This question tests safe medication administration practices for enteral medications in clients with aspiration history. Key safety considerations for oral and enteral routes include proper positioning to prevent reflux and aspiration. Raising the head of bed to at least 30–45 degrees ensures client safety and effective medication delivery by reducing aspiration risk during administration. Lowering the bed increases reflux; clamping for 8 hours is excessive; deep breaths may not help. A fundamental nursing principle is to elevate the head during enteral procedures. Another principle is to maintain elevation for 30-60 minutes post-administration. A strategy for ensuring safe medication administration is to adhere to the rights of medication administration, including right positioning for safety.

This question tests safe medication administration practices for extended-release medications in clients with swallowing issues. Key safety considerations for oral and enteral routes include not crushing formulations that alter release. Requesting an alternative formulation or medication because extended-release tablets should not be crushed ensures client safety and effective medication delivery by maintaining controlled release and preventing overdose. Crushing with applesauce risks rapid release; chewing is inappropriate; dissolving in hot water is not standard. A fundamental nursing principle is to check 'do not crush' lists for safety. Another principle is to assess client preferences and abilities for adherence. A strategy for ensuring safe medication administration is to adhere to the rights of medication administration, including right client education on alternatives.

This question tests safe medication administration practices for electrolyte supplements via enteral tubes. Key safety considerations for oral and enteral routes include dilution to prevent irritation and flushing for patency. Diluting the liquid medication with water and flushing the tube before and after ensures client safety and effective medication delivery by minimizing gastrointestinal irritation from concentrated potassium. Administering undiluted risks burns; mixing with formula may cause incompatibility; extended-release is not suitable for tubes. A fundamental nursing principle is to dilute irritants like potassium chloride for safe administration. Another principle is to monitor electrolytes post-dose for therapeutic effect. A strategy for ensuring safe medication administration is to adhere to the rights of medication administration, including right preparation technique.

This question tests safe medication administration practices for antihypertensive medications via the oral route. Key safety considerations for oral and enteral routes include monitoring vital signs and assessing for contraindications like hypotension before dosing. Holding the medication and notifying the provider of the low blood pressure ensures client safety and effective medication delivery by preventing further hypotension or adverse events from the ACE inhibitor. Administering despite low BP risks exacerbation; giving with grapefruit juice can dangerously increase drug levels; delegating orthostatic checks post-dose neglects pre-administration assessment. A fundamental nursing principle is to withhold medications if parameters like blood pressure fall below safe thresholds to avoid harm. Another principle is to recognize that conditions like diabetes may heighten risks of hypotension with antihypertensives. A strategy for ensuring safe medication administration is to adhere to the rights of medication administration, including right assessment of client status before giving the dose.

This question tests safe medication administration practices for anticonvulsants via enteral tubes with continuous feedings. Key safety considerations for oral and enteral routes include managing drug-feeding interactions and maintaining therapeutic levels. Stopping the tube feeding 1–2 hours before the dose and flushing the tube per policy ensures client safety and effective medication delivery by preventing phenytoin binding to formula, which reduces absorption. Mixing into the feeding bag risks inconsistent dosing; increasing the rate compensates inappropriately; discontinuing feedings ignores nutritional needs. A fundamental nursing principle is to hold enteral nutrition around phenytoin administration to optimize bioavailability. Another principle is to monitor for subtherapeutic levels if interactions occur, adjusting as needed. A strategy for ensuring safe medication administration is to adhere to the rights of medication administration, including right documentation of feeding pauses.

This question tests safe medication administration practices for discharge planning with antihypertensives. Key safety considerations for oral and enteral routes include reconciling home medications to avoid duplications. Verifying the home medication list and clarifying with the provider whether lisinopril should be discontinued ensures client safety and effective medication delivery by preventing additive effects from similar drug classes. Administering all three risks hypotension; telling to stop if dizzy is unsafe self-management; substituting without order is inappropriate. A fundamental nursing principle is to perform medication reconciliation at transitions of care. Another principle is to educate on potential interactions between ACE inhibitors and ARBs. A strategy for ensuring safe medication administration is to adhere to the rights of medication administration, including right documentation of home meds.

This question tests safe medication administration practices for anticoagulants like warfarin. Key safety considerations for oral and enteral routes include monitoring for bleeding and lab values post-dose. Monitoring for signs of bleeding and notifying the provider of the elevated INR ensures client safety and effective medication delivery by addressing supratherapeutic effects promptly. Urine output is unrelated; lung sounds are not primary; pupil constriction is irrelevant. A fundamental nursing principle is to assess coagulation studies regularly for dose adjustments. Another principle is to educate on signs of bleeding like gum issues. A strategy for ensuring safe medication administration is to adhere to the rights of medication administration, including right evaluation of therapeutic response.

This question tests safe medication administration practices for enteral feedings in clients with dysphagia. Key safety considerations for oral and enteral routes include checking residuals and symptoms of intolerance to prevent aspiration. A gastric residual volume of 275 mL with nausea requires immediate intervention as it indicates delayed emptying and aspiration risk. Present bowel sounds are expected; requesting ice chips is inappropriate for NPO status; scheduled feedings are standard. A fundamental nursing principle is to withhold feedings if residuals exceed policy thresholds, typically 200-250 mL, and notify the provider. Another principle is to reassess frequently for signs of gastrointestinal distress. A strategy for ensuring safe medication administration is to adhere to the rights of medication administration, including right assessment of tolerance before proceeding.

This question tests safe medication administration practices for enteral feedings with aspiration risk. Key safety considerations for oral and enteral routes include monitoring respiratory status during infusion. Coughing with wet respirations and a drop in oxygen saturation during feeding requires immediate intervention as it suggests aspiration, which can lead to pneumonia. Mild fullness is tolerable; residual formula in tubing is normal; proper labeling prevents errors. A fundamental nursing principle is to stop feedings immediately if aspiration signs appear. Another principle is to position clients upright during and after feedings. A strategy for ensuring safe medication administration is to adhere to the rights of medication administration, including right monitoring of tolerance.

This question tests safe medication administration practices for beta-blockers in clients with bradycardia. Key safety considerations for oral and enteral routes include checking apical pulse before dosing. Holding the medication and notifying the provider of bradycardia ensures client safety and effective medication delivery by preventing further heart rate suppression. Administering risks worsening bradycardia; encouraging ambulation is unsafe; doubling the dose ignores the issue. A fundamental nursing principle is to hold beta-blockers if heart rate is below 50-60 beats per minute. Another principle is to assess for symptoms like dizziness that may indicate hemodynamic instability. A strategy for ensuring safe medication administration is to adhere to the rights of medication administration, including right verification of vital signs.