hi I'm Janisha Thomas I'm your instructor today we're going to be going over safe medication administration as the nurse you are professionally ethnically legally and personally responsible for every dose of medication you administer all of this is very important and if neglected someone can seriously get Hurt So before we get into this little picture above before um even preparing and giving a medication you should be looking up that drug you need to know what the drug is used for where does the drug work what body system it will affect what the drug is made of some drugs can affect more than one body system and can be used for multiple things all of you need to invest in a drug handbook with this picture um at the scene a patient had an you know order for morphine what all has to go into thought for an RN to give that medication right so you need to know the rights right medication right documentation right route right time right client right dosage you need to know um you know how is this medication going to be given you need to know um if you need to follow up on anything so you just need to know everything about that particular drug you want to always check the to that it's the right patient drug those time and R even if you get a verbal prescription you want to repeat it back to that prescriber to make sure you heard it correctly and you also want to ask yourself is this medication suitable for this patient right all right triple check make sure your area is clean gather all supplies needed for Preparation um pull prep P so when you pull the first thing you want to do you want to check against the more right you want to be sure that the name route does and time match the mar entry pull upon initial removal from the dispensing system so before you pull you want to do those things when you get ready to prep you want to check the medication against the mo as well before you pour mix a drw up your medication even before you dispense or put the medication back into the the cart when it's time to pass at the bed side you want to check it again make sure to have the medication ready to present at the bedside you know the patient has the right to know what medication is being given to them okay on this slide um we have um it's a pixes dispensing system um depends on what your hospit to have now in this all the medications are um in the card and as you can see the nurse um goes inside so you have to scan your finger to even get a medication out okay um after you're able to get in you can look up your patient's name look at all the medications and when you decide to pull a medication down at the bottom um once you pick that medication it'll show you where it is and it pops open and this is where you you know you check to make sure you have you get you pull the right medication okay it's called a medication room so you'll be able to prep your medication inside the rooms six rights plus four right patient right time right medication right dose right rout right documentation additional rights right reason right response right to know right to refuse when giving medications you want to make sure that the medication is there if the medication isn't there you're going to call pharmacy and get that medication you're going to document when medication um isn't on time for any reason you always document that don't assume if if a medication is supposed to be given but you don't see it charted don't assume that it was given because then if you do give it then the patient is at risk for an overdose you can give a medication 30 minutes before and 30 minutes after it also depends on the hospital because some some hospitals let you give the medication an hour before um give you that time an hour before hour after if you don't know how to or where to give them medication you want to look it [Music] up if for any reason you make a mistake for example giving the wrong dose giving the wrong medication mixing up patients give the wrong medicine you must immediately assess the patient vitals and physical status then report it to the doctor the PCP you would then follow your Institution policy andile a report Etc but that is after you take care of your patient do not leave any medications at the bedside and when it is time to administer or give medication you want to make sure you check for identification with the additional rights right reason um this would just be you know if a patient was on was you know prescribe a sleeping Med medication and because the patient can't sleep and they're very anxious and you know anxious about a surgery coming up or whatnot but not for the convenience of yourself or you know any other nurse um is basically for the patients not for you like for your own personal reasons okay you can't get mad and say you know what I'm going to put this patient to sleep because this patient is working on my nerves no it has to be for a right reason right to know you should tell the patient the name of the medication why it is being given um what is used for and potential side effects and of course the patient has the right to refuse regardless of the reason they can refuse at any time for you know whatever all right seven parts of an order every medication prior to administering must have an order or prescription for my doctor so this this J right here is nxone these are for patients you know that is addicted to have a dependence or narcotics so right here the first thing is a patient's name you need the name um name address okay and then the second thing is you have the actual medication the third thing you want to make sure you have the 8.6 mg 2.1 mg right then for you want to know well including with the dosage is two tabs right um then four you want to know where is sublingual two tabs of lingle you g two tabs underneath the tongue five how many times so once daily six she have a date when it's prescribed seven the actual Physicians that's that's given it okay so you need all of these parts for proper order and also if it's a written prescription it must have the PTI I mean the doctor's DEA on it okay all right all right all medication um so with pills um you know you don't touch them you have to wear your gloves you set them up this is the most used route for medication you know pills with liquid you just want to make sure you pick the right cup okay so if it's in tablespoon you want to pick that cup with tablespoon on it if it has ounces or milliliters you want to make sure that cup has ounces and milliliters on it right um make sure you're able to put it on a flat surface and then when you're pouring this liquid you want to make sure that it's at eye level you you're pouring at eye level um and making sure it's on the correct line with with Buco and sublingual medications these medications are placed in your mouth they are rapidly absorbed um rather than in the actual G track so these medications with the sublingual you're placing this medication directly under the tongue and with the bual medication um is like