A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. The medication is provided as hydromorphone 8 mg per tablet. Which of the following actions is appropriate for the nurse to take?
Return the remaining medication to the facility's pharmacy.
Dispose of the remaining ’edication while another nurse observes.
Store the remaining half of the pill in the automated medication dispensing system.
Place the remaining half of the pill in the unit-dose package.
None
None
The Correct Answer is B
Answer: B. Dispose of the remaining medication while another nurse observes.
Rationale:
A) Return the remaining medication to the facility's pharmacy: Return the remaining medication to the facility's pharmacy: This is not typical practice for partial doses of controlled substances like hydromorphone. The pharmacy usually does not accept leftover portions of such medications.
B) Dispose of the remaining medication while another nurse observes: This is the correct and appropriate action. When administering controlled substances, any unused portion must be properly disposed of to prevent misuse or diversion. Having another nurse observe and document the disposal ensures accountability and adherence to safety protocols.
C) Store the remaining half of the pill in the automated medication dispensing system: Storing a partial tablet of a controlled substance is not appropriate. The automated medication dispensing system is designed to store and dispense whole doses of medication as prescribed. Storing partial tablets can lead to confusion, contamination, and potential misuse. It also increases the risk of medication errors, as the partial dose may not be easily identifiable or accurately accounted for.
D) Place the remaining half of the pill in the unit-dose package: his practice is not acceptable for controlled substances due to the risk of misuse, contamination, and the potential for medication errors. Controlled substances require strict handling and disposal procedures to ensure safety and compliance with regulatory standards. Placing a partial tablet back into the unit-dose package does not align with these standards and could lead to inappropriate use or administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Respirations deep at a rate of 10/min: This finding indicates respiratory depression, which is a significant concern with morphine administration. Respiratory depression can lead to hypoxia and respiratory arrest, posing a life-threatening situation for the client. Therefore, it is the priority finding that requires immediate intervention, such as reducing the dose of morphine, administering naloxone (an opioid antagonist), or providing respiratory support.
B) Urinary output of 20 mL within 1 hr: While decreased urinary output may indicate potential renal impairment or dehydration, it is not as immediately life-threatening as respiratory depression. However, it should still be monitored and addressed appropriately.
C) Vomiting 30 mL of fluid: Vomiting can be a side effect of morphine but may not require immediate intervention unless it leads to aspiration or dehydration. Nonetheless, it should be closely monitored for complications.
D) Blood pressure 90/60 mm Hg: Hypotension can occur as a side effect of morphine due to its vasodilatory effects. While low blood pressure should be addressed, it is not as immediately life-threatening as respiratory depression. Monitoring and appropriate interventions, such as fluid administration or adjusting the dose of morphine, can be implemented to manage hypotension.
Correct Answer is B
Explanation
A) Ex edicationr bubble from the syringe prior to administering the medication: Expelling air bubbles is necessary when administering medications via intravenous injection to prevent air embolisms. However, with subcutaneous injections like enoxaparin, the presence of small air bubbles is not usually a concern, and expelling them is not necessary.
B) Administer the medication into the anterolateral or posterolateral abdominal area: This is the correct action for administering enoxaparin. Enoxaparin is typically administered subcutaneously into the anterolateral or posterolateral abdominal wall. This site is preferred due to its high vascularity and good absorption of the medication.
C) Hold the skin taut at the injection site while administering the medication: While holding the skin taut can help reduce discomfort during the injection, it is not always necessary. The choice to hold the skin taut depends on the client's body habitus and the nurse's preferenc’. It is not a specific requi’ement for administering enoxaparin.
D) Massage the injection site after administering the medication: Massaging the injection site after administering enoxaparin is not recommended. It can increase bruising or bleeding at the injection site. Instead, after administering the medication, the nurse should apply gentle pressure with a dry cotton ball or gauze pad to help minimize bleeding.
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