A nurse is assisting with teaching a newly licensed nurse about preventing puncture injuries. Which of the following instructions should the nurse include?

D. After administering the PPD solution intradermally, the nurse should not withdraw the needle and massage the site. Massaging can cause the PPD to disperse outside the intended area and affect the accuracy of the test result. Instead, the nurse should gently blot the site with a gauze pad if there is any bleeding, without massaging.

A. For a Mantoux tuberculin skin test, the standard technique involves injecting a small amount of tuberculin purified protein derivative (PPD) intradermally to create a wheal or bleb that is typically 6 mm in diameter. If the nurse creates a bleb significantly larger or smaller than the recommended size, it could affect the interpretation of the test result.

B. It's important to avoid visualizing the needle tip under the skin during the injection. This can lead to inaccurate placement of the PPD solution, potentially resulting in an improperly administered test.

C. Stretching the skin tightly before injection is actually a correct technique for performing a Mantoux tuberculin skin test. This helps stabilize the injection site and ensures the needle is inserted at the correct angle for an intradermal injection.

B. Before administering any medication, especially antibiotics like amoxicillin, the nurse must assess the patient for allergies or previous adverse reactions to amoxicillin or other beta-lactam antibiotics. Allergic reactions can range from mild rashes to severe anaphylactic reactions, so it's essential to confirm the

patient's allergy status and assess for any signs or symptoms of allergic reaction before proceeding with administration.

A. Flushing the IV site with normal saline is typically not required specifically before administering IV amoxicillin unless it is part of the institution's standard practice to flush all IV lines before and after medication administration.

C. While monitoring intake and output (I&O) is important for assessing fluid balance and kidney function, it is not directly necessary before administering IV amoxicillin unless there are specific concerns related to the patient's fluid status or renal function. However, it is good practice to have a general understanding of the patient's recent fluid intake and output patterns.

D. Creatinine clearance is a measure of kidney function. Checking the latest creatinine clearance result is important for assessing renal function, especially before administering medications excreted by the kidneys. However, amoxicillin is primarily excreted by the kidneys in its unchanged form, so knowing the patient's renal function status can help in determining the appropriate dosage or adjusting the dosing interval if necessary.