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 A
Explanation
A) "I should let the medication dissolve completely": This statement is correct and indicates that the client understands the proper administration of buccal medication. Buccal medications are designed to dissolve slowly between the gum and cheek, allowing for absorption directly into the bloodstream.
B) "I can only drink water, not juice, with this medication": This option is not accurate for buccal medications. While it is important to avoid swallowing the medication prematurely, there are generally no restrictions against consuming juice unless specified by the healthcare provider.
C) "I better chew my medication first for faster distribution": This statement indicates a misunderstanding. Buccal medications should not be chewed, as this can interfere with the intended slow release and absorption of the medication.
D) "I will place the medication in the same location": While placing the medication in the buccal pouch is important, it is not necessary to place it in the same exact spot every time. Rotating the site can help prevent irritation. This statement does not indicate a complete understanding of the proper technique.
Correct Answer is C
Explanation
A) 6 weeks from the start of using the inhaler: This option is not accurate. The timing for refilling should be based on the actual usage rather than a fixed period, and 6 weeks may not align with the client’s actual consumption.
B) As soon as the client leaves the hospital: This option is premature. The client does not need to refill the inhaler immediately upon discharge since they may not have used many puffs yet.
C) 50 days after discharge: This is the correct answer. If the client is to administer 2 puffs twice daily, that totals 4 puffs per day. With 200 puffs in the inhaler, the inhaler would last for 50 days (200 puffs ÷ 4 puffs per day = 50 days). Advising the client to refill the medication approximately 50 days after discharge ensures they have enough medication available.
D) When the inhaler is half empty: This option could lead to refilling too early or too late, depending on the individual’s usage pattern. Advising to refill based on a specific number of days or puffs used provides a more precise recommendation.