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?
Store the remaining half of the pill in the automated medication dispensing system.
Dispose of the remaining medication while another nurse observes.
Return the remaining medication to the facility’s pharmacy.
Place the remaining half of the pill in the unit-dose package.
The Correct Answer is B
This is because hydromorphone is a controlled substance and any unused portion should be discarded in the presence of a witness. Some possible explanations for the other choices are:
Choice A is wrong because storing the remaining half of the pill in the automated medication dispensing system could lead to errors in dosage or diversion of the drug.
Choice C is wrong because returning the remaining medication to the facility’s pharmacy is not a recommended practice for controlled substances and could also result in errors or diversion.
Choice D is wrong because placing the remaining half of the pill in the unit-dose package could compromise the integrity and stability of the medication and expose it to environmental factors.
Normal ranges for hydromorphone are not applicable as it is a synthetic opioid analgesic that does not have a therapeutic level.
However, some factors that may affect its pharmacokinetics and pharmacodynamics are age, weight, renal function, liver function, genetic polymorphisms, and drug interactions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Pioglitazone is a medication that belongs to a class of drugs called thiazolidinediones, which are used to treat type 2 diabetes by improving insulin sensitivity. One of the common side effects of pioglitazone is edema, which is swelling caused by excess fluid in the body tissues. This can lead to fluid retention and weight gain and may worsen heart failure in some patients.
Choice A is wrong because tinnitus, which is ringing or buzzing in the ears, is not a known side effect of pioglitazone.
Choice B is wrong because insomnia, which is difficulty falling or staying asleep, is not a known side effect of pioglitazone.
Choice C is wrong because orthostatic hypotension, which is a drop in blood pressure when standing up from a sitting or lying position, is not a known side effect of pioglitazone.
In fact, pioglitazone may cause low blood sugar (hypoglycemia) when used with other diabetes medications, which can cause symptoms such as dizziness, sweating, and confusion.
Correct Answer is B
Explanation
This will help reduce swelling and discomfort caused by the infiltration of fluid into the tissues. Elevating the extremity also promotes venous return and prevents further fluid accumulation.
Choice A is wrong because applying pressure to the IV site can increase the risk of tissue damage and infection.
Pressure can also obstruct blood flow and cause thrombophlebitis.
Choice C is wrong because slowing the infusion rate will not stop the infiltration of fluid into the tissues.
Slowing the infusion rate can also delay the delivery of medication or fluid to the client.
Choice D is wrong because flushing the IV catheter can worsen the infiltration of fluid into the tissues.
Flushing the IV catheter can also introduce air or bacteria into the bloodstream and cause complications.
Normal ranges for peripheral IV infusion are dependent on the type and volume of fluid, the size and location of the catheter, and the condition of the client. Generally, peripheral IV infusion rates should not exceed 100 mL/hr for adults and 60 mL/hr for children.
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