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The patient you are caring for has been placed on warfarin (Coumadin) to prevent blood clots. Which teaching will you provide?
- A. Do not take aspirin or products containing aspirin while you are taking Coumadin.
- B. Report excessive bruising or bleeding from the gums, eyes, kidneys, intestines, or vagina.
- C. Do not consume milk or other dairy products while you are taking Coumadin.
- D. Do not drink grapefruit juice or eat grapefruit while you are taking Coumadin.
Correct Answer: A,B
Rationale: Aspirin increases bleeding risk with warfarin, and excessive bleeding is a serious side effect to report. Dairy and grapefruit do not significantly interact with warfarin.
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Identify the three times to check the medication, dose, route, and patient to ensure that you are administering the medication safely.
- A. When removing the medication from the storage area
- B. When preparing the medication
- C. When administering the medication to the patient
- D. When documenting the administration
- E. When reviewing the patient's chart
- F. When consulting the pharmacist
- G. When checking the medication order
Correct Answer: A,B,C
Rationale: Checking the medication, dose, route, and patient at removal, preparation, and administration ensures safety by catching errors at multiple points.
Before administering any antihypertensive medication, you will first
- A. Ask the patient if he or she is allergic to any antibiotics.
- B. Check the chart for the most recent temperature readings.
- C. Ensure that any ordered blood cultures have already been drawn.
- D. Check the patient's blood pressure to ensure that it is not too low.
Correct Answer: D
Rationale: Checking blood pressure before administering antihypertensives prevents giving the medication if the pressure is too low, avoiding hypotension.
A patient with pneumonia is allergic to cephalosporin antibiotics. He tells you that he breaks out in a rash and itches if he takes it. The health-care provider has prescribed cefazolin (Ancef) for him because it is one of the few antibiotics that will kill the bacteria cultured from his sputum. What will you do?
- A. Hold the medication and notify the health-care provider.
- B. Give the medication and administer oral diphenhydramine (Benadryl) without an order because it is an OTC medication.
- C. Ask the supervising nurse to give the medication because the patient may have an allergic reaction.
- D. Give the medication and watch the patient closely for any signs of anaphylaxis.
Correct Answer: A
Rationale: Due to the patient's known allergy, administering cefazolin risks a severe reaction. Holding the medication and notifying the provider is the safest action.
The oral route of medication administration includes
- A. Sublingual and buccal medicines.
- B. Inhalants and mists.
- C. Ointments and patches.
- D. Eye and ear drops.
Correct Answer: A
Rationale: Sublingual and buccal medications are administered through the mouth, qualifying as oral routes, whereas the others involve different administration methods.
Which of the following is an example of an over-the-counter medication?
- A. Hydrocodone (Lortab)
- B. Amoxicillin (Amoxil)
- C. Acetaminophen (Tylenol)
- D. Cefazolin (Ancef)
Correct Answer: C
Rationale: Acetaminophen (Tylenol) is available without a prescription, making it an over-the-counter medication, unlike the others, which require prescriptions.