The physician has ordered SoluMedrol 75 mg IM. How many milliliters will the nurse administer? (Use LABEL #4 - SoluMedrol: ROUND TO TENTHS PLACE: LABEL CORRECTLY TO RECEIVE CREDIT)

Choice A rationale

Using a large bore needle (e.g., 18-gauge) for withdrawing medication from an ampule is generally avoided unless the medication is highly viscous, because it can create a larger hole in the ampule, increasing the risk of glass particle introduction. The primary concern with ampules is preventing glass shards from entering the syringe, which is addressed by filtration, not needle bore size alone.

Choice B rationale

Ampules are single-dose glass containers. When an ampule is opened, small, invisible glass fragments can break off. A filter needle contains a microscopic filter that traps these glass particles, preventing their aspiration into the syringe and subsequent injection into the patient, thus mitigating the risk of phlebitis, emboli, or other complications from particulate matter.

Choice C rationale

A small gauge needle (e.g., 25-gauge) has a very narrow lumen, which would make withdrawing medication from an ampule unnecessarily difficult and slow, especially for viscous solutions. Furthermore, a small gauge needle does not mitigate the risk of glass particle aspiration, which is the paramount concern when withdrawing medication from a glass ampule.

Choice D rationale

Placing a cotton ball over the opening of an ampule is not a scientifically sound method to prevent being cut or to prevent glass shards from entering the medication. Ampules are designed to be broken cleanly. Proper ampule opening techniques and the use of a filter needle are the established safety measures to prevent injury and contamination.

Choice A rationale

The charge nurse, by virtue of their leadership role and oversight of unit operations, is typically authorized to ensure patient safety and continuity of care. This includes re-verifying and administering medications in urgent situations when the preparing nurse is unavailable, adhering to established protocols and double-checking the medication before administration to prevent errors.

Choice B rationale

Limiting medication administration solely to the preparing nurse could delay critical treatment, especially during emergencies. While optimal, this practice is superseded by the need for timely patient care and adherence to a "second nurse check" policy, which enhances safety by having an additional qualified professional verify the medication.

Choice C rationale

Any licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN) on the unit, if familiar with the patient and their condition, possesses the scope of practice and clinical competency to administer medications. This ensures patient safety through appropriate verification, patient identification, and adherence to the "rights" of medication administration, maintaining continuity of care.

Choice D rationale

Pharmacy technicians are not licensed healthcare professionals authorized to administer medications directly to patients. Their scope of practice is limited to preparing, packaging, and distributing medications under the supervision of a licensed pharmacist, lacking the clinical assessment and administration privileges of nursing staff.