Question

The physician orders nitroglycerin (Nitro Bid) \(0.4 \mathrm{mg}\) SL now. Which of the following options would indicate that the murse correctly administered the medication? a. Tablet placed under the clients tongue and client instructed to allow medication to dissolve. b. Tablet given to the client with 8 oz of water after checking \(\mathrm{BP}\) and heart rate. c. Tablet given to the client with 4 oz of juice to assist with masking bitter flavor. d. Tablet placed under client's tongue and client instructed to chew slowly to assist with absorption.

Short answer

The nurse correctly administered the medication as described in option a.

Step-by-step solution

Understand the Route of Administration

SL stands for sublingual, which means the medication is to be given under the tongue to dissolve. It's important not to swallow the tablet as it's designed to be absorbed directly into the bloodstream through tissues under the tongue.

Evaluate the Options

Assess each option to see which one correctly describes administering a sublingual medication. Option a describes placing the tablet under the tongue and letting it dissolve, which is the right method for sublingual administration.

Eliminate Incorrect Responses

Options b, c, and d involve swallowing the tablet or altering the method of administration, which would not be following the sublingual route correctly. Therefore, these options are incorrect.

Key concepts

Sublingual Medication Administration

When it comes to administering medication, understanding the route is crucial for ensuring the drug's efficacy and patient safety. Sublingual medication administration involves placing the drug underneath the patient's tongue and allowing it to dissolve naturally. This method is used because the area under the tongue is rich in blood vessels and allows for rapid absorption of the medication directly into the bloodstream, bypassing the digestive system.

The sublingual route is particularly beneficial for certain medications like nitroglycerin, which is used to treat chest pain (angina) in people with heart conditions. Unlike oral medications that undergo digestion, sublingual drugs take effect more quickly and avoid degradation by stomach acids.

Proper Technique for Sublingual Administration

The nurse should ensure the patient’s mouth is moist, place the tablet under the tongue, and instruct the patient to avoid swallowing until the tablet dissolves completely. The patient should also be advised not to eat or drink anything until the medication has been fully absorbed.

Nursing Pharmacology

Nursing pharmacology encompasses the study of how drugs interact with the human body and the impact they have on treating diseases. For nurses, a solid grip on pharmacology principles is fundamental to administering medications safely and effectively.

The principles include understanding drug mechanisms of action, therapeutic uses, side effects, and drug interactions. In the case of nitroglycerin, nurses need to be aware of its vasodilatory effects, which help to increase blood flow and reduce heart workload. Additionally, they need to monitor vital signs, particularly blood pressure, as nitroglycerin can cause hypotension.

Importance of Pharmacological Knowledge

A comprehensive understanding of pharmacology aids nurses in educating patients about their medications, recognizing contraindications, and anticipating possible side effects. They can also identify signs of overdose or allergic reactions, making timely interventions to mitigate adverse effects.

Medication Administration Procedures

Medication administration is a multi-step process that requires nurses to adhere to best practices and protocols to ensure patient safety and therapeutic effectiveness. The process includes several critical steps from verifying physician orders to documenting the administration.

The first step is the verification of the physician's order, understanding the medication's purpose, and confirming the proper route and dosage. Then, the 'five rights' of medication administration are followed, which include the right patient, right medication, right dose, right time, and right route.

Documentation and Monitoring

Once the medication is given, it is essential to document the administration details in the patient's medical record. After administration, nurses should monitor the patient for the medication's effects, as well as any potential adverse reactions. This diligence ensures patient safety and upholds the integrity of the healthcare provided.