medication administration

A nurse is administering intramuscular injections to clients. What needle size(s) has the nurse used correctly? Select all that apply.

-5/8-inch (2-cm) needle for the vastus lateralis site -1 1/2-inch (3.75-cm) needle for an adult in the deltoid site -5/8-inch (2-cm) needle for a child in the deltoid site

The nurse plans discharge teaching for a client leaving the medical center with new medication prescriptions. Which action(s) does the nurse include in the discharge teaching? Select all that apply.

-Explain the benefit in placing medications in a place that links to normal events in the client's life such as brushing teeth or going to bed -Provide client with a list of medications and directions for taking them -Confirm that the client understands the reason for the medications -Teach client and caregivers how to fill a pill box using the medicine list as a guide

The charge nurse on the medical/surgical unit is reviewing health care provider orders for a client with a diagnosis of congestive heart failure. Which infusion orders would the nurse question?

1000 D5W to run in 30 minutes

Intramuscular (IM)

23 or 21 gaugeLength depends on size of person volume - no more than 2 mL

The nurse is preparing to insert an intravenous needle in a 1-year-old child for a one-time administration of fluids due to dehydration. Which needle would the nurse likely select?

A 23-gauge winged infusion set Winged infusion or small vein needles may be used for short-term or one-time infusion therapies or may be used with infants and small children.

A young woman has an IV infusing for magnesium sulfate to treat preterm labor. The woman develops a fever. What is the first assessment the nurse should make?

Assess the IV site for redness.

A client is being started on total parenteral nutrition (TPN). When initiating the therapy, the nurse gradually tapers up the infusion rate as ordered to prevent which potential complication?

Hyperglycemia Metabolic complications also may present a problem for the client receiving TPN. Most commonly, clients experience hyperglycemia if they are unable to tolerate the high glucose content of the TPN solution

When preparing medications to provide to a client via enteral tube administration, which nursing action(s) is appropriate? Select all that apply.

Mix powdered drugs with warm water. Finely crush non-enteric-coated medications. Open the shell of capsules to release the powdered drug. Refrain from adding bulk-forming laxatives to the mix.

To convert 0.8 grams to milligrams, the nurse should do which of the following?

Move the decimal point 3 places to the right.

A client requests more medication for pain at the surgical site rated 8 out of 10. There is a PRN prescription for 10 mg PO of oxycodone for pain greater than 6 out of 10 on the pain scale. Which action should the nurse take first?

Verify clients name and date of birth

A nurse needs to administer a subcutaneous injection to a client. How far from the previous injection site to the area should the nurse administer the injection?

at least 1 inch (2.5 cm)

The nurse beginning a shift has received a report from the previous nurse, who reports that a client has a catheter inserted into the subclavian vein. The oncoming nurse will plan to assess which type of catheter?

peripherally inserted cutaneous catheter

A nurse needs to administer a prescribed medication to a client using IV push. In which way is the medication being administered to the client?

bolus administration

Types of Medication Action

therapeutic effect side effect adverse effect toxic effect idiosyncratic reaction: abnormal reaction allergic reaction

Which instruction should the nurse give to a client to ensure that a nasal medication is deposited within the nose rather than into the throat?

"Aim the tip of the container toward the nasal passage."

Which statements made by the nurse indicate how insulin pens simplify self-administered insulin for clients? Select all that apply.

"The cylinder of the insulin pen contains a prefilled reservoir of insulin." "The dose of insulin in an insulin pen is displayed in a window of the syringe." "The insulin pen automatically resets the dose window to zero, following the injection."

A nursing student is teaching the client regarding insertion of a central line catheter. Which statement by the student would cause the nurse to intervene?

"The risks are the same for a central line as they are for peripheral lines."

A new prescription has been noted in the medical record for an adult client with chest pain to receive a medication that comes in the form of a transdermal patch. The nurse will consider which precaution(s) to ensure safety with this form of drug use?

-May cause injury with defibrillation. -Fold the patch in half before disposal. -Remove the patch prior to magnetic resonance imaging (MRI). -Monitor the client for early identification of adverse effects. -Assess for fever prior to application.

a nurse has reconstituted a powdered medication. What information should the nurse include on the label?

-date if reconstitution -expiration and time -initials -dose of strength -time of reconstitution

In which order should the nurse instruct the client to use an inhaler?

