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?

Dispose of the remaining medication 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.

Return the remaining medication to the facility's pharmacy.

Answer and Explanation

The Correct Answer is A

A. Dispose of the remaining medication while another nurse observes:
This is the correct choice. When a nurse administers a fraction of a tablet, it is not safe or appropriate to store the remaining portion for future use, even if another dose is scheduled. Hydromorphone tablets are meant to be taken whole, and cutting or breaking them can lead to inconsistent dosages. It's important to follow safe medication administration practices and dispose of the unused portion while another nurse observes, ensuring proper disposal.
B. Store the remaining half of the pill in the automated medication dispensing system:
This choice is incorrect. Storing a fraction of a tablet in the automated medication dispensing system is not appropriate. The system is designed for intact medications, and splitting tablets could compromise the accuracy and safety of future doses.
C. Place the remaining half of the pill in the unit-dose package:
This choice is incorrect. Placing a partial tablet back into a unit-dose package could lead to confusion and potential administration errors in the future. The medication packaging should reflect the correct and complete dosage as prescribed.
D. Return the remaining medication to the facility's pharmacy:
This choice is incorrect. Returning a partially used tablet to the pharmacy is not advisable, as the pharmacy cannot ensure the tablet's integrity or accurately verify its dosage. Medication storage and handling standards are in place to ensure patient safety, and using a fraction of a tablet may compromise those standards.

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Correct Answer is B

Explanation

A. Hct 43%
Explanation: Hematocrit (Hct) measures the proportion of blood volume that is occupied by red blood cells. A low Hct level could indicate anemia, which might affect the body's ability to deliver sufficient oxygen to tissues.
B. Creatinine 2.5 mg/dL
Explanation: Elevated creatinine levels indicate potential kidney dysfunction. Tobramycin is primarily excreted by the kidneys, so elevated creatinine levels can increase the risk of tobramycin toxicity due to reduced drug clearance.
C. Sodium 137 mEq/L
Explanation: Sodium level within the normal range. It doesn't directly impact the administration of tobramycin.
D. Hgb 15 g/dL
Explanation: Hemoglobin (Hgb) measures the concentration of oxygen-carrying protein in the blood. A normal hemoglobin level is not directly related to the administration of tobramycin.

A. "I will need to have blood levels drawn." B. "I can take my medication in the morning with my coffee." C. "I may sprinkle the medication in applesauce." D. "I should limit my fluid intake while on this medication."

Correct Answer is A

Explanation

A. "I will need to have blood levels drawn."
Theophylline is a medication used to treat respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD). It is important to monitor the blood levels of theophylline because it has a narrow therapeutic range – meaning that there is a fine line between a therapeutic dose and a toxic dose. Regular blood tests help to ensure that the client is receiving the appropriate dose for their condition.
B. "I can take my medication in the morning with my coffee." - Theophylline should be taken consistently with meals, so taking it with coffee might not be ideal as it can affect its absorption.
C. "I may sprinkle the medication in applesauce." - Theophylline is usually taken as a sustained-release capsule, which means it is designed to release the medication slowly over time. Crushing or sprinkling the medication can disrupt this mechanism and lead to unintended consequences.
D. "I should limit my fluid intake while on this medication." - There's no requirement to limit fluid intake with theophylline, and in fact, adequate hydration can help prevent some side effects of the medication.

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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?

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