Nonparenteral Administration - Ccma

1. What is the correct instruction for administering a sustained-release or extended-release tablet?

   Swallow whole; do not crush, chew, or split. Preserving the tablet's integrity maintains the controlled release mechanism, ensuring steady drug levels over an extended period.

2. What does the term nonparenteral medication administration mean?

   Administration by routes other than injection. Nonparenteral methods deliver medications without penetrating the skin or mucous membranes via needles, ensuring safer and often more patient-friendly administration.

3. What is the standard check frequency for verifying a medication label before administration?

   Three checks: when removed, when prepared, before giving. Performing these three checks reduces medication errors by repeatedly verifying the label against the order at key preparation stages.

4. What is the correct instruction for administering an enteric-coated tablet?

   Swallow whole; do not crush or chew. Enteric coating protects the drug from stomach acid, ensuring release in the intestines for optimal absorption and reduced irritation.

5. Which information must be compared between the medication label and the order before administration?

   Patient, drug, dose, route, time, expiration, indications. Comparing these details ensures the medication matches the provider's order, preventing administration errors and ensuring patient safety.

6. What is the correct action if a medication is expired at the time you are preparing a dose?

   Do not administer; discard per facility policy. Expired medications may lose potency or become unsafe, so proper disposal follows protocols to maintain efficacy and prevent harm.

7. What is the correct technique to prevent systemic absorption after instilling ophthalmic drops?

   Apply nasolacrimal occlusion for $1$ minute. Nasolacrimal occlusion minimizes drainage into the nasopharynx, enhancing ocular retention and reducing unintended systemic absorption.

8. What is the correct action before applying a new transdermal patch when an old patch is present?

   Remove the old patch first and dispose safely. Removing the old patch prevents drug accumulation and overdose, while safe disposal avoids accidental exposure to others.

9. Identify the best device for measuring small liquid doses such as $2.5\,\text{mL}$ accurately.

   Oral syringe (calibrated). Calibrated oral syringes provide precise measurement for small volumes, reducing dosing errors in pediatric or low-dose scenarios.

10. What is the correct patient instruction for a sublingual medication dose?

    Place under tongue and let dissolve; do not swallow. Allowing dissolution under the tongue facilitates direct mucosal absorption, maximizing bioavailability and rapid therapeutic effects.

11. What are the medication administration rights that must be verified before giving a dose?

    Right patient, medication, dose, route, time, documentation, reason, response. These expanded rights ensure safe medication administration by verifying all critical aspects to prevent errors and promote patient safety.

12. What is the correct route for a tablet intended to be swallowed and absorbed through the GI tract?

    Oral (PO). This route allows absorption through the digestive system, providing systemic effects after metabolism in the liver.

13. Which route delivers medication directly into the conjunctival sac of the eye?

    Ophthalmic. Ophthalmic administration targets the eye's conjunctiva for localized treatment of ocular conditions with minimal systemic effects.

14. Which route places a medication under the tongue for rapid absorption and avoids first-pass metabolism?

    Sublingual (SL). This route enables quick absorption via sublingual blood vessels, bypassing hepatic first-pass metabolism for faster onset.

15. Which route delivers medication to the nasal mucosa for local or systemic effect?

    Intranasal. Intranasal delivery targets the nasal passages for rapid absorption, effective for both local relief and systemic drug distribution.

16. What is the correct immediate action if a patient reports a new allergy before receiving a medication?

    Hold the medication and notify the provider. Withholding the dose prevents potential allergic reactions, allowing the provider to assess and adjust the treatment plan accordingly.

17. Which route uses a patch applied to intact skin for systemic absorption over time?

    Transdermal. Transdermal patches deliver medication steadily through the skin, providing controlled release for long-term systemic effects.

18. Which two identifiers should you use to confirm the correct patient before medication administration?

    Full name and date of birth. Using these two identifiers minimizes the risk of medication errors by accurately confirming patient identity in clinical settings.

19. Which route places medication between the cheek and gum for absorption through oral mucosa?

    Buccal. Buccal placement allows absorption through the cheek's mucous membrane, providing an alternative to swallowing for better compliance.

20. What is the correct step to reduce contamination when using a nasal spray device?

    Do not touch the tip to the nasal mucosa. Avoiding contact prevents bacterial transfer from the nose to the device, maintaining sterility and reducing infection risk.

21. What is the correct technique for measuring liquid medication in a dosing cup at eye level?

    Read the volume at the bottom of the meniscus. Reading at the meniscus bottom ensures accurate volume measurement, accounting for liquid surface tension in calibrated devices.

22. What is the correct action when a medication order states "shake well" for an oral suspension?

    Shake thoroughly before measuring and administering. Shaking distributes suspended particles evenly, ensuring consistent dosing and therapeutic efficacy with each administration.

23. What is the correct documentation detail specific to transdermal patches after application?

    Record date/time and exact site of application. Documenting these details tracks application sites for rotation, preventing skin irritation and ensuring accurate medical records.

24. What is the correct action if a patient cannot swallow a prescribed oral tablet safely?

    Hold dose and notify the provider for an alternative. Notifying the provider ensures patient safety by seeking a suitable alternative form or route when swallowing is impaired.

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