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Medication Administration and
Nursing Interventions
Intramuscular Injection Technique
Angle of Administration
When administering an intramuscular injection to an adult client, the nurse should administer the medication at a 90-degree angle.
Patient-Controlled Analgesia (PCA)
Interventions for Patients Receiving PCA
When caring for a patient receiving patient-controlled analgesia (PCA), the nurse should encourage the patient to use the PCA prophylactically prior to activities that are likely to augment pain levels, such as dressing changes.
Warfarin Therapy
Monitoring Therapeutic Effect
When caring for a patient who is prescribed warfarin therapy for an artificial heart valve, the nurse should monitor the prothrombin time (PT) to assess the therapeutic effect of warfarin. The PT should typically be approximately 2-3 times the normal value, depending on the indication for therapeutic anticoagulation.
Medication Error Assessment
First Action for Assessing Client Injury
The first action the nurse should take to assess the client for injury due to a medication error is to assess the patient.
Adverse Effects of Medications
Chest Pain as an Adverse Effect
When a nurse is reviewing the medical record of a client who received medications one hour ago and reports having chest pain, the nurse should recognize that chest pain can be an adverse effect of albuterol.
Ranitidine for Zollinger-Ellison Syndrome
Mechanism of Action
When providing teaching to a client who has a new prescription for ranitidine for the treatment of Zollinger-Ellison syndrome, the nurse should explain that this medication treats ulcers by reducing gastric acid production.
Acetazolamide and Sulfa Allergies
Allergy Screening
Prior to administering the first dose of acetazolamide to a client with open- angle glaucoma, the nurse should ask the patient if they have an allergy to sulfa-based medications.
Combination Antiretroviral Therapy
Rationale for Combination Therapy
When caring for a client with HIV who is starting therapy with ritonavir and zidovudine, the nurse should explain that taking two medications together keeps the client from becoming resistant to either of them.
Exenatide Administration
Timing of Administration
When providing teaching to a client with type 2 diabetes who is starting immediate-release exenatide, the nurse should instruct the client to take the medication one hour before morning and evening meals.
Folic Acid Importance
Rationale for Folic Acid Supplementation
When providing teaching to a client with a new prescription for folic acid, the nurse should explain that folic acid is important for the building of blood cells.
Extended-Release Potassium Chloride
Administration Instruction
When providing teaching to a client with a new prescription for oral extended-release potassium chloride tablets, the nurse should instruct the client not to crush the medication.
Levothyroxine Onset of Action
Client Understanding
When providing teaching to a client with a new prescription for levothyroxine, the nurse should consider the client's statement "I might not realize the full effects of this medication for several weeks" as an indication of understanding.
Medication Error Reporting
Timing of Incident Report
When assessing a client at the beginning of the shift and noting that the client received a medication in error from the nurse on the previous shift, the nurse should plan to complete an incident report as soon as the assessment is complete.
Packed Red Blood Cell Transfusion
Monitoring for Circulatory Overload
When preparing to administer a second unit of packed red blood cells to a client experiencing hemorrhagic shock, the nurse should monitor the client for dyspnea as an indication of circulatory overload.
Neutropenia Management
Medication Administration
When planning care for a client with neutropenia, the nurse should expect to administer filgrastim.
Brimonidine for Glaucoma
Client Understanding
When teaching a client with a new prescription for brimonidine to treat open-angle glaucoma, the nurse should consider the client's statement "I
can expect to feel some irritation when I put these drops in my eyes" as an indication of understanding.
Varicella Zoster Virus Treatment
Medication Administration
When caring for a client with varicella zoster virus, the nurse should expect to administer acyclovir.
Heparin Toxicity Management
Medication Administration
When caring for a client receiving a continuous intravenous infusion of heparin, the nurse should expect to administer protamine if the client experiences acute heparin toxicity.
Carbidopa-Levodopa for Parkinson's Disease
Nursing Instruction
When providing teaching to a client with Parkinson's disease who has a new prescription for carbidopa-levodopa, the nurse should include the instruction to move slowly when standing up.
Leuprolide for Prostate Cancer
Nursing Instruction
When teaching a client starting subcutaneous leuprolide for the treatment of prostate cancer, the nurse should include the instruction to increase calcium intake.
Zidovudine Monitoring
Laboratory Finding to Report
When reviewing the laboratory findings for a client taking zidovudine to treat HIV, the nurse should report a neutrophil count of 650 to the provider.
