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) Measure liquid medication by bringing liquid medication cup to eye level: This is the correct action. Measuring liquid medications at eye level ensures accuracy and helps the nurse confirm the correct dosage, minimizing the risk of administration errors.
B) Crush enteric-coated medication and place it in a medication cup with water: This option is incorrect. Enteric-coated medications are designed to dissolve in the intestine, not in the stomach, and crushing them can alter their effectiveness and increase the risk of side effects. These medications should be administered whole.
C) Place all of the client's medications in the same cup, except medications with assessments: This option is not advisable without knowing how the medications interact. Certain medications may have specific requirements for administration and should not be mixed together, as this could lead to confusion or adverse reactions.
D) Remove the medication from the wrapper and place it in a cup labeled with the client's information: While labeling is crucial for safety, medications should ideally be kept in their original packaging until administration to prevent confusion and ensure that the nurse has all necessary information about the medication at hand. Medications should only be removed when preparing for immediate administration.
Correct Answer is D
Explanation
A) Cerumen or drainage is occluding the ear canal: While cerumen or drainage can cause discomfort, it is less likely to be the direct cause of dizziness following the administration of eardrops. Dizziness is more commonly associated with changes in pressure or temperature in the ear.
B) Too much pressure was applied during instillation, with subsequent injury to the eardrum: Although excessive pressure can lead to injury, the immediate symptom of dizziness after eardrop administration is more closely related to other factors, particularly temperature or positioning.
C) The client failed to remain in the side-lying position long enough: This option is incorrect because not maintaining the position may affect medication absorption but is unlikely to cause immediate dizziness and nausea.
D) The medication was too cold when it was administered: This is the most likely cause of the dizziness. Cold eardrops can cause a rapid change in temperature within the ear canal, potentially stimulating the vestibular system and leading to dizziness or vertigo. It is generally recommended to warm eardrops to body temperature before administration to minimize this risk.