The nurse is teaching a patient about the long-term use of Fluticasone. The patient demonstrates understanding when they state:

Choice A reason: CT scan with contrast is an order that the nurse should question for the client who is taking metformin for hyperglycemia. Metformin is a medication that lowers the blood glucose level by decreasing the hepatic glucose production and increasing the insulin sensitivity¹. Metformin can cause a rare but serious complication called lactic acidosis, which is a buildup of lactic acid in the blood that can cause symptoms such as weakness, nausea, vomiting, or breathing problems. CT scan with contrast involves injecting iodinated contrast material into the bloodstream, which can affect the kidney function and increase the risk of lactic acidosis in patients taking metformin. The nurse should consult with the prescriber and the pharmacist about the need to stop metformin before and after the CT scan with contrast, and to monitor the kidney function and the blood glucose level of the client.

Choice B reason: Chest X-ray 1 view is not an order that the nurse should question for the client who is taking metformin for hyperglycemia. Chest X-ray is a diagnostic test that uses a small amount of radiation to produce images of the lungs, heart, and chest wall. Chest X-ray does not involve any contrast material or affect the kidney function or the blood glucose level. The nurse should follow the standard precautions and procedures for performing a chest X-ray, such as verifying the client's identity, checking for pregnancy, removing any metal objects, and positioning the client properly.

Choice C reason: V/Q scan is not an order that the nurse should question for the client who is taking metformin for hyperglycemia. V/Q scan is a diagnostic test that measures the ventilation and perfusion of the lungs, and can detect any abnormalities such as pulmonary embolism or chronic obstructive pulmonary disease. V/Q scan involves injecting a radioactive tracer into the bloodstream and inhaling a radioactive gas, which are then detected by a special camera. V/Q scan does not affect the kidney function or the blood glucose level. The nurse should follow the standard precautions and procedures for performing a V/Q scan, such as verifying the client's identity, checking for allergies, explaining the procedure, and monitoring the vital signs.

Choice D reason: Bilateral lower extremity ultrasound is not an order that the nurse should question for the client who is taking metformin for hyperglycemia. Bilateral lower extremity ultrasound is a diagnostic test that uses sound waves to produce images of the blood vessels in the legs, and can detect any abnormalities such as deep vein thrombosis or peripheral arterial disease. Bilateral lower extremity ultrasound does not involve any contrast material or affect the kidney function or the blood glucose level. The nurse should follow the standard precautions and procedures for performing a bilateral lower extremity ultrasound, such as verifying the client's identity, explaining the procedure, and applying a gel and a probe to the legs.

The correct answer is: a. Right route, c. Right dose, d. Right person, e. Right documentation, f. Right medication.

Choice A: Right route

The right route ensures that the medication is administered via the correct method, such as oral, intravenous, or intramuscular. This is crucial because different routes can affect the medication’s absorption and effectiveness. Administering medication via the wrong route can lead to ineffective treatment or even harm the patient.

Choice B: Right to refuse

While patients do have the right to refuse medication, this is not one of the five main rights of medication administration. The five main rights focus on the correct administration process to ensure patient safety and effective treatment.

Choice C: Right dose

The right dose ensures that the patient receives the correct amount of medication. Administering too much or too little can lead to adverse effects or ineffective treatment. This right involves verifying the prescribed dose and measuring it accurately.

Choice D: Right person

The right person ensures that the medication is given to the correct patient. This is typically verified using two identifyers, such as the patient’s name and date of birth, to prevent medication errors.

Choice E: Right documentation

The right documentation involves accurately recording the administration of the medication. This includes noting the time, dose, route, and any observations. Proper documentation is essential for maintaining accurate medical records and ensuring continuity of care.

Choice F: Right medication

The right medication ensures that the correct drug is given to the patient. This involves checking the medication label against the doctor’s order to prevent errors. Administering the wrong medication can have serious consequences.