The nurse is preparing to perform a physical assessment.
Which statement is true about the physical assessment? The inspection phase:

Choice A rationale

Giving water after a buccal medication would cause the medication to be swallowed. Buccal medications are designed for absorption through the rich vascularization of the buccal mucosa, allowing direct entry into the systemic circulation and bypassing first-pass hepatic metabolism. Swallowing defeats this purpose.

Choice B rationale

Buccal medications are intended to dissolve slowly in the buccal pouch (between the cheek and gums) and be absorbed directly into the bloodstream through the mucous membranes. Consuming water would wash the medication away, leading to premature swallowing and subsequent degradation by gastric enzymes or first-pass metabolism in the liver, thus reducing its therapeutic effect.

Choice C rationale

The client's preference for water does not supersede the pharmacokinetic principles governing buccal medication administration. The route of administration is chosen specifically for its absorption profile, and introducing water compromises the intended local absorption mechanism, regardless of patient comfort.

Choice D rationale

The type of medication is precisely why water should be avoided. Buccal medications, by their very design, rely on sustained contact with the oral mucosa for systemic absorption. Regardless of the specific drug, water interferes with this fundamental mechanism, rendering the buccal route ineffective.

Choice A rationale

Instilling water to rinse the tube is an important step after medication administration or prior to administering incompatible medications, but it is not the initial and most crucial step before delivering any drug. Placement verification is paramount.

Choice B rationale

Scientifically, confirming tube placement is the absolute first and most critical step before administering any substance, including medication, through an enteral tube. Misplaced tubes can lead to aspiration pneumonia or inefficient drug absorption, posing significant patient safety risks.

Choice C rationale

Laying the client flat may increase the risk of aspiration, especially if the tube is misplaced or if the client has impaired gag reflex. Proper positioning, typically semi-Fowler's, is crucial for safe enteral feeding and medication administration.

Choice D rationale

Assessing bowel sounds is important for evaluating gastrointestinal motility and absorption capacity before initiating or continuing enteral feedings, but it is not the primary immediate safety check required before administering a single dose of medication.