A nurse is planning to administer ceftriaxone IM to an adult client. Which of the following actions should the nurse plan to take?

Administer the medication using a 5/8-inch needle.

Administer the medication using a Z-track technique.

Administer the medication in the deltoid muscle.

Administer the medication at a 45° angle.

Answer and Explanation

The Correct Answer is B

A) Administer the medication using a 5/8-inch needle:
Ceftriaxone is typically administered using a longer needle to ensure proper injection into the muscle. A 5/8-inch needle is more suitable for subcutaneous injections rather than intramuscular (IM) injections.

B) Administer the medication using a Z-track technique:
The Z-track technique is appropriate for IM injections of medications like ceftriaxone, which can be irritating to tissues. This technique helps prevent the medication from leaking into the subcutaneous tissue and minimizes discomfort by creating a zigzag path in the muscle.

C) Administer the medication in the deltoid muscle:
Ceftriaxone is generally administered in larger muscle groups, such as the vastus lateralis or gluteus muscle, rather than the deltoid. The deltoid is more commonly used for vaccines or smaller volume injections.

D) Administer the medication at a 45° angle:
For IM injections, the needle should be inserted at a 90° angle to the skin. A 45° angle is more appropriate for subcutaneous injections.

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Correct Answer is C

Explanation

A) Wear sterile gloves and break off the neck of the glass ampule with a single snap to the right side:
While wearing gloves can be part of the technique, breaking the ampule to the right side is not standard practice. It is more important to use a sterile gauze pad and break the ampule carefully to avoid glass shards falling into the medication.

B) Tap the bottom of the ampule, place a gauze pad around the ampule neck, and break off the bottom with a forward motion away from the body:
Tapping the bottom of the ampule is not the recommended practice; the top of the ampule should be tapped instead. Additionally, breaking the ampule away from the body is good practice, but it’s crucial to break the top of the ampule, not the bottom.

C) Tap the top of the ampule, place a sterile gauze pad around the ampule neck, and break off the top by bending it toward the body:
This is the correct technique. Tapping the top of the ampule helps to ensure that all the liquid is at the bottom, and placing a sterile gauze pad around the neck protects against glass shards. Breaking the top away from the body reduces the risk of injury and contamination.

D) Wear sterile gloves and break off the neck of the glass ampule with a single snap in a downward motion:
Breaking the ampule downward is not recommended because it can increase the risk of glass shards falling into the medication or causing injury. Proper technique involves breaking the ampule away from the body to ensure safety and avoid contamination.

A. Discard the medication. B. Give the medication. C. Return the medication to the pharmacy. D. Notify the provider.

Correct Answer is A

Explanation

A) Discard the medication:
The safest action is to discard the medication. Medications past their expiration date may not be effective and could potentially be unsafe. Using expired medications can pose risks, and discarding them ensures that the client is not exposed to potentially compromised treatments.

B) Give the medication:
Administering expired medication is not appropriate as it could be ineffective or harmful. The expiration date indicates that the medication may no longer be guaranteed to work as intended or might have degraded, making it unsafe to give.

C) Return the medication to the pharmacy:
Returning expired medication to the pharmacy is not a standard practice. The medication should be disposed of according to facility protocols, and the pharmacy should be notified of the issue so they can take appropriate actions.

D) Notify the provider:
While notifying the provider is important if there are issues with medication availability or alternatives, the immediate action regarding the expired medication itself is to discard it. The provider can be informed as part of addressing the medication issue and determining the next steps.

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A nurse is planning to administer ceftriaxone IM to an adult client. Which of the following actions should the nurse plan to take?

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