Medication Administration: Administration By Route

Front 1

The physician orders ear drops for an adult patient. When instilling ear drops into patient's ear, the nurse should?

Back 1

Pull pinna of the ear up and back. This will straighten the ear canal.

Front 2

If a doctor orders a specific PO medication to be administered through a nasogastric tube, how many minutes will the doctor specify for discontinued use of gastric suctioning?

Back 2

Usually 30 minutes, to allow absorption of the medication.

Front 3

What position should the client be in when administering a PO drug?

Back 3

Sitting with the head of the bed elevated.

Front 4

What is drug induced esophagitis, what can you do to prevent this, and what to do if this happens?

Back 4

An inflammation of the esophagus, may occur if a PO tablet or capsule lodges in the esophagus and begins to dissolve there.
.Prevent: encourage client to drink about 100mL of fluid after swallowing tab or cap, when possible.
.If happens: offer a small portion of soft food, such as banana or piece of bread, to help move the med.

Front 5

What is the technique used for antifungal liquid medications, such as nystatin that work through contact with mucous membranes in the mouth?

Back 5

Swish and Swallow

Front 6

Which type of PO med should never be crushed?

Back 6

enteric-coated or sustained release tablets. Crushing of enteric drugs allow the very irritating medication to come incontact with the oral or gastric mucosa. Crushing sustained release drugs allows all the medication to be absorbed at same time, resulting in higher than expected initial drug level and shorter than expected duration.

Front 7

How would you reduce aspiration risk when administering a crushed PO medication through feeding tubes?

Back 7

Properly position patient in high-fowlers, and elevate the head of the clients head for at least 30 minutes after administration or whenever feedings are administered.

Front 8

How many mL of warm water should be flushed through feeding tubes before and after administering medication?

Back 8

30-45mL Want to keep patency of the tubes.

Front 9

What should you do for a client with a dry mouth/mucous membranes, before administering a sublinugal medication?

Back 9

Use 1mL of normal saline solution or warm water to wet the membranes under the tongue, so that absorption can occur.

Front 10

When administering a transdermal patch, where should you dispose of patch after folding it in half?

Back 10

in the sharp disposal container.

Front 11

What is the best method to disperse medication instilled into the ear of an adult?

Back 11

Press several times on the targus of the ear

Front 12

Before administering a medication that is teratogenic, the nurse should ask the patient?

Back 12

If they are pregnant?

Front 13

To administer a rectal suppository to an adult, the nurse should?

Back 13

lubricate the medication before insertion, the insert the medication 1 inch past the sphicter.

Front 14

What should the nurse do when preparing to draw up medication from a vial, after ensuring that the needle is firmly attached to the syringe?

Back 14

Clean the top of the vial with an alcohol swab for 15 seconds, and insert the ordered dose amount of air into the vial.

Front 15

Which factor related to administration is unique to the intradermal injection?

Back 15

Insert needle with beveled edge facing up.

Front 16

Nurse must administer a 2mL intramuscular injection to an adult who is in severe pain and lying in the supine position. The muscle that is the safest and most therapeutic is the?

Back 16

The vastus lateralis is preferred, because this muscle has no major nearby nerves and blood vessels and absorbs the drug rapidly. Plus, this muscle does not require repositioning.

Front 17

When using an insulin syringe with a 1/2 inch needle to administer the insulin, the nurse should insert the needle at an angle of?

Back 17

90 degree angle would be appropriate for this subcutaneous injection. It injects insulin into the loose connective tissue under the dermis.

Front 18

Blood appears at the hub of the needle while the nurse is aspirating an IM. The nurse should?

Back 18

discard the syringe and prepare a new injection. The blood indicates that a small blood vessel was pierced, which contaminates the injection.

Front 19

Because of the physiological changes associated with aging, when administering drugs to older adults, the nurse should specifically assess for signs of?

Back 19

Toxicity. Biotransformation is less efficient in older adults. When the drugs are not fully metabolized, degraded, or excreted, toxic levels of the drug can accumulate.

Front 20

The nurse plans to inject IV medication via an existing IV line. What should the nurse do first?

Back 20

Determine patency of the IV line

Front 21

Nurse is filling a syringe with a medication from a multidose vial. What should the nurse do?

Back 21

Keep the needle below the level of the liquid (to prevent air from entering syringe)and record the date and time on the vial when opened.

Front 22

When administering an intradermal injection, the nurse understands that the patient is at highest risk for exhibiting an?

Back 22

Allergic reaction

Front 23

Nurse is administering medication via the Z-track injection method. Which action is unique to this procedure?

Back 23

The skin is pulled laterally, before needle is inserted. This method is used during IM injections. When the skin is release after the injection, the fluid is sealed in the muscle tissue, so that the medication does not rise in the needle tract leaking into the subcutaneous tissue.

