A nurse is preparing to administer medications to a client. At which of the following times should the nurse compare the medication administration record and the medication label? (Select all that apply.)

A. Use trochanter rolls beside the client's legs.

Trochanter rolls are supportive devices placed alongside the client's hips and thighs to prevent external rotation of the hips and maintain proper alignment of the legs. They help prevent hip abduction and rotation, which can lead to hip dislocation or pressure injuries, especially in immobile clients. Therefore, using trochanter rolls is essential in the care of immobile clients to maintain proper alignment and prevent complications.

B. Place the client's arms at their side when turning them: Placing the client's arms at their side during turning may limit movement and comfort. Instead, the nurse should support the client's arms in a position that promotes comfort and maintains proper alignment.

C. Cross the client's ankles when lying supine: Crossing the client's ankles can lead to compromised circulation and pressure on the bony prominences of the ankles, increasing the risk of pressure injuries. It is not recommended to cross the client's ankles in the supine position.

D. Logroll the client every 4 hr: Logrolling is a technique used to move clients with suspected spinal cord injuries while maintaining spinal alignment. However, it is not necessary to logroll an immobile client every 4 hours unless there are specific indications, such as suspicion of a spinal injury. Frequent repositioning, including the use of trochanter rolls, is essential to prevent pressure injuries and maintain skin integrity but should be individualized based on the client's needs and condition.

. Combine the medications with the formula in the feeding bag:

Combining medications with the enteral feeding formula in the feeding bag is not recommended as it may alter the medication's efficacy or stability. Additionally, mixing medications with the feeding formula could result in interactions between the medications or between the medications and the formula components.

B. Dilute each crushed medication with warm water:

While diluting crushed medications with warm water may facilitate administration through the NG tube, it is not always necessary or appropriate for all medications. Dilution should be done according to specific medication guidelines or manufacturer recommendations. Some medications may not require dilution, while others may require a specific diluent or method of administration.

C. Flush the NG tube with 5 mL of sterile water for irrigation prior to administration.

Flushing the NG tube with 30-60ml sterile water for irrigation before administering medications helps ensure that the tube is clear of any residual feeding formula or medication residue. This step helps prevent potential clogging of the tube and ensures that the medications are delivered effectively to the client's stomach or intestines.

D. Mix the medications together in a single syringe:

Mixing medications together in a single syringe may increase the risk of drug interactions or chemical incompatibilities between the medications. Each medication should be administered separately to ensure accurate dosing and prevent potential interactions. Administering medications separately also allows for better monitoring of the client's response to each medication.