not be able to insert the injection if it is held at a 180-degree angle.

A physician at a health care facility suggests the use of a metered-dose inhaler for an asthmatic client. Which of the following describes the mechanism of a metered-dose inhaler?

A canister containing medication that is released when the container is compressed Explanation: A metered-dose-inhaler is a canister that contains medication under pressure; the aerosolized drug is released when the container is compressed. A turbo-inhaler is a propeller-driven device that spins and suspends a finely powdered medication. An aerosol results after a liquid drug is forced through a narrow channel using pressurized air or an inert gas.

Which of the following clients receives a drug that requires parenteral route?

A woman who has been ordered intravenous antibiotics Explanation: The parenteral route includes such methods as intravenous administration and injections. Pills are given by an oral route and a nebulizer is administered by the pulmonary route. An ointment is a topical medication.

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

Check the patient's identification band. Explanation: For all patients, the preferred method of confirming identity is to read the patient's identification band.

A severe allergic reaction from a medication requires

Epinephrine Explanation: A severe allergic reaction, called an anaphylactic reaction, requires immediate medical intervention because it can be fatal. Treatment includes discontinuing the medication and administering epinephrine, IV fluids, and antihistamines.

A nurse is administering a prescribed dose of medication to a client through a medication lock. How often should the nurse flush the medication lock to maintain patency?

Every 8 to 12 hours Explanation: To maintain patency, nurses usually flush medication locks every 8 to 12 hours with saline or heparin. Nurses do not flush medication locks every one or two hours, 36 to 48 hours, or every 72 to 96 hours to maintain patency. In fact, nurses change medication locks either when they change the IV site or at least every 72 hours.

The nurse is beginning to administer oral medications to a client. The client states, "I haven't taken that pill before. Are you sure it's correct?" You recheck the CMAR/MAR and find that the medication is scheduled to be administered. Which of the following responses is most appropriate?

Explanation: This is an example of a standing order, which is to be carried out as specified until it is cancelled by another order

A nurse is using the Z-track technique to administer an injection to a client. Which of the following injection routes utilizes the Z-track technique?

Intramuscular Explanation: When administering intramuscular injections, nurses may administer drugs that may be irritating to the upper levels of tissue by the Z-track technique. Clients report slightly less pain during (and the day after) a Z-track injection compared with the usual intramuscular injection technique. The Z-track technique is not suitable for intravenous injections as they are administered into the veins, nor is it used for intradermal or subcutaneous injections

A nurse is explaining to a client the correct method of using a metered-dose inhaler when self-administering a prescribed dose of medication. Which of the following is a feature of a metered-dose inhaler?

It is a canister that contains pressurized medication. Explanation:A meter-dose inhaler has a canister that contains medication under pressure. It is much more commonly used than the turbo-inhaler, which is a propeller-driven device that spins and suspends a finely powdered medication. A turbo-inhaler, not a meter-dose inhaler, has propellers that get activated during inhalation.

A nurse at a health care facility has to instill ear drops in a client. The nurse knows that which of the following techniques varies for an adult and child client?

Manipulation of the client's ear to straighten the auditory canal Explanation:The nurse should be aware that the method of manipulation of the client's ear to straighten the auditory canal varies between an adult and child. In a young client, the nurse pulls the ear down; in an adult client, the nurse pulls the ear up and back. The medication is not diluted; the number of medication drops instilled is as per the physician's prescription, and does not depend on the client's age. The position in which the client remains until the medication reaches the eardrum, and the amount of time before instilling medication in the client's opposite ear, does not differ with the age of the client.

If the dosage is inappropriate for a client, who is responsible?

Nurse Explanation: Whereas physicians and other healthcare providers prescribe and pharmacists dispense therapeutic agents, it is the nurse's legal domain to administer medications in a safe and timely manner.

A nurse has to administer a subcutaneous injection to a client. For which of the following clients can the nurse administer a subcutaneous injection at a 90-degree angle?

Obese clients Explanation: The nurse inserts the needle at a 90-degree angle to reach the subcutaneous tissue in a normal-size or obese client who has a 2-inch tissue fold when it is bunched. For thin clients who have a 1-inch fold of tissue, the nurse inserts the needle at a 45-degree angle. Bunching is preferred for infants, most children, and thin adults.

Which of the following routes of medication administration is most commonly prescribed?

Oral Explanation: Oral administration is the most commonly used route of administration. It is usually the route most convenient and comfortable for the patient.

A nurse is using a volume control set to administer a dose of prescribed medication to a client. The nurse opens the lower clamp until the tubing is filled with fluid and then reclamps it. Which of the following statements explains the nurse's action?

Purges air from the tubing Explanation: The nurse opens the lower clamp until the tubing is filled with fluid and then reclamps it because doing so purges air from the tubing. In order to provide diluent for the medication, the nurse opens the clamp above the calibrated container, fills the chamber with desired volume of fluid, and reclamps. To remove colonizing microorganisms, the nurse swabs the injection port on the calibrated container. To mix the medication thoroughly with the fluid, the nurse rotates the fluid chamber back and forth.

A client has been prescribed nasal medication. What care should the nurse take to avoid potential complications due to the administration of this medication?

