A nurse is teaching a class about safe medication administration. The nurse should include in the teaching that which of the following references are acceptable for safe medication administration? (Select all that apply.)

A. Give the medication: Administering expired medication poses potential risks to the client's safety and efficacy of treatment. Therefore, giving the medication is not appropriate.

B. Discard the medication: Expired medications may have decreased potency or even become harmful due to chemical changes over time. It is essential to discard expired medications to ensure client safety and maintain the effectiveness of treatment.

C. Notify the provider: While it's important to communicate issues related to medication administration to the healthcare provider, in this case, the expired medication should not be used regardless of provider notification.

D. Return the medication to the pharmacy: Returning expired medication to the pharmacy might be appropriate in some settings, but it is not the primary action to take in this situation. The priority is to ensure the client does not receive expired medication.

B. Shake the container vigorously:

This is the correct action. Phenytoin suspension tends to settle over time, leading to non-uniform distribution of the medication in the suspension. Therefore, shaking the container vigorously before administering each dose ensures proper dispersion of the medication and helps maintain consistent drug concentration, thus promoting therapeutic efficacy.

A. Check the child's blood pressure:

Checking the child's blood pressure is not directly related to the administration of phenytoin suspension. Monitoring blood pressure may be indicated in certain clinical situations or with certain medications, but it is not specifically required before administering phenytoin suspension.

C. Be sure the child has not eaten within the hour:

While it's important to consider food-drug interactions with certain medications, such as those affected by food intake, there are no specific dietary restrictions associated with phenytoin suspension administration. Therefore, checking whether the child has eaten within the hour is not a necessary step before administering phenytoin suspension.

D. Perform mouth care:

Performing mouth care is not directly related to the administration of phenytoin suspension. However, oral hygiene is important for overall health, especially in children who may have difficulty performing adequate mouth care independently. While mouth care should be encouraged, it is not specifically required before administering phenytoin suspension.