A nurse in a mental health clinic is caring for a client who has bipolar disorder and a prescription for an antipsychotic medication. The provider and nursing staff suspect the client is not adhering to his medication therapy. Which of the following interventions should the staff use to encourage the client's adherence? (Select all that apply.)
Rotate staff that administer the medications.
Engage the client in conversation following medication administration.
Use sustained-release forms.
Provide for once-daily dosing.
Perform mouth checks following the administration of the medication.
Correct Answer : B,C,D,E
A. Rotating the staff who administer medications is generally counterproductive for a client with bipolar disorder or suspected non-adherence. Consistency in the nursing staff helps build a therapeutic alliance and trust, which are foundational for successful medication management. Frequent changes in personnel can lead to confusion, increased suspicion, and a lack of accountability in the nurse-client relationship.
B. Engaging the client in conversation immediately following the administration of medication is a subtle but effective clinical intervention. This strategy ensures the client has swallowed the medication by requiring vocalization, which prevents the client from "cheeking" or hiding the dose in the buccal cavity. It provides a non-confrontational method to verify ingestion while maintaining a positive and social therapeutic environment.
C. The use of sustained-release forms or long-acting injectable antipsychotics significantly improves adherence by reducing the frequency of administration. These formulations maintain a stable therapeutic serum concentration over a longer period, which is especially beneficial for clients who struggle with daily regimens. Reducing the burden of medication management minimizes the risk of relapse associated with missed doses.
D. Providing for once-daily dosing is a scientifically proven strategy to enhance medication compliance by simplifying the treatment schedule. Complexity in drug regimens is a primary barrier to adherence, particularly in psychiatric populations where cognitive symptoms may be present. A single daily dose is easier for the client to incorporate into a routine, thereby increasing the likelihood of long-term therapy maintenance.
E. Performing mouth checks following the administration of medication is a direct nursing intervention used to confirm that the client has truly swallowed the dose. This process involves a respectful but thorough inspection of the oral cavity, including under the tongue and along the gum lines. It is a standard safety protocol in mental health settings to ensure the delivery of prescribed psychiatric treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "It doesn't really matter what time you take your medications as long as you don't skip any doses": This statement is incorrect because adherence to the prescribed dosing schedule is crucial for the effectiveness of medications. Inconsistent timing of doses can lead to suboptimal therapeutic outcomes or potential adverse effects.
B. "Let's work together to devise a time schedule that is convenient for you on a daily basis": This is the most appropriate instruction. Collaborating with the client to establish a medication schedule that aligns with their daily routine increases the likelihood of adherence. It promotes patient autonomy and empowers the client to take ownership of their medication regimen.
C. "You really shouldn't change the schedule we established here in the facility": While maintaining consistency in medication administration times is important, rigidly adhering to a schedule established during the facility stay may not always be feasible or practical for the client at home. Flexibility in adjusting the schedule to fit the client's lifestyle is essential for long-term adherence.
D. "We'll have to talk to your provider about switching to an alternative schedule": Switching to an alternative schedule should be considered only if the current schedule is not feasible for the client or if it compromises medication adherence. However, exploring options for adapting the existing schedule to better suit the client's needs should be attempted first before considering a switch.
Correct Answer is ["50"]
Explanation
To calculate the volume of phenytoin oral solution to administer per dose, we'll use the formula:
Volume(mL)=Totaldoseneeded(mg)/Concentrationofthemedication(mg/mL)
Given: Total dose needed per dose = 250 mg
Concentration of phenytoin oral solution = 25 mg/5 mL
(which simplifies to 5 mg/mL)
Substituting the given values into the formula:
Volume(mL)=250 mg/5 mg/mL
Volume(mL)=50 mL
Rounded to the nearest whole number, the nurse should administer 50 mL of phenytoin oral solution per dose.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.