A nurse is caring for an infant who has spina bifida. Which of the following actions should the nurse take?

A. Measure the elixir in a medicine cup before transferring to a syringe:

This option involves measuring the medication using a medicine cup before transferring it to an oral medication syringe. While measuring the medication accurately is important, transferring it from a medicine cup to a syringe introduces an extra step that may increase the risk of spillage or dosage error. It's generally more efficient and accurate to directly draw the medication into the oral syringe.

B. Place the infant supine in a crib prior to administration:

Placing the infant in a supine (lying flat on the back) position in a crib prior to administering oral medication is not recommended, particularly for infants of this age. This position increases the risk of choking or aspiration, as it may cause the medication to flow toward the back of the throat rather than being swallowed properly. It's safer to administer oral medication to infants in an upright or slightly reclined position.

C. Position the syringe to the side of the infant's tongue:

This is the correct choice. Positioning the syringe to the side of the infant's tongue helps facilitate swallowing and reduces the risk of choking or aspiration. Placing the syringe toward the cheek allows the infant to more easily swallow the medication, as it minimizes the chance of the medication flowing toward the back of the throat.

D. Mix the medication with 10 mL of formula:

Mixing medication with formula is not a standard practice for administering oral medication using an oral syringe, particularly without specific instructions from the healthcare provider. Mixing medication with formula may alter the medication's effectiveness and is unnecessary for most oral medications. It's important to administer oral medication directly using an oral syringe to ensure accurate dosing and effectiveness.

A. "When I use this technique the medication will not run out of the ear."

This explanation is not entirely accurate. While pulling the auricle down and back may help prevent ear drops from immediately dripping out of the ear, the primary purpose of this technique is to straighten the ear canal, facilitating the passage of the medication into the inner ear region for optimal effectiveness. The prevention of medication runoff is a secondary benefit.

B. “This opens the ear canal, allowing medication to reach the inner ear region.”

This explanation is correct. Pulling the auricle down and back helps to straighten the ear canal, making it easier for the ear drops to enter the ear canal and reach the inner ear where they can effectively treat the condition. This is the main purpose of using this technique.

C. “This is the safest and easiest way to administer this medication.”

While pulling the auricle down and back is a commonly used technique for administering ear drops, describing it as the safest and easiest way may not fully capture its purpose. Safety and ease of administration are important considerations, but the primary rationale for this technique is to facilitate the delivery of medication to the inner ear.

D. “When I use the technique, your child experiences less pain.”

This explanation is inaccurate. Pulling the auricle down and back may not directly reduce pain. The main purpose of this technique is to ensure that the medication reaches the inner ear region for effective treatment. While discomfort during administration may be minimized with proper technique, the primary focus is on medication delivery rather than pain reduction.