Review the client's medication, allergy, and medical history Explanation:To avoid any potential complications, the nurse should review the client's medication, allergy, and medical history. The nurse should read and compare the label on the medication with the medical record at least three timesbefore, during, and after preparing the medicationto ensure that the right medication is given at the right time by the right route. Administering the medication within 30 to 60 minutes of the scheduled time demonstrates timely administration and compliance with the medical order. Allowing sufficient time to prepare the medication with minimal distraction promotes the safe preparation of medications.

The nurse transcribes an order that reads: Colace 100 mg PO daily. This is an example of which type of order?

Standing order

A client has been admitted to the health care facility with an asthmatic attack. The medication order for the client indicates that the nurse administer the prescribed medication immediately. Which of the following standard abbreviations indicates immediate medication?

Stat Explanation: The standard abbreviation "Stat" indicates that the client's medication should be started immediately. The abbreviation "q.d." means the medication needs to be administered every day. The abbreviation "t.i.d." indicates that the medication needs to be administered three times a day; "q4h" indicates that the medication needs to be administered every four hours

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

The narcotics for the division are counted

A client with chronic obstructive pulmonary disease has been prescribed an inhaled bronchodilator. Which of the following techniques should the nurse implement in order to ensure safe and complete delivery of the prescribed medication?

Use a spacer or extender with the metered-dose inhaler. Explanation:The use of an extender or spacer ensures that the client receives as much of the inhaled medication as possible. MDIs are placed one to two inches in front of the mouth, not deeply into the mouth. Oxygen therapy prior to administration does not aid in delivery. Multiple puffs, if ordered, are given after 1 to 5 minutes.

A nurse needs to administer a prescribed injection to an elderly client with impaired mobility. Which of the following intramuscular sites is preferred for administering an injection to elderly clients?

Ventrogluteal The ventrogluteal or deltoid muscles may be the preferred intramuscular sites for older adults experiencing impaired mobility. The dorsogluteal site, which has the gluteus maximus, should be avoided because of the risk of damage to the sciatic nerve with diminished musculature. The vastus lateralis muscle site is most suitable for small children and infants or clients who are extremely thin. The upper chest muscle is part of intradermal injections, not intramuscular injections. p.730

Children's medication dosages are most often calculated using the child's body surface area and

Weight

Which of the following are recommended guidelines for the nurse who is administering a piggyback intermittent intravenous infusion of medication?

a. Attach infusion tubing to the medication container by inserting the tubing spike into the port with a firm push and twisting motion. Attach the infusion tubing to the medication container by inserting the tubing spike into the port with a firm push and twisting motion, taking care to avoid contaminating either end. The IV piggyback delivery system requires the intermittent or additive solution to be placed higher than the primary solution container. The nurse is responsible for calculating and regulating the infusion with an infusion pump. Using aseptic technique, remove the cap on the tubing spike and the cap on the port of the medication container. p. 802

After administering medication to a client subcutaneously, the nurse removes the needle at the same angle at which it was inserted. Which of the following explains the nurse's action?

b. Minimizes tissue trauma to the client Removing the needle at the same angle at which it was inserted to administer medication minimizes tissue trauma and discomfort to the client. To verify correct injection of the drug, the nurse pushes the plunger and watches for a small wheal. To prevent needle-stick injuries, the nurse covers the needle with a protective cap. Holding the client's arm and stretching the skin taut helps to control placement of the needle. p.755

Medications administered that are renal toxic should have frequent assessments of which blood values?

d. BUN and creatinine If medications are known to cause kidney dysfunction, kidney function tests (serum creatinine, blood urea nitrogen) should be frequent. p. 730

A nurse needs to use a moisturizer for an older adult client with dry skin. Why is the onset of the medication action atypical in an older adult client?

diminished subcutaneous fat The onset of medication action is atypical for topical medications due to diminished subcutaneous fat, resulting in quicker absorption. Decreased appetite, diminished physical mobility, and decreased body temperature may not lead to atypical action with relation to the application of topical medication. p. 730

A nurse is bunching the tissue of a client when administering a subcutaneous injection to that client. The nurse knows that which of the following is the reason for bunching when injecting subcutaneously?

to avoid instilling medication within the muscle Nurses bunch tissue between the thumb and fingers before administering the injection to avoid instilling medication within the muscle. Bunching does not prevent needle-stick injuries, it does not facilitate blood circulation at the injection site, nor does it ensure the accuracy of landmarking. p. 750

A nurse is caring for a client undergoing IV therapy. The nurse knows that intravenous administration of medication is appropriate in which of the following situations?

when the client has disorders that affect the absorption of medications Intravenous administration may be chosen when clients have disorders, such as severe burns, that affect the absorption and metabolism of medications. IV therapy is also used in an emergency when a quick response is needed. Intravenous administration is not chosen when a client wants to avoid the discomfort of an intradermal injection but rather when the client wants to avoid the discomfort of repeated intramuscular injections. A single administration of a drug does not indicate the need for intravenous administration. p. 755

The "Rights of Medication Administration" help to ensure accuracy when administering medications. Which of the following represent these five rights? Select all that apply.

• Dosage • Client • Medication • Route Explanation: To prevent medication errors, always ensure that the: (1) Right medication is given to the (2) right client in the (3) right dosage through the (4) right route at the (5) right time.