Alternative Routes
Expose conjunctival sac and apply a thin ribbon of ointment along the entire length of the visible sac
What is Ophthalmic Ointment
Position of patient during Tube feeding and immediately after they receive feeding
What is
Head of bed must be elevated at least 30 degrees at all times with continuous feeding or for at least 1hr for Bolus feeding
If blood glucose >240, urine is usually checked for?
What is
Ketones
What would the nurse educate the patient to do prior to administering Vaginal cream!
What is
Empty your bladder
You have Synthroid 50 mcg tablets available. You are to give Synthroid 0.05 mg. How much will you give?
What is
1 Tablet
What is the greatest advantage of giving medications by alternate route?
What is
Bypassing the first pass effect
Gold Standard test to verify placement of Enteral Tube
What is
Xray
What should be on the label of specimen before it is sent to the lab
What is
patient’s name,
date of birth
medical record#
date, time
your initials
specimen type
Patient teaching for administration of Sublingual/Buccal route medications
What is
Mucous membranes need to be wet.
others
Instruct patient not to eat, drink, or smoke while tablet is dissolving
The nurse needs to administer medication based on the client’s weight in kg. The client weighs 132 lbs. What is the weight in kg?
What is
60kg
Position of patient when administering a nasal spray
What is
Patent should be on their back with the neck hyperextended
Other
Have patient block one nostril and inhale through nose as atomizer is squeezed
How often should Tube placement be checked?
What is
every shift and before feeding or administering medication
Where and when should a specimen be labelled?
What is
Side of container
At the bedside
Nursing consideration on Vital signs when administering Inhalers
What is
Increase HR and BP
A nurse is to administer 10 milligrams of morphine sulfate to a patient with 3 fractured ribs. The available concentration for this drug is 20 mg/mL. How many milliliters should the nurse give?
What is
0.5ML
Apply to clean, dry, hairless skin, intact skin and left in place, or as a paste that is spread on a small area of skin
What is
Transdermal Medications
What are the objective assessments of patients with Enteral Tube
What is
Assessing skin integrity
Tube placement
Gastrointestinal function
Signs of complications:
When should antibiotic be started?
What is
After specimen is collected
How often should oral care be performed to patients with Enteral tube feeding
What is
Every 2 hours
How many milliliters would you document for the following:
2 cups broth (consumed ½)
4oz sherbet
8oz juice
24oz water
1 cup ice cream
What is
1560 ML
Steps to administer MDI using a spacer
What is
Shake canister for 5 seconds to mix med with propellant. Place spacer in mouth. Completely exhale from nose. Depress canister once to release med into spacer. Breathe in slowly (if horn noise, slow down). Hold breath 10 sec, try not to cough. This allows med to penetrate lung mucosa. Exhale thru nose; take 2 or 3 short breaths. Continue to breathe in med from chamber. If second puff ordered, wait at least 1 min;allows first dose to be fully absorbed
What should a nurse do if their patient has Residual of 350cc at 10am
What is
If residual between 200 and 500 mL (or per agency policy), replace withdrawn fluids, document, notify RN (or PCP) and decrease rate or stop feeding-per protocol
Steps to collect sample for blood sugar check
What is
Cleanse skin with alcohol for 30 seconds
Allow site to dry
Puncture the skin using the lancet
Gently squeeze above site if needed – DO NOT milk or massage the finger as may introduce excess tissue fluid and hemolyze the specimen
Wipe away first drop of blood, use second drop
Dispose of test strip, lancet & bloody supplies inbiohazard/sharps
Clean glucometer
Document results
Patient teaching on diet before collecting stool for guaiac
What is
Avoid red meat for 3 days, no aspirin or NSAIDs for 7 days, and avoid vitamin C 3-7 days
The doctor orders carbamazepine (Tegatrol) 900 mg P.O. daily in four divided doses for a pediatric patient with seizures who weighs 66 lb.
a.) How many mg of the drug should the patient receive with each dose?
b.) The recommended range is 10 to 20 mg/kg P.O. daily. Does the prescribed dose fall within this range?
What is
a) 225mg
b) No