Which nursing instruction is most appropriate after inserting a vaginal suppository?
Resume ambulation immediately
Avoid use of a sanitary pad
Remain lying down for 15 minutes
Douche within 1 hour to enhance absorption
The Correct Answer is C
Vaginal suppositories are used to deliver medications directly to the vaginal mucosa, often for infections, hormone therapy, or local conditions. For maximum absorption and therapeutic effect, the medication must remain in contact with the vaginal walls long enough to dissolve. Nurses play a vital role in educating clients about post-insertion care, especially the need to remain lying down to prevent premature expulsion of the suppository.
Rationale for correct answer:
3. Remain lying down for 15 minutes:
Staying in a lying position allows the suppository to fully dissolve and be absorbed by the vaginal mucosa. This step supports maximum drug effect and is a standard nursing instruction.
Rationale for incorrect answers:
1. Resume ambulation immediately:
Walking or sitting up too soon after insertion can cause the suppository to leak before it's fully dissolved, reducing therapeutic effectiveness. Remaining supine helps retain the medication in the vaginal canal.
2. Avoid use of a sanitary pad:
While tampons should be avoided, sanitary pads can help manage minor leakage without affecting absorption. Advising against their use isn't necessary unless it interferes with comfort or hygiene.
4. Douche within 1 hour to enhance absorption:
Douching is not recommended after suppository use. It may flush out the medication and irritate the mucosa, interfering with absorption and increasing infection risk.
Take-home points:
- Instruct clients to lie down for at least 15 minutes after vaginal suppository insertion.
- Early movement can reduce absorption and should be avoided.
- Douching is contraindicated as it disrupts effectiveness and mucosal health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
To ensure safe and effective medication delivery, nurses must adhere to evidence-based practices when applying topical ointments. These practices are essential for promoting optimal drug absorption, minimizing adverse effects, and ensuring therapeutic outcomes. One of the most critical steps in this process is proper skin preparation before application.
Rationales:
4. Cleaning and drying the skin before application:
Cleaning removes debris, oil, or contaminants, and drying prevents dilution or interference with absorption. This step ensures that the ointment contacts the skin effectively for localized or systemic effect.
1. Applying a large amount over a wide area:
Using excessive medication may not improve absorption and could increase the risk of systemic side effects. The goal is to apply only the prescribed amount to the affected area.
2. Massaging the medication vigorously into the skin:
Vigorous massage may irritate the skin or cause unintended systemic absorption. Gentle application is preferred unless otherwise specified by the medication guidelines.
3. Applying to moist, inflamed skin:
While inflamed skin may absorb more medication, it can also increase the risk of irritation or toxicity. Medication should generally be applied to intact, clean, and dry skin unless directed otherwise.
Take-home points:
- Clean, dry skin enhances absorption and reduces the risk of contamination or irritation.
- Avoid overuse or excessive application of ointments to prevent side effects.
- Follow product-specific instructions for massage or application pressure.
Correct Answer is C
Explanation
Administering eardrops safely and effectively in pediatric patients requires knowledge of anatomical differences and age-appropriate techniques. In children under 3 years old, the ear canal is shorter and more horizontal than in adults, which affects how the medication is delivered. To ensure the drops reach the inner ear canal properly in a 2-year-old, the nurse should gently pull the earlobe down and back.
Rationale for correct answer:
3. Pull the earlobe down and back:
This is the appropriate technique for children under 3 years old. It straightens the horizontal ear canal, ensuring the drops flow inward effectively without causing pain or resistance.
Rationale for incorrect answers:
1. Pull the auricle up and back:
This method is used for older children and adults (typically over age 3) to straighten the more vertical ear canal. For toddlers, this direction may misalign the canal and reduce the effectiveness of the drops.
2. Warm the drops in a microwave before use:
Microwaving eardrops is unsafe and may cause the solution to overheat, risking burns to the delicate ear tissues. Drops should be warmed in the hands or placed in warm water to reach body temperature before administration.
4. Instill the drops with the patient seated upright:
The child should ideally be lying on their side with the affected ear facing up to allow the drops to remain in place and prevent spillage. Afterward, keeping the position for a few minutes enhances absorption.
Take-home points:
- For children under 3, gently pull the earlobe down and back when administering eardrops.
- Avoid microwaving eardrops; instead, warm them safely by hand.
- Positioning the child on their side helps retain the drops and ensures full therapeutic effect.
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