onside the cheek inside your cheek on side the tongue and with those two you don't leave until it's dissolved don't drink flers or eat until it's dissolve okay interal medication um is for these patients that that cannot swallow or have um feeding tools you know you can give oral medication through NG the the gastrostomy or the jeno tubes right um as far as metam you do not give this medication through the feeding tools because they attract water and will solidify the tooth you're going to stop tubing stop um Tobe feedings and stop suction 30 minutes after for crushing tablets you know you cannot Crush certain certain tablets because crushing them can change that action like the the interor recorded extended release medications right you want to also always check those J reference and sources as far as continuous Tobe feedings you want to disconnect flush the tube in before given medications you're going to flush before and after as far as interal tooth section you want to discontinue stop that section for 30 minutes after Administration again keep the tube clamp allow the tube for the drug to be absorbed um if needed so let's go over the steps you want to get gather your supplies um you have your Pistons dur ringe medication cups water peill Crusher gloves you want to place the patient in high fers position check placement do multiple checks you know you want to make sure the patient um does have certain conditions you want to check x-ray um make sure the patient want aspirate Etc check for residuals then you're going to flush the tub in with 30 MS of um water you want to instill that medication you want to flush 5 to 10 ms between each medication and then you want to flush with 30 MS after the medication sit for at least 30 minutes you want to make sure you stop the feeding to when you giving your medications okay you always want to stop the feeds if need an empty stomach you want to wait 30 minutes after stopping the feeding as far as special consideration uh you just want to be mindful of certain medications that discolor the teeth uh use a straw or dilute medic some may have like bad taste you can like the ice sh and the taste buds um stuff you have to be mindful of if the patient is n that mean what they do do not get anything um nothing by mou um patient has comos risk for aspiration signs and symptoms of Nan vomiting you want to um figure out alternative routes for medication you know if they have trouble swallowing again you want to crush those pills you want to mix it into a liquid or applesauce and you want to know what kind of pills can be crushed or split right as far as the elderly we just know that they have a decreased absorption everything is slower slower with elderly and I want to say that is it unless you guys have any questions regarding this information okay oh also I want to point out as far as the NG tubes um when you you're um measuring and I can actually show you this um you're going to measure from the it's ear ear to nose down to Z for process but we'll get into it lotion screams and ointments ex say for skin Kindra indications um you want to make sure the skin is not irritated you want to make sure that the skin doesn't have any open lesions when applying these lotion cream ointments you want to use a have on gloves right you want to use cotton swad a tongue blade or a glove finger to rub on these um skin lesions or irritations Aeros Sol powder this right here this is a naizer they are different types but the they all deliver um spray powder mist from a liquid drug the patient inhales and it absorbs through the respiratory tract your book shows you an inhaler and advantage of this is that you get pump or push a high dose of medication directly to your lungs avoiding systemic side effects disadvantage is that you have to manually push the canister to administer that do that particular do trans thermal you want to make sure you clean the skin wear gloves rotate sights write the date time and initials after placement at advise the patient not to use a heating pad with these patches um it absorbs through the skin and releases constant control amounts of medication over 24 to 72 hours example of these patches are nicotine nitroglycerin patches when you do remove the new patch right they have a protective covering um with this protective covering you want to make sure you don't touch the adhesive or the inside part of that because it contains the medication you want to put this patch on a clean dry hair list or minimum hair skin area right you want to make sure you press it down for about 10 seconds with your palm and make sure that this area is free of scars lesions or irritations right um always rotate sights again these SES are you know trunk L stomach Lura back but o and when I said um do not use the heating pads is because you know the ointments um can become irritable or even burn the patient's skin right um write the date time and initials on the patch and you Al always want to wash your hands before and after installations with installations these are drops sprays aerosols right for opal this medication goes into your wear your eyes so you want to make sure you position a patient in a high fers position um hair relax back you want to make sure you have on gloves we going clean the edges of the eye inner to Outer you're going to use your dominant hand on the forehead pull the lower lid with the non-dominant hand position the eye drop about half an inch to an inch patient um ask patient to look up drop the insallation into the medication into the conjunctive of SEC ask the patient to blank several times then you're going to hold the sa mod duct for about 1 to 2 minutes and this goes as this the same for o as well never drop onto the eye or never drop the ointment on the eye never let the bottle touch the eyeball okay these are things you should never do those three things itic actic is the air um the room should be at room temperature not cold nor hot cuz this can call vertigal a vertical sorry vertical and all your environment you want to lay the patient on the side clean external air straighten the air canal and instead the prescribed drops on side of ear for um old the kids and adults going to pull the ear up do not touch dropper on the ear after you instill the medication you're going to tug on the air at the drops for about 5 to 10 seconds you're going to tell a patient to lay on their side for about 5 to 10 minutes you're going to place a cotton ball for about 15 minutes inside the air nasal your no patient can pretty much do these themselves it's different from the book you just want to make sure you set a patient nose over toes so they're going to bend forward with the opposite hand for opposite nostril breathe out when next inhale the spree and you want to repeat it you want to make sure you don't touch the dropper to the nose do not blow the nose after for five minutes okay you can blow your nose before to clean out any you know boogers or mucus before you actually put