A nurse is reviewing the medication administration records from the previous shift. Which of the following findings should indicate to the nurse a need for an incident report?

A client received crushed bupropion XL tablet mixed with applesauce.

A nurse injected Demerol 1M into the vastus lateralis site of adult.

A nurse used a 25-gauge inch needle to administer heparin injection.

A client received gentamicin intermittent IV bolus over I hr.

Answer and Explanation

The Correct Answer is A

Bupropion XL tablets should be taken whole. Crushing the tablet interferes with the pharmacokinetics of the drug leading to reduced efficacy and increased risk of toxicity. Administering bupropion XL inappropriately could result in harm to the client and should prompt the nurse to file an incident report to document the error and ensure appropriate follow-up and monitoring.

B. Meperidine is a commonly administered opioid analgesic and can be given intramuscularly in appropriate doses and sites.

C. Selection of the needle length and gauge depend on the route of administration and individual client's characteristics

D. Gentamicin can be administered by intermittent IV bolus over a prolonged period as part of its dosing regimen.

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Correct Answer is C

Explanation

When administering phenytoin in suspension, it is essential to shake the container vigorously to ensure that the medication is well mixed and the correct dose of the active ingredient is given.

A. Dilute the medication with sterile water before injecting. B. Administer the medication over 1 min. C. Follow the IV injection with sterile water. D. Slow the injection if the medication crystallizes.

Correct Answer is B

Explanation

A. Diluting phenytoin with sterile water before injecting is not recommended, as phenytoin is incompatible with most used diluents. Diluting it can lead to precipitation and potentially cause adverse effects such as tissue irritation and phlebitis.
B. Administering the medication over 1 min is recommended. Phenytoin should be administered at a rate of 50mg/min.
C. Following the IV injection with sterile water is unnecessary and not indicated for administering phenytoin.
D.Phenytoin precipitates out of solution when mixed with certain diluents or when administered too quickly. Crystallized phenytoin can cause local irritation, tissue damage, and potentially more serious adverse effects. Therefore, it should not be administered at all.

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A nurse is reviewing the medication administration records from the previous shift. Which of the following findings should indicate to the nurse a need for an incident report?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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