Question

Which instruction should the nurse give a client for whom a vaginal cream has been prescribed? A. Lie on your left side for about 5 minutes. B. Remain supine with hips elevated for 5–10 minutes. C. Remove excess medication with soap and water in 15 minutes. D. Urinate and wipe front to back in 15–30 minutes.

Short answer

B. Remain supine with hips elevated for 5–10 minutes.

Step-by-step solution

Understand the Question

Identify what the exercise is asking for: the correct instruction a nurse should give to a client prescribed vaginal cream.

Evaluate Each Option

Carefully read through each option to see which fits best with nurse instructions for using vaginal cream.

Analyze Option A

Option A: 'Lie on your left side for about 5 minutes.' This is generally not a common instruction for vaginal cream application as it does not aid in keeping the cream in place.

Analyze Option B

Option B: 'Remain supine with hips elevated for 5–10 minutes.' This is a common instruction for vaginal cream usage as it helps retain the medication within the vaginal canal.

Analyze Option C

Option C: 'Remove excess medication with soap and water in 15 minutes.' This instruction is not appropriate because the medication needs time to be absorbed, and washing it off would remove its effectiveness.

Analyze Option D

Option D: 'Urinate and wipe front to back in 15–30 minutes.' This instruction pertains to general hygiene but is not specifically related to the application nor retention of vaginal cream.

Select the Best Instruction

Based on the analysis, the correct instruction is B. Remaining supine with hips elevated helps the medication to stay in place and be absorbed properly.

Key concepts

Medication Retention

Medication retention is crucial when administering vaginal cream. Ensuring that the medication stays within the vaginal canal long enough allows it to be fully absorbed, which maximizes its effectiveness. Patients should be instructed to remain in a position that minimizes leakage immediately after application. The recommended position is to lie supine (on your back) with the hips slightly elevated for 5 to 10 minutes. This position uses gravity to keep the cream in place. Avoid activities like standing up or walking, which could cause the medication to leak out. Proper retention ensures the medication works efficiently and achieves the desired therapeutic effect.

Patient Positioning

The way a patient positions themselves during and after applying vaginal cream is essential for effective treatment. Lying on the back with the hips elevated allows the medication to settle in the vaginal canal without being expelled. Here’s how to properly position yourself:
1. Lie down on a flat surface, such as a bed.
2. Use pillows to elevate your hips slightly.
3. Keep your knees bent and feet flat on the bed.
This position should be maintained for about 5–10 minutes. Ensuring that the vaginal cream stays in place helps in fully absorbing the medication. Patients should be comfortable, as discomfort might make it hard to stay in the position long enough.

Nurse-Patient Communication

Effective nurse-patient communication is vital for ensuring that patients correctly follow medication instructions. Nurses should provide clear, simple, and concise instructions when explaining how to apply vaginal cream. Here are some tips:
1. Use layman’s terms and avoid medical jargon.
2. Demonstrate the application process if possible.
3. Encourage questions to clarify any doubts.
Additionally, reinforce the importance of adhering to the instructions to maximize the medication's effectiveness. Communication should also be compassionate and supportive to make the patient feel comfortable discussing sensitive issues.

Pharmacological Nursing Interventions

Pharmacological nursing interventions involve administering the medication correctly and educating the patient on its use. For vaginal creams, such interventions include:
1. Confirming the correct medication and dosage.
2. Instructing on the proper application technique.
3. Emphasizing the importance of positioning and retention.
4. Monitoring for side effects or adverse reactions.
Nurses play a critical role in ensuring that medications are administered safely and effectively. By providing detailed education and support, they help patients achieve the best therapeutic outcomes.