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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Free Nursing Study Resources

Correct Answer is C

Explanation

A) "Crushing the medication is a good idea, and I can mix it in some ice cream for you."
Crushing enteric-coated medications is not advisable as it can disrupt the medication’s intended release mechanism. Enteric coatings are designed to protect the stomach lining and ensure that the medication is released in the intestines. Crushing the medication would bypass these protective mechanisms.

B) "Crushing the medication might cause you to have a stomachache or indigestion."
While this statement is somewhat true, it does not fully address the primary concern. Enteric-coated medications are designed to protect the stomach lining and to ensure proper absorption. Crushing them could lead to other issues beyond just stomachache or indigestion.

C) "Crushing the medication would release all the medication at once, rather than over time."
This is the most accurate response. Enteric-coated aspirin is designed to dissolve in the intestines rather than the stomach, and crushing it would lead to the medication being released all at once, which could potentially cause irritation or harm to the stomach and reduce the medication's effectiveness.

D) "Crushing is unsafe, as it destroys the ingredients in the medication."
While crushing enteric-coated medications can be unsafe, the primary issue is not the destruction of the ingredients but the loss of the medication’s intended release mechanism. This can result in adverse effects or reduced efficacy.

A. A nurse injected Demerol IM into the vastus lateralis site of adult. B. A client received gentamicin intermittent IV bolus over 1 hr. C. A client received a crushed bupropion XL tablet mixed with applesauce. D. A nurse used a 25-gauge 3/8 inch needle to administer a heparin injection.

Correct Answer is C

Explanation

C) A client received a crushed bupropion XL tablet mixed with applesauce:
Extended-release (XL) medications like bupropion XL are designed to release their active ingredients gradually over time. Crushing these tablets can alter their release mechanism, potentially leading to an overdose or reduced efficacy. This is a significant error that should be reported through an incident report to ensure patient safety and evaluate the potential impact of the mistake.

A) A nurse injected Demerol IM into the vastus lateralis site of adult:
Injecting Demerol (meperidine) intramuscularly into the vastus lateralis site is not an error. This site is commonly used for intramuscular injections in adults, though other sites like the deltoid or gluteus maximus are also appropriate depending on the situation.

B) A client received gentamicin intermittent IV bolus over 1 hr:
Gentamicin is often administered as an intermittent IV bolus over a period of time, and administering it over 1 hour is a common practice. This does not indicate an error that would require an incident report.

D) A nurse used a 25-gauge 3/8 inch needle to administer a heparin injection:
Heparin injections are typically administered with a smaller gauge needle, but a 25-gauge needle is acceptable for subcutaneous injections. The needle size might be less than ideal but does not necessarily warrant an incident report unless it directly impacts the effectiveness of the medication or causes an issue.

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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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Explanation

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