Front 24

Which site should the nurse use for SC injection to ensure the most rapid absorption?

Back 24

The abdomen

Front 25

When administering a vaginal suppository, the nurse should?

Back 25

insert along the posterior wall of the vagina.

Front 26

Immediately after administering liquid medication in the eye of a patient, the nurse should?

Back 26

Press gently on the inner canthus.

Front 27

An active safety design feature on a needle is?

Back 27

is a design that requires the nurse to activate the safety mechanism after use to protect against accidental needle sticks. Once activated the needle will be locked and unusable.

Front 28

Is a needle gauge (diameter size) of 14 large or small?

Back 28

Needle gauges vary from 14-29, with 14 being the largest diameter, used to administer viscous medications or for mixing medications. And 29 being the smallest, used for medications such as insulin.

Front 29

When recapping a needle you should put the cap onto the table and scoop the needle into the cap, staying at table level? True or false?

Back 29

True. inserting the needle into the cap at table level prevents accidental needle sticks.

Front 30

What should you do after administering a steroid powder through a metered-dose-inhaler?

Back 30

Have client rinse mouth out. If steroid medication remains in the oral cavity, oral fungal infections such as thrush can occur.

Front 31

What does a metered-dose inhaler mean?

Back 31

each puff contains a specific dose of medication.

Front 32

What should you instruct a client to do when administering medication through a metered-dose inhaler?

Back 32

Shake the canister, breathe slowly through the mouth, put inhaler in mouth, as client starts inhaling have them press canister to release on puff dose. Hold breath for 10 seconds(if possible), then exhale slowly through pursed lips.

Front 33

How many minutes should you wait before administering another puff by metered-dose inhaler?

Back 33

One minute, allowing dose to be distributed and absorbed. Usual orders prescribe 2 doses

Front 34

What Metered-dose inhaler modification can you use, for a patient who has difficulty inhaling slowly and deeply or who cannot coordinate pressing the canister while simultaneously inhaling?

Back 34

By attaching a spacer to the mouthpiece.

Front 35

Why would you warm a medication to be administered in the patient's ear to room temperature?

Back 35

Because a cold solution may cause vertigo or nausea.

Front 36

What angle would you administer a SC injection?

Back 36

45 to 90 degree angle

Front 37

Why don't you aspirate with SC injections?

Back 37

Because a SC injection is given in the fat and subcutaneous tissue, which is not a vascular area.

Front 38

When withdrawing medication from an ampule, what do you do after assembling a filter needle on the syringe and flicking the the ampule's upper stem?

Back 38

Wrap a sterile gauze pad around the ampule neck, as a protective barrier, breaking it off along the scored line, with an outward snapping motion.

Front 39

Which direction should you break the neck of of the ampule?

Back 39

Always pull towards your body, so shattered glass will go in the opposite direction, avoiding accidental cuts.

Front 40

Why do you use a filter needle when preparing a medication from an ampule?

Back 40

The filter needle catches any shattered glass from the ampule, so that it does not contaminate the medication.

Front 41

Should you administer a medication using a filter needle?

Back 41

No! The filter needle is only used to prepare the medication from an ampule. After preparing the medication always change the needle, before administration.

Front 42

When drawing mixed medication from 2 vials, one being insulin and the other a suspension, which vial should you draw into the syringe first?

Back 42

The insulin. Avoiding contaminating the insulin with the suspension.

Front 43

When drawing a mixed solution should you inject air into both vials, before drawing any medication?

Back 43

Yes, inject air into both medication vials first, which reduces the chance of contamination, then draw a dose from the vial containing the clear liquid, followed by the vial with the solution.

Front 44

Why should you inject a SC with slow and even pressure?

Back 44

To avoid client discomfort and prevent tissue damage

Front 45

Why should you systematically rotate insulin injection sites?

Back 45

to prevent lipodystrophy and variable insulin absorption

Front 46

What is the fastest site of absorption for insulin administration?

Back 46

the abdomen, followed by the arms, thighs, and buttocks.

Front 47

What can increase insulin absorption?

Back 47

exercise of a muscle group at site of administration.

Front 48

What would you assess, when selecting an appropriate site for an IM injection?

Back 48

inspecting muscle size and integrity. Consider the volume of the medication. Larger muscles can absorb larger volumes of medication.

Front 49

What should you do before administering an intermittent IV medication into Primary IV line?

Back 49

Assess the IV site for inflammation or infiltration. If assessment reveals infiltration or phlebitis, do not administer the IV medication.

Front 50

Where should you position the medication (secondary) bag in relation to the primary bag, when administering Intermittent IV medication into Primary IV line?

Back 50

Position the secondary (medication) bag above the level of the primary bag. Positioning the secondary bag higher stops the primary IV solution flow, while the medication infuses.