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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Explanation
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C. Fluoxetine 20 mg PO every a.m.: This prescription is clearly stated, with an appropriate dosage and frequency. Fluoxetine is commonly prescribed for depression and can be taken in the morning, making this prescription acceptable.
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Correct Answer is B
Explanation
A. Medication: The prescription specifies escitalopram, which is a well-known selective serotonin reuptake inhibitor (SSRI) used to treat depression. There is no ambiguity regarding the medication itself, making this aspect clear.
B. Time: While escitalopram can be taken at any time of day, it is important to clarify whether it should be taken in the morning or evening, especially if the client has a history of sleep disturbances. This timing can impact the client's daily routine and overall treatment effectiveness, so confirming the preferred time for administration is essential.
C. Dose: The prescribed dose of 10 mg daily falls within the typical therapeutic range for escitalopram. This dosage is standard for initiating treatment, so there is no need for clarification on this point.
D. Route: The prescription states that the medication is to be taken orally, which is the standard route for escitalopram. There is no confusion regarding the route of administration, making this aspect clear as well.