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

Choice A rationale

A 25-gauge 1/2-inch needle with an insulin syringe is typically used for subcutaneous injections, especially for insulin administration. Insulin syringes are calibrated in units, which is not appropriate for general medication administration requiring volume measurement for intradermal injections.

Choice B rationale

A 23-gauge 1-inch needle with a 3 mL syringe is commonly used for intramuscular injections. The 23-gauge needle is too large and the 1-inch length is too long for the superficial nature of an intradermal injection, which only penetrates the epidermis and a small portion of the dermis.

Choice C rationale

A 21-gauge 1 1/2-inch needle with a 5 mL syringe is typically used for intramuscular injections, especially for viscous medications or larger muscle masses. The needle gauge is too large and the length is excessive for an intradermal injection, which requires a very short, fine needle.

Choice D rationale

A 25-gauge to 27-gauge needle and a 3/8-inch to 5/8-inch length are appropriate for intradermal injections because they are very fine and short, allowing for precise placement within the dermis to create a wheal. Tuberculin syringes are calibrated in hundredths of a milliliter, allowing for accurate measurement of the small volumes (0.01-0.1 mL) typically administered intradermally.

Choice A rationale

Surgical history provides context regarding past medical interventions and potential anatomical alterations. While relevant for comprehensive patient assessment, it does not directly impact the immediate safety of medication administration in the same critical manner as identifying drug hypersensitivities, which can precipitate life-threatening anaphylactic reactions.

Choice B rationale

Drug tolerance refers to a diminished physiological response to a medication over time, requiring increased doses to achieve the same effect. While important for therapeutic efficacy and dose adjustment, it is secondary to the immediate danger posed by an allergic reaction, which can be acute and severe.

Choice C rationale

Diet history is crucial for identifying potential drug-food interactions or nutritional deficiencies that might influence medication absorption or metabolism. However, an adverse food interaction, while potentially problematic, typically poses less immediate and severe risk than an unknown drug allergy, which can be fatal.

Choice D rationale

Allergy history is paramount because exposure to an allergen can trigger a severe, potentially life-threatening immunological response, such as anaphylaxis. Identifying known allergies prevents direct exposure to the offending agent, thereby safeguarding the patient from acute hypersensitivity reactions and ensuring immediate patient safety.