Permissible sites for subcutaneous injections are? (SELECT 3 CORRECT OPTIONS)

Choice A rationale

A standing order is a pre-written medication order and protocol that applies to a specific patient population or clinical situation, allowing nurses to initiate treatment without immediate physician consultation. While it provides a framework, a daily medication is more specifically classified by its regular administration schedule, distinguishing it from general standing orders.

Choice B rationale

A routine order signifies a medication order that is carried out as prescribed until a discontinuation order or change is made. The medication is given on a regular, scheduled basis, often daily, multiple times a day, or weekly. This ensures consistent therapeutic levels for chronic conditions. Lasix 40 mg PO daily fits this description, as it is given consistently each day.

Choice C rationale

A STAT order (statim) means "immediately" and indicates that the medication must be administered as soon as possible, typically within 30 minutes of the order. This type of order is reserved for urgent situations where delay could significantly impact patient outcomes. Lasix ordered daily does not fall into this urgent category.

Choice D rationale

A PRN order (pro re nata) means "as needed.”. This type of order allows the nurse to administer medication based on the patient's symptoms or specific criteria rather than on a fixed schedule. Since Lasix is ordered "daily," it implies a fixed schedule, not an "as needed" administration.

Choice A rationale

Having the patient lie flat before administering medications through a tube increases the risk of aspiration, as gastric contents can reflux into the esophagus and potentially enter the airway. Proper patient positioning is crucial to promote safe medication delivery and prevent pulmonary complications.

Choice B rationale

Administering medications when gastric residual volume is 200 mL or more is generally not recommended. A high residual volume indicates delayed gastric emptying, increasing the risk of aspiration and potentially affecting medication absorption. Typically, residuals of 200-250 mL or more warrant holding the feeding and reassessing.

Choice C rationale

Mixing all medications together before administration is often inappropriate and can lead to several problems. Drug incompatibilities can occur, altering medication effectiveness, causing precipitation, or leading to tube occlusion. Each medication should generally be administered separately, flushed with water between doses.

Choice D rationale

Elevating the head of the patient's bed to at least 30 degrees before administering medications through a tube significantly reduces the risk of aspiration. This semi-Fowler's position utilizes gravity to keep gastric contents in the stomach, promoting safe passage of medications and minimizing reflux into the esophagus and lungs.