The nurse is preparing to administer medications through a tube.
Which of the following should she remember before administering the medications?

Have the patient lie flat before administering the medications.

Administer the medications if the residual is 200 ml or more.

Mix all medications together before putting them through the tube.

Elevate the head of the patient's bed at least 30 degrees before administering the medications.

Answer and Explanation

The Correct Answer is D

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.

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Correct Answer is C

Explanation

Choice A rationale

Pulling the lobe up and back is the correct technique for administering ear drops to adults and children older than three years of age. This maneuver straightens the ear canal in older individuals due to the anatomical development and orientation of the Eustachian tube and external auditory meatus.

Choice B rationale

Instructing parents to hold the child upright for 10 minutes is an appropriate post-administration instruction to facilitate medication absorption and prevent spillage. However, this action is not part of the physical technique for correctly preparing the ear canal for drop instillation.

Choice C rationale

For children under 3 years old, the external auditory canal is straighter and angled differently than in adults. Pulling the pinna down and back straightens this shorter, more upwardly curved canal, allowing the medication to flow more effectively and reach the tympanic membrane for optimal absorption.

Choice D rationale

Massaging the tragus after instillation helps to distribute the medication throughout the ear canal and facilitate its passage deeper. However, massaging the tragus before administering the drops does not contribute to straightening the ear canal and is not a preparatory step for instillation.

A. 4 hours before the next scheduled dose. B. 24 hours after the drug was given. C. 30 minutes before the administration of the drug. D. 1 hour after the medication has been infused.

Correct Answer is C

Explanation

Choice A rationale

Ordering a trough level 4 hours before the next scheduled dose would likely result in an inaccurate reading. The trough level represents the lowest concentration of a drug in the bloodstream, typically occurring just before the next dose, ensuring that the drug concentration remains within the therapeutic range to exert its pharmacological effect.

Choice B rationale

Obtaining a trough level 24 hours after the drug was given is too late and would not provide an accurate assessment of the drug's lowest concentration before the subsequent dose. By this time, depending on the drug's half-life, the concentration may be significantly lower or undetectable, making it irrelevant for therapeutic monitoring.

Choice C rationale

The trough level of a medication is measured to ensure that the drug concentration remains above the minimum effective concentration and below toxic levels. Collecting the blood sample 30 minutes before the administration of the next dose allows the drug to reach its lowest concentration in the systemic circulation, providing an accurate representation of the drug's true trough level.

Choice D rationale

Measuring the drug level 1 hour after the medication has been infused would represent a concentration much closer to the peak level, not the trough. The peak level indicates the maximum drug concentration, typically occurring shortly after administration or infusion, and is used to assess for potential toxicity or adequate absorption.

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The nurse is preparing to administer medications through a tube. Which of the following should she remember before administering the medications?

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The nurse is preparing to administer medications through a tube.
Which of the following should she remember before administering the medications?