Before delivering a drug through an enteral tube, it is most important for the nurse to do which of the following FIRST?

Choice A rationale

Delayed documentation increases the risk of medication errors, as details about administration, patient response, and specific timing can be forgotten or inaccurately recalled, compromising patient safety and the accuracy of the medical record.

Choice B rationale

Nurses are legally and professionally obligated to document medications they personally administer. Documentation by a pharmacy technician is inappropriate and violates the principle of direct accountability for medication administration.

Choice C rationale

Only the individual who directly administers the medication should document its administration. This ensures accuracy, accountability, and traceability of the medication process, preventing errors and maintaining legal integrity of the medical record.

Choice D rationale

Immediate documentation after medication administration is a critical safety principle. It accurately reflects the precise time of administration, allowing for timely assessment of patient response, identification of adverse effects, and continuity of care.

Choice A rationale

Dullness upon percussion indicates increased tissue density, such as in consolidation (e.g., pneumonia), pleural effusion, or a tumor. This occurs because the sound waves are attenuated and dampened by the solid or fluid-filled structures, resulting in a short, high-pitched, thudding sound.

Choice B rationale

Tympany is a drum-like, high-pitched, loud sound typically heard over air-filled organs like the stomach or intestines. When percussing the lungs, tympany suggests a large pneumothorax or a distended abdomen impinging on the thoracic cavity, indicating abnormal air accumulation.

Choice C rationale

Resonance is the expected percussive sound over healthy, air-filled lung tissue. It is a low-pitched, clear, hollow sound produced by the vibration of air within the alveoli and bronchi. This sound indicates normal lung aeration and the absence of significant pathology.

Choice D rationale

Hyperresonance is a louder, lower-pitched sound than normal resonance and suggests an increased amount of air in the lung or pleural cavity, such as in emphysema or pneumothorax. This hyperinflation causes greater vibration and a more boomy quality to the sound.