A nurse is preparing to administer fentanyl 400 mcg via the buccal route. Which of the following actions should the nurse take?
Dissolve the tablet in 118 mL (4 oz) liquid.
Have the client chew the medication before swallowing.
Mix the medication in 5 mL (1 tsp) soft food.
Place the tablet between the client's cheek and gums.
The Correct Answer is D
A. Dissolve the tablet in 118 mL (4 oz) liquid: This option is incorrect because buccal tablets are specifically designed to dissolve in the mouth without liquid. Using liquid can dilute the medication and hinder effective absorption.
B. Have the client chew the medication before swallowing: Chewing the buccal tablet is not appropriate, as it can lead to rapid release and loss of the intended slow absorption through the mucous membranes. This method undermines the effectiveness of the medication.
C. Mix the medication in 5 mL (1 tsp) soft food: This action is also incorrect, as mixing the buccal tablet with food may interfere with its absorption. Buccal medications are intended to dissolve between the cheek and gums for optimal effect.
D. Place the tablet between the client's cheek and gums: This is the correct method for administering a buccal tablet. This placement allows the medication to dissolve slowly and be absorbed effectively through the buccal mucosa, providing the desired therapeutic effect.
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Correct Answer is B
Explanation
A. The medication should be administered as needed: This interpretation is incorrect because the prescription specifies a regular dosing schedule of twice daily (BID), indicating that it is not PRN (as needed) but rather a scheduled medication.
B. The medication is administered orally: This is correct as the prescription states "PO," which stands for "per os," meaning the medication is to be taken by mouth. This indicates the route of administration and is essential for ensuring the client receives the medication correctly.
C. The nurse should administer 1.5 mg twice daily: This interpretation is incorrect. The prescription specifically indicates a total dose of 3 mg to be taken, not divided into 1.5 mg doses. The correct administration is 3 mg at each dosing time, totaling 6 mg per day.
D. The medication is administered with every meal: This is not specified in the prescription. The dosing schedule of BID does not imply administration with meals unless explicitly stated. The nurse should follow the prescribed timing and not assume meal-related administration without clear instructions.
Correct Answer is D
Explanation
A. Dissolve the tablet in 118 mL (4 oz) liquid: This option is incorrect because buccal tablets are specifically designed to dissolve in the mouth without liquid. Using liquid can dilute the medication and hinder effective absorption.
B. Have the client chew the medication before swallowing: Chewing the buccal tablet is not appropriate, as it can lead to rapid release and loss of the intended slow absorption through the mucous membranes. This method undermines the effectiveness of the medication.
C. Mix the medication in 5 mL (1 tsp) soft food: This action is also incorrect, as mixing the buccal tablet with food may interfere with its absorption. Buccal medications are intended to dissolve between the cheek and gums for optimal effect.
D. Place the tablet between the client's cheek and gums: This is the correct method for administering a buccal tablet. This placement allows the medication to dissolve slowly and be absorbed effectively through the buccal mucosa, providing the desired therapeutic effect.