A client complains about the taste of the sublingual nitro-glycerine and admits that he swallows it rather than holding it under his tongue. The nurse explains that sublingual medications:
should not be swallowed because it alters the absorption potential.
can be held against the roof of the mouth with the tongue to reduce taste.
can be inserted rectally without loss of absorption potential.
can be taken between the cheek and tongue to diminish taste.
The Correct Answer is A
A) Should not be swallowed because it alters the absorption potential: This is the correct explanation. Sublingual medications, such as nitroglycerin, are designed to be absorbed quickly through the mucous membranes under the tongue. Swallowing the medication can significantly reduce its effectiveness and delay absorption, which is crucial for medications used in acute situations like angina.
B) Can be held against the roof of the mouth with the tongue to reduce taste: This option is not correct. Holding the medication against the roof of the mouth does not facilitate the intended sublingual absorption and may not significantly mitigate the taste issue. The medication needs to dissolve under the tongue for effective absorption.
C) Can be inserted rectally without loss of absorption potential: This option is incorrect. Sublingual medications are formulated for absorption through the sublingual mucosa and would not provide the same effects if administered rectally. Different routes of administration have different absorption profiles.
D) Can be taken between the cheek and tongue to diminish taste: While this may help with taste, it does not achieve the desired sublingual absorption. For optimal effect, the medication should be held under the tongue, where it can dissolve and be absorbed directly into the bloodstream.
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Correct Answer is C
Explanation
A) Upward and back: This direction is appropriate for adults and older children but not for infants. The anatomy of an infant's ear canal requires a different approach for effective eardrop administration.
B) Upward and outward: This option is also incorrect for infants. Similar to option A, this technique does not effectively account for the anatomical differences in an infant's ear canal.
C) Downward and back: This is the correct action when administering eardrops to an infant. Pulling the auricle downward and back straightens the ear canal, allowing for better access to deeper structures and ensuring that the drops reach the intended area.
D) Downward and inward: This direction is not appropriate for straightening the ear canal. The correct technique is to pull downward and back to achieve the desired angle for effective administration of eardrops in infants.
Correct Answer is B
Explanation
A) Ask the client if he would prefer to give the medication to himself: While involving the client in their care is important, this option does not assess the client’s ability to safely take the medication. The nurse should first ensure that the client can swallow the medication safely.
B) Assess the swallowing reflex by offering a sip of water: This is the correct action. Assessing the swallowing reflex is essential, especially in older adults, to determine if they can safely swallow liquid medications without risk of aspiration.
C) Mix thoroughly in applesauce or pudding: This option is not appropriate unless specifically ordered or indicated. Mixing medications in food may not be suitable for all clients, and it can affect the medication's absorption or effectiveness. Additionally, it does not assess the client's swallowing ability.
D) Assess the ability to understand information relative to the medication: While this is important, it is secondary to ensuring that the client can physically take the medication safely. Assessing understanding can occur after confirming the client’s ability to swallow the medication.