A nurse is teaching a newly licensed nurse about routes of medication administration for preschoolers. Which of the following nursing interventions should the nurse include in the teaching? (Select All that Apply.)
Using a medicine cup for oral medication administration
Instructing the child to swallow sublingual medication
Administering rectal medication into the client's anus
Selecting a suitable vein for intravenous medication administration
Educating the client on proper inhalation technique for inhaled medication
Applying topical or transdermal medication directly to the client's open wound
Correct Answer : A,C,D,E
A. Using a medicine cup for oral medication administration: Medicine cups allow accurate measurement of liquid medications and are appropriate for preschool-aged children who can cooperate with oral intake. This method reduces dosing errors and facilitates safe administration.
B. Instructing the child to swallow sublingual medication: Sublingual medications are designed to dissolve under the tongue for rapid absorption. Preschoolers may lack the developmental ability to hold the medication properly, making this route unsafe without close supervision. This instruction is not routinely appropriate for this age group.
C. Administering rectal medication into the client's anus: Rectal administration is a valid route for preschoolers, especially when oral administration is not possible due to vomiting or refusal. Proper technique ensures absorption and minimizes discomfort.
D. Selecting a suitable vein for intravenous medication administration: IV administration requires careful vein selection to ensure effective delivery and reduce complications. Preschoolers often need smaller-gauge catheters, and site choice is critical for safety.
E. Educating the client on proper inhalation technique for inhaled medication: Preschoolers can be taught to use inhalers with spacers or masks to optimize medication delivery to the lungs. Education helps improve adherence and therapeutic effect.
F. Applying topical or transdermal medication directly to the client's open wound: Applying topical medications directly to an open wound is inappropriate unless specifically prescribed for wound care. Standard transdermal patches are intended for intact skin; misuse can lead to systemic toxicity or local irritation.
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Related Questions
Correct Answer is D
Explanation
A. Infections caused by inadequate diaper changes: While proper hygiene is important, persistent crying itself does not directly cause infections, so this is not the primary concern in this scenario.
B. Colic as a common cause of crying in newborns: Colic can explain inconsolable crying, but education about colic alone does not address the serious safety risks associated with caregiver frustration.
C. Failure to thrive related to poor feeding techniques: Although inadequate feeding can contribute to failure to thrive, the scenario focuses on parental stress and the risk of harm from inconsolable crying, making this a secondary concern.
D. Shaken baby syndrome due to parental frustration and excessive crying: Persistent inconsolable crying is a major risk factor for caregiver frustration, which can lead to abusive actions such as shaken baby syndrome. Immediate education on safe coping strategies is crucial to prevent serious injury or death.
Correct Answer is B
Explanation
A. Loose stool: Infant botulism more commonly presents with constipation due to decreased gastrointestinal motility from neuromuscular blockade. Botulinum toxin inhibits acetylcholine release, reducing smooth muscle activity in the gut. Loose stools are not a typical early manifestation.
B. Difficulty breastfeeding: Botulinum toxin causes flaccid paralysis by blocking acetylcholine at the neuromuscular junction, leading to weak suck and poor feeding. Difficulty breastfeeding is often one of the earliest signs in infants. This reflects bulbar muscle involvement and generalized hypotonia.
C. Crying for long periods of time: Infant botulism is associated with a weak or diminished cry rather than excessive crying. Neuromuscular weakness limits vocal cord strength and respiratory effort. Prolonged crying is more suggestive of pain or discomfort from other causes.
D. Spasms involving the whole body: Botulism produces flaccid paralysis, not spasticity or muscle spasms. Increased muscle tone and generalized spasms are more consistent with conditions such as tetanus or seizure activity. This finding does not align with the toxin’s mechanism of action.
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