Medication Error Prevention
Most Frequent Cause of Fatal Medication Errors
When teaching a group of newly licensed nurses about the prevention of medication errors, the nurse should identify name confusion between two
Beclomethasone Inhaler Teaching
Instruction for Use
When teaching a client with asthma about using a beclomethasone inhaler along with an albuterol inhaler, the nurse should instruct the client to gargle with water after each use of the beclomethasone inhaler.
Ketorolac Administration
Laboratory Finding to Report
When reviewing laboratory results prior to administering ketorolac to a patient, the nurse should report a creatinine level of 1.6 to the provider prior to administration.
Nitroglycerin Patch Application
Nursing Instruction
When providing teaching to a client with a new prescription for transdermal nitroglycerin patches to treat angina pectoris, the nurse should include the instruction to apply a new patch each day after waking up.
Spironolactone Adverse Effects
Manifestation Requiring Dose Withholding
When assessing a client taking spironolactone 50 mg PO daily for several months, the nurse should withhold the prescribed dose and notify the provider if the client reports muscle weakness.
Misoprostol Contraindications
Contraindication for Pregnant Patients
The nurse should recognize that misoprostol is contraindicated for a client who might be pregnant when caring for clients with peptic ulcer disease.
Medication Refusal Management
Nursing Actions
When caring for a client who refuses a prescribed dose of a proton pump inhibitor 250 mg PO due to nausea, the nurse should: - Educate the client about the possible consequences of not taking the medication - Suggest the client take the medication with food to minimize gastrointestinal effects -
Document the patient's refusal in the medication administration record - Recommend the provider prescribe an enteric-coated medication
Montelukast for Exercise-Induced Asthma
Client Understanding
When providing teaching to a client with a new prescription for montelukast, the nurse should consider the client's statement "I will take this medication every day to control my exercise-induced asthma" as an indication of understanding.
Oxycodone Overdose Management
Medication Administration
When caring for a client experiencing respiratory depression after taking an excessive dose of oxycodone, the nurse should expect to administer naloxone.
Hypoglycemia Management
Initial Action for Unresponsive Patient
When teaching the partner of a client with diabetes mellitus how to manage episodes of severe hypoglycemia when the patient is unresponsive, the nurse should instruct the partner to administer glucagon intramuscularly to the patient first.
Anticholinergic Medication Adverse Effects
Nursing Education Content
When planning a staff education session about adverse effects of medications, the nurse should include the following information when discussing the adverse effects of anticholinergic medications: - Blurred vision - Tachycardia - Constipation
Prolonged QT Interval with Citalopram
Findings to Report to Provider
When reviewing medical records for a group of patients, the nurse should report a patient who is taking citalopram and has a prolonged QT interval to the provider.
Metronidazole Teaching Priorities
Priority Teaching Point
When providing teaching for a client with a new prescription for oral metronidazole, the priority for the nurse to include is that the client should report a rash to their provider.
Digoxin Toxicity
Manifestation to Report
When assessing a client with heart failure who is taking digoxin, the nurse should report vomiting to the provider as an indication of digoxin toxicity.
Urinary Tract Infection Management
Medication Administration
When caring for a client with recurrent urinary tract infections, the nurse should expect to administer nitrofurantoin.
Alosetron Therapeutic Effect
Expected Outcome
When caring for a client with a new prescription for alosetron, the nurse should expect the client to experience a decrease in the frequency of defecation as a therapeutic effect.
Methyldopa for Hypertension
Nursing Instruction
When teaching a client who is to start taking methyldopa for the treatment of hypertension, the nurse should include the information that this medication can cause dizziness.
Ferrous Sulfate for Children
Nursing Instruction
When providing teaching to the parents of a child who is starting to take liquid ferrous sulfate, the nurse should include the instruction to monitor the child for constipation.
Hydrochlorothiazide Effectiveness
Indicator of Effectiveness
When assessing a client who has been taking hydrochlorothiazide, the nurse should consider the client's statement "the swelling in my feet has decreased" as an indication that the medication is effective.
Magnesium Sulfate Monitoring
Priority Finding
When assessing a client in preterm labor who is receiving magnesium sulfate via continuous IV infusion, the nurse should identify a deep tendon reflex of +1 as a priority finding.
Warfarin and Garlic Interaction
Potential Adverse Effect
When caring for a client who reports using the herbal medication garlic along with prescribed warfarin, the nurse should identify that an increased risk of bleeding is a potential adverse effect of taking both of these products concurrently.
