A nurse is preparing to administer medications to a client through an enteral feeding tube.
Which of the following actions should the nurse take?
Pinch the tube while connecting the syringe to it.
Elevate the head of the client's bed to 10°.
Flush the tube with normal saline following medication administration.
Combine crushed medications together in a single syringe.
The Correct Answer is C
Choice A rationale:
Pinching the tube while connecting the syringe to it could potentially damage the tube and does not aid in medication administration.
Choice B rationale:
Elevating the head of the client’s bed to only 10° may increase the risk of aspiration. The head of the bed should be elevated to at least 30° during medication administration and for at least an hour afterward.
Choice C rationale:
Flushing the tube with normal saline following medication administration helps ensure that all medication has been administered and helps maintain tube patency.
Choice D rationale:
Combining crushed medications together in a single syringe can lead to drug interactions and can also increase the risk of tube clogging. Each medication should be administered separately.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Mixing insulin lispro and insulin glargine in the same syringe is not recommended. Insulin glargine has a different pH and mixing it with other insulins could affect its action.
Choice B rationale:
Insulin glargine is a long-acting insulin that is typically given once a day. It provides a steady level of insulin over a 24-hour period.
Choice C rationale:
Shaking insulin vials is not recommended as it can lead to inaccurate dosing. Instead, insulin vials should be gently rolled between the hands to ensure proper mixing.
Choice D rationale:
Insulin lispro is a rapid-acting insulin and should be taken right before a meal. This helps to control the blood glucose spike that occurs after eating.
Correct Answer is B
Explanation
Choice A rationale:
Asking the client to demonstrate dose delivery can be part of patient education and helps ensure that the client understands how to use the PCA device. This action does not require intervention.
Choice B rationale:
The nurse administering a PCA dose for the client requires intervention. PCA stands for “Patient-Controlled Analgesia,” meaning that only the patient should administer doses to themselves. This prevents overdosing and ensures that pain medication is administered according to the patient’s needs.
Choice C rationale:
Reassuring the client that the PCA device will not cause an overdose is appropriate because PCA devices are designed with safety measures to prevent overdosing.
Choice D rationale:
Monitoring for oversedation is an important part of care for a client using a PCA device. This action does not require intervention.
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