The nurse is reviewing the absorption of a client's prescribed medication. Which factor would influence the absorption of the medication?

quality of liver function

route of administration

previous treatment with the prescribed medication

protein binding capacity of the prescribed medication

Answer and Explanation

The Correct Answer is B

A. quality of liver function: Hepatic function primarily influences the metabolism and biotransformation of a drug rather than its initial absorption into the systemic circulation. While the first-pass effect occurs in the liver after enteral absorption, the term "absorption" refers to the movement from the site of administration to the blood.

B. route of administration: This is the primary determinant of the speed and extent of drug absorption. Intravenous routes provide 100% bioavailability immediately, while oral routes are subject to gastric pH, presence of food, and intestinal surface area. The physical path a drug takes dictates how it enters the systemic compartment.

C. previous treatment with the prescribed medication: Past exposure to a drug may influence a client's immunological response or tolerance, but it does not change the physical absorption process. The physiological mechanisms of diffusion or active transport across membranes remain constant regardless of how many times the patient has taken the medication.

D. protein binding capacity of the prescribed medication: Protein binding is a factor of drug distribution rather than absorption. It determines how much of the drug is pharmacologically active once it has already reached the bloodstream. It does not affect how the drug initially crosses from the site of administration into the vascular system.

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Correct Answer is B

Explanation

A. Wound debridement: Debriding dry, stable eschar on a distal extremity with poor vascularity can expose underlying tissue to infection without sufficient blood flow to heal. In patients with diabetes and peripheral arterial disease, aggressive debridement of stable eschar is often contraindicated.

B. Maintenance and protection of the intact eschar: For stable, dry, and intact eschar on ischemic limbs or digits, the clinical goal is to keep the area dry and protected. This "natural cover" prevents the entry of pathogens into deeper tissues while avoiding the risks of surgical or chemical intervention.

C. Use of a topical antimicrobial agent to prevent infection: Topical agents often introduce moisture, which can soften the eschar and promote bacterial proliferation. If the eschar is dry and intact without signs of infection, the priority is maintaining that dryness rather than applying creams or ointments.

D. Removal of eschar to create a moist environment for healing: Creating a moist environment is beneficial for many wounds but dangerous for ischemic, stable eschar. Softening this tissue can lead to "wet gangrene," which spreads rapidly and significantly increases the risk of limb amputation in diabetic patients.

A. Assess vital signs B. Assess bowel sounds C. Listen to breath sounds D. Determine the date of the client's last bowel movement

Correct Answer is A

Explanation

A. Assess vital signs: Morphine is a potent opioid agonist that can cause life-threatening respiratory depression and hypotension. Establishing a baseline respiratory rate and blood pressure is the critical safety step before administration. This ensures the client can hemodynamically tolerate the CNS-depressant effects of the medication.

B. Assess bowel sounds: While opioids decrease gastrointestinal motility and can lead to paralytic ileus, this is a secondary concern compared to immediate respiratory safety. Assessing bowel sounds is part of a comprehensive post-operative exam but is not the priority action before analgesic administration.

C. Listen to breath sounds: Auscultating for adventitious sounds provides information about lung aeration, but the primary risk of morphine is a decrease in respiratory rate and depth. While important, it is less critical than the quantitative assessment of the respiratory rate and overall hemodynamic stability.

D. Determine the date of the client's last bowel movement: This information helps manage potential opioid-induced constipation, but it has no bearing on the immediate safety of administering an acute dose for severe pain. Pain management and respiratory monitoring take clinical precedence over bowel history in the early post-operative period.

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The nurse is reviewing the absorption of a client's prescribed medication. Which factor would influence the absorption of the medication?

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