1. Shake the canister to distribute the drug in the pressurized chamber. 2. Place the inhaler in your mouth and close your lips around the mouthpiece. 3. Press down on the canister once to release the medication. As the medication is released, breathe in slowly through your mouth for 3-5 seconds. 4. Hold your breath for 10 seconds. 5. Clean the inhaler daily by rinsing it in warm water daily.

Which medication interaction illustrates a synergism?

A client takes acetaminophen to help her sleep. She also takes an oxycodone for pain related to recent hip surgery, which makes her even more drowsy.

A nurse receives orders from the health care provider to mix a client's insulin in a syringe with two other medications. What is the recommended guideline in this situation?

Call the pharmacist to determine compatibility of the drugs.

The nurse is caring for a client who has had a cerebrovascular accident. Prior to administering oral medications, what is the nurse's appropriate action?

Consult with a speech therapist for dysphagia.

A client has been ordered nasal drops, which the nurse will administer. How should the nurse best position the client?

For the administration of nasal drops, the client should be assisted to an upright position with the head tilted back.

Which parenteral route of administration has the longest absorption time?

Intradermal

The nurse is teaching a client with diabetes how to withdraw insulin from a vial. In which order should the nurse explain the steps to the client?

Select appropriate syringe and needle. Remove the metal cover from the rubber stopper. Fill the syringe with a volume of air equal to the volume that will be withdrawn from the vial. Pierce the rubber stopper with the needle and instill the air. Invert the vial, hold, and brace it while pulling on the plunger. Date and initial the vial for future use.

Subcutaneous (SQ)

Shorter, fine gauge needle

The nurse is administering medication to a client through a drug-infusion lock using the saline flush. During the process, the client complains of pain at the site. Which interventions are appropriate in this situation? Select all that apply.

Stop the medication and assess the site for signs of infiltration and phlebitis. Flush the medication lock with normal saline again to recheck patency. If site is within normal limits, resume medication administration at a slower rate.

A nurse is administering enoxaparin sodium (anticoagulant) to a client with deep vein thrombosis, via the subcutaneous route. What is a recommended guideline when administering a subcutaneous injection?

Subcutaneous injections are administered into the adipose tissue layer just below the epidermis and dermis.

Angioedema

Swelling of lips, tongue, mucous membranes that can occlude throat

5 medication forms

Tablet Capsules Elixirs Suppositories Troches (lozenge)

The nurse is creating a professional development presentation about medication orders. Which teaching will the nurse include? Select all that apply.

The health care providers must sign all orders. Be extra cautious with look-alike and sound-alike drugs.

The nurse is administering a rectal suppository. How far will the nurse insert the suppository?

To be effective, a suppository must be inserted past the internal sphincter

A nurse is administering medication to a client via a gastric tube and finds that the medicine enters the tube and then the tube becomes clogged. What is the appropriate intervention in this situation?

Use a syringe to plunge the tube to try to dislodge the medication.

Which client would most likely require placement of an implantable port?

a 58-year-old woman with stage 3 breast cancer requiring weekly chemotherapy This client needs frequent IV access. A central port is easily accessed for chemotherapy sessions, then the access is discontinued even though the port remains in place subcutaneously. A central port also allows for the infusion of chemotherapy into a central vessel; this is important because chemotherapy is caustic and severely damages peripheral vessels.

A medication order has ac written after the medication dosage. What does ac stand for?

before meals

Which client does the nurse recognize will require an intramuscular administration of the medication instead of an intravenous administration?

client who is low risk for hemorrhage and prescribed the Hepatitis B vaccination The hepatitis B vaccine is administered intramuscularly.

Medication routes

enteral, parenteral, topical

main organ of excretion

kidney

Main organ of Metabolism

liver

The nurse is administering medications to the team of clients. It is 0730. For the first client, the nurse administers the following medications: levothyroxine 25 mcg po daily scheduled for 0600 but not administered pantoprazole 40 mg po daily scheduled for 0800 metformin 500 mg po two times a day scheduled for 0800 amd 1700 The nurse identified the client by asking name and client identifier while looking at the client identification band, The nurse verified the medications for drug name, dose, and route with three checks. Which right(s) did the nurse make an error? Select all that apply.

right time