A nurse is caring for a client who is taking multiple medications. Which of the following medications should the nurse identify as a controlled substance?

Rationale:

A. Administer the medication into the vastus lateralis muscle: The vastus lateralis is the preferred site for intramuscular injections in infants because it is well-developed and free of major nerves and blood vessels. This site allows for safe and effective absorption of the medication.

B. Administer the medication with a 20-gauge needle: A 20-gauge needle is too large for infants and can cause unnecessary tissue trauma. A smaller gauge, typically 22–25, is appropriate for IM injections in infants to minimize pain and tissue damage.

C. Administer the medication into the deltoid muscle: The deltoid muscle is underdeveloped in infants, making it unsuitable for IM injections due to limited muscle mass and risk of injury to underlying structures. It is generally used only in older children or adults.

D. Administer the medication over 2 min: IM injections are typically administered at a moderate pace, but a 2-minute administration is unnecessarily slow for infants. Proper technique involves steady, controlled injection without causing excessive discomfort.

Rationale:

A. Inactivated influenza vaccine: The inactivated influenza vaccine is safe during any trimester of pregnancy and helps protect both the mother and the fetus from influenza-related complications. It is routinely recommended for pregnant clients during flu season.

B. Varicella vaccine: The varicella vaccine is a live attenuated vaccine and is contraindicated during pregnancy because it poses a risk of fetal infection and congenital abnormalities. It should be administered before pregnancy or postponed until after delivery.

C. Tetanus, diphtheria, and acellular pertussis vaccine: The Tdap vaccine is recommended during pregnancy, ideally between 27 and 36 weeks gestation, to protect the newborn from pertussis. It is safe and provides passive immunity to the infant.

D. Inactivated polio vaccine: Inactivated polio vaccine (IPV) is safe during pregnancy and can be administered if the client is at risk for exposure or requires immunization. Live attenuated oral polio vaccine is contraindicated.

E. Rubella vaccine: The rubella vaccine is a live attenuated vaccine and is contraindicated during pregnancy due to the risk of congenital rubella syndrome. Women should be screened for immunity prior to pregnancy and vaccinated if nonimmune before conception.