Chapter 10: Drug administration QUESTIONS!

Which intervention will the nurse use when administering a medication subcutaneously? Use a 1- to 1½-inch, 23- to 25-gauge needle. Insert the needle at a 45- to 90-degree angle, depending on patient size, to penetrate subcutaneous tissue. Aspirate only with specific medications, such as heparin. Landmark between the greater trochanter and the superior iliac crest for the vastus lateralis site.

Insert the needle at a 45- to 90-degree angle, depending on patient size, to penetrate subcutaneous tissue. The proper technique for subcutaneous injections involves the use of a ⅝-inch needle, 23- to 25-gauge, at a 45- to 90-degree angle of insertion, dependent on patient size. A 1- to 1-½ inch needle is used for intramuscular injection. Aspiration is done with all medications except 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.

What is the site of medication administration in an intraosseous infusion? Into the spinal canal Into the bone marrow Into the iliac crest Into the kidney pelvis

Into the bone marrow The intraosseous (IO) method of drug administration involves the infusion of medication directly into the bone marrow.

Which behavior describes the appropriate administration of eye drops? Medication is applied directly on the eyeball surface. Medication is applied in the conjunctival sac. Mediation is applied while patient is looking at the floor. Medication is applied in the lacrimal sac.

Medication is applied in the conjunctival sac. Administer the prescribed number of drops into the center of the sac. If the drug is placed directly on the cornea, it can cause discomfort or damage. The patient is instructed to lie down or sit back in a chair and to look at the ceiling. The lacrimal duct is gently pressed with a sterile cotton ball or tissue for 1 to 2 minutes after instillation to prevent systemic absorption through the lacrimal canal.

Which is the best intervention for the nurse to use when administering medications to an infant? Administer all medications quickly. Administer medications only with parents in the room. Administer only intravenous medications. Move slowly and have a nonthreatening approach.

Move slowly and have a nonthreatening approach. The nurse should have a nonthreatening approach to the infant and move slowly. Medications should not be administered quickly to an infant. For accuracy, medications should be administered slowly. Parents do not have to be in the room to administer medications to infants. The intravenous route is not the only acceptable route for medication administration in infants.

7. The nurse prepares to administer oral medications to a patient. What nursing intervention is needed in addition to the "five-plus-five" rights to ensure safety? a. Assess the patient for risk of aspiration. b. Mix two of the four medications into the meal. c. Administer drugs on a full stomach if food interferes with medication absorption. d. Administer irritating drugs without food to decrease gastrointestinal discomfort.

a

1. The nurse is administering oral medications to a patient. Which are important considerations? (Select all that apply.) a. Administer irritating drugs with food. b. Avoid mixing medications in infant formula. c. Enteric-coated capsules may be chewed or crushed. d. Oral medication should be stopped if the patient is vomiting. e. Cut all transdermal patches to the correct dose.

abd

8. A patient is to start on a lidocaine transdermal patch. What is essential for the nurse to include in the patient's teaching? (Select all that apply.) a. Wear gloves when applying the patch. b. Cut the patch in half if a reduced dose is needed. c. Wear gloves when removing the patch. d. Rotate placement of patch to different sites. e. Remove the patch if it becomes loose.

acd

4. The nurse administers a variety of drugs to a patient. Which statement by the patient indicates a need for further teaching? a. I do not eat or drink when I have sublingual nitroglycerin in place. b. I mix all of these meds in my dessert and hope I am not too full to finish it. c. I keep the meds in their original labeled containers. d. I store medications away from children and pets.

b

5. The nurse is teaching a patient to use an inhaler. What common teaching point is essential for the nurse to include? a. Cleaning the metered-dose inhaler or nebulizer is not recommended. b. The semi-Fowler or high Fowler position is recommended. c. Spacers decrease delivery of medication. d. Nebulizers change medications to a large-particle powder mist.

b

2. The clinic nurse is preparing to administer an intradermal injection. Which supplies are most appropriate for this procedure? a. A 21-gauge, ⅝-inch needle b. A 27-gauge, ⅝-inch needle and a 3-mL syringe c. A 25-gauge needle and an insulin syringe d. A 25-gauge needle and a tuberculin syringe

d

3. The nurse is administering an intramuscular injection to a 5-year-old child. Choose the correct site the nurse will use. a. Intravenous b. Dorsogluteal c. Deltoid d. Ventrogluteal

d

6. A 3-year-old patient has an intramuscular medication ordered. What is the most appropriate approach to gain the child's cooperation? a. Engage the help of a second nurse to hold the child. b. Give a pretend injection to a toy animal. c. Restrain the patient's upper extremities. d. Ask family members to leave the room.

b

The nurse is administering a schedule III controlled substance. What is an essential nursing action? Select all that apply. Keep the medication in the patient's drawer and the medication cart locked. Count the available doses of medication before administering and record them. Document the time and date of administration. Have a second nurse sign any administration record. Countersign all discarded or wasted medication.

Count the available doses of medication before administering and record them. Document the time and date of administration. Countersign all discarded or wasted medication. Nursing interventions for controlled substances include accounting for all controlled drugs, keeping a controlled substance record for required information, and countersigning all discarded or wasted medications. In addition, the drugs should be in a locked storage area, with narcotics under double lock. Only authorized persons should have access to keys. The medication should not be kept in the patient's drawer. A second nurse does not have to sign the administration record.

The charge nurse is observing a new nurse preparing to administer medications. Which observation would require immediate intervention by the charge nurse? The nurse verifies the medication order three times. The nurse washes hands prior to drawing up medication in a syringe. The nurse crushes an enteric-coated tablet. The nurse roles a bottle of NPH gently prior to withdrawing the medication.

The nurse crushes an enteric-coated tablet. Enteric-coated and timed-release capsules must be swallowed whole to maintain a therapeutic drug level. If crushed, the initial excessive drug release poses a risk of toxicity such that it could lead to a potentially fatal overdose.

The nurse needs to administer an intramuscular injection to an infant. Which is the most appropriate site to utilize for this patient? Ventrogluteal Deltoid Vastus lateralis Abdomen

Vastus lateralis The vastus lateralis is a large muscle mass in the pediatric infant patient in comparison to the ventrogluteal and deltoid muscles. The abdomen is not a muscle and is not appropriate to utilize as an intramuscular injection site.

When would the nurse plan to use Z-track technique for the administration of an intramuscular injection? When there is insufficient muscle mass in the landmarked area When massaging the area after medication administration is contraindicated With medications that are known to be irritating, painful, and/or straining to tissues With any injection that is given into the ventrogluteal muscle

With medications that are known to be irritating, painful, and/or straining to tissues The Z-track method prevents medication from leaking into subcutaneous tissues where it can be irritating and/or painful.