In order to safely administer enteral medications, the nurse would do which of the following?
Hold all medications if the residual was less than 150ml.
Mix the medications with the client's prescribed feeding formula
Flush the tube after each medication administered
Check for tube placement only if the client has a history of placement problems
The Correct Answer is C
A. Hold all medications if the residual was less than 150ml: Medications should not be withheld based on a small residual alone. Withholding unnecessarily can delay treatment. Residuals are assessed to guide feeding tolerance, but small amounts generally do not contraindicate medication administration.
B. Mix the medications with the client's prescribed feeding formula: Medications should be administered separately from enteral feedings. Mixing them with formula can alter drug absorption, cause tube clogging, or reduce efficacy. Administering medications with water ensures proper delivery and prevents interactions.
C. Flush the tube after each medication administered: Flushing the enteral tube with water after each medication clears the tube of residue, prevents clogging, and ensures the full dose is delivered. This step is essential for safe and effective administration of enteral medications.
D. Check for tube placement only if the client has a history of placement problems: Tube placement must be verified before every administration, regardless of history. Failure to consistently confirm placement risks administering medications into the lungs, which can lead to aspiration and severe complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Report the discrepancy immediately after preparing the medication: Once a discrepancy in a controlled substance count is identified, the nurse should not continue handling or preparing the medication. Proceeding with preparation before resolving the discrepancy may further complicate accountability and chain-of-custody documentation.
B. Notify the Doctor and the Pharmacist immediately: Although pharmacy may eventually be involved in reconciliation, the first step is not to notify the physician. The appropriate immediate action is to follow institutional policy by notifying the charge nurse or supervisor responsible for controlled substance oversight rather than the prescribing provider.
C. Stop preparing the medication and notify the appropriate person immediately: A narcotic count discrepancy requires immediate action before any further medication handling occurs. Stopping preparation preserves the integrity of the count, prevents additional documentation errors, and initiates formal investigation per controlled substance regulations and facility policy.
D. Continue to pour as the count only needs to be correct at the end of the shift: Controlled substance counts must be accurate at all times, not just at shift change. Continuing to administer medication when a discrepancy exists violates legal standards, increases diversion risk, and places the nurse’s license at risk.
Correct Answer is B
Explanation
A. The ventrogluteal: The ventrogluteal site is considered the safest for IM injections because it is free of major nerves and blood vessels. Even in thin patients, it provides adequate muscle mass and reduces the risk of nerve injury, making it a preferred site for medications like morphine.
B. The dorsalgluteal: The dorsalgluteal site is located near the sciatic nerve, which increases the risk of nerve injury, especially in extremely thin or cachectic patients like Mrs. Westmore. Due to her significant muscle and fat loss, the likelihood of accidentally hitting the nerve is higher, making this the least favored site for IM injections.
C. The vastus lateralis: The vastus lateralis (anterolateral thigh) is safe for IM injections, particularly in adults who may have reduced gluteal mass. It is free of major nerves and vessels, making it a suitable alternative when the gluteal muscles are atrophied.
D. The deltoid: The deltoid muscle is an option for small-volume IM injections, but in cachectic patients, muscle mass may be insufficient for larger doses. However, it is still safer than the dorsalgluteal site because it avoids proximity to the sciatic nerve.
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