the medication a spray inside the nose Okay um as far as vaginal you want to make sure the bladder is empty so empty the bladder position the patient a dorsal recant or a Sims position remove the wrapper or Draw up needed amount make sure you have on gloves um clean the vagina lube the medication or tube you want to separate the labia insert suris to 3 in and inject if needed stay in position for 5 to 15 minutes recto um empty the rectum when to place the patient in Sim's position want to make sure you have on gloves unwrap and Lube the medication separate the buttock insert suppository it a half an inch to 1 in for infants it'll be about 1 to three I mean for infants is a half an inch to an inch and for adults it's about 1 to 3 in retain suppository white stay sideline for at least 10 minutes okay kind of went over Na's treatment a little already for MDI and DPI um patient should be in high followers rinse them out Shake remove cap breathe out slowly place the spacer in the mouth SE lips press down and breathe in slowly hold breath for 10 seconds wait one minute and deliver another puff cortical steroids rinse out after whitee mouthpiece DPI is a dry powder inhalation don't use spacer one breath usually for those all right par interal medications equipment and what we can reuse and what we cannot reuse what is thorough what is not all right so we have needles um gauges bevel's lens hubs syringe can be pre-filled they have disposable pre-fill syringes safety syringes Ono syringes you know you have tip Barrel plunger flanges and and here is a picture so what parts on the syringe is sterile the bevel which is that opening at the end of the needle the needle and our shaft of the plunger the tip inside of the barrel and the actual plunger is sterile you should not be touching any of those things the only part of the syringe you can touch is the barrel and the the bottom part of that pager the end of it the bevel and everything else is there all right so this first picture um this is a low a is a lower lock syringe it twists on you see this um it has a thicker part where it twists on and then B is a non low lock that just slips on and off right here is is a prefill unit do system and other is a disposable prefill self-contained system so normally um you will see the disposable ones in the hospital and these syringes are like um lenx are um they're already prefilled and you basically just twisting it up attach the needle and give the medication it's already have the correct dose and everything in it this last picture um the first one is the insulin syringe so it's 100 units the second one is a TB syringe is 1 mil 1 mil TB syringe and 0.01 M increments and I'll show you that more in class the third one is a 3 m standard syringe and 0.1 M increments I'm going let you guys take a look at the differences uh the first picture we have safety syringe uh guard uh is guarded which is away you want to make sure the syringes the needle is away from you um you have before and after use of injection you have the top on and the medication has been given um right here you have the sliding needle with the Shield attached so um some needles just come with the actual top or Shield b um this arrange has a retractable needle and I'll show you once you push that plunger the needle retracts back and C has a needle with the covers attached so some of them did just have a cover and you just um flip that attachment uh the cover part on to the needle all right um drawing up medications um you can drop a medication out of a vow or ampule um with these well with the ampute medications or the vows sometime you may have to reconstitute uh mix meds so when it's time to prep these medication for The Vow you want to wipe the top I don't have a picture of The Vow but I will show you um you just want to wipe the top of the vow draw up air insert the needle invert it inject the air withdraw the do okay I'll show you that more in dep um with the ampule you want to make sure you have the proper supplies you want to make sure you break the ampu away within with a gauze okay a gauze or with um alcohol white that's unopen you're going to invert it amp you and you're going to withdraw the dose do not break the ampu with your hands or with uh alcohol the actual alcohol white when it's time to reconstitute medications U you're going to use sterile water saline um it's going to stated it on the powder V it's going to let you know mix in you want to make sure you check compatibility the total do is within um acceptable limits of that and they both have the same route how do you know they are compatible what happens when they are not um most medications come with what they're compatible with um some you have to look up um what happens when they're not compatible um you will see a color change um the solution might become cloudy or something um might see bubbles might see small particles anytime the actual medication changes you know then that's a problem you don't want to give that medication as far as Dead Space um for subcutaneous you can have like 0.2 M of air to drive medications into like um let's say A linge you want to make sure you change the needles after drawing up the medication right so they're saying that some of the needles have air in them and that the is not receiving all the medication so with this you're going to add air and then when you switch it you want to I guess I could probably show you more in depth um but you're going to change the needles after drawing up the m and just be sure there isn't any in the O needle and then when you push that air in it's going to push that push the rest of the medication out okay never recap a contaminated needle um meaning after giving an injection you place it uncap right into the sharps dispos a container this is to protect you from sticking yourself and being exposed to pathogens sometimes in certain situation you may have to recap a contamin need for an example like me and a nicku um sometimes we had to draw blood U keep a certain amount if you know if needed because you know with the babies is a little different so with one hand you will use the scoop method it's done by placing syringe in the top that's placed on the table and then you just scoop it up and just attach that cap and now with sterile recapping is a little bit different but you should not ever recap a contaminated needle okay just wrap it in the Box please with the Disposable they have different disposable containers um this is the medical way disposable chart you have your Sharps container container where you put all your needles your ampules your broken glass Staples um you know your med medications and stuff in the sharp container for that biohazard container this is where like the blood products weights IV tubing and um ppes and everything go into and every floor has this room with the biohazards and everything in it okay um this is the chemo container only Cho items and everything goes in that yellow container this is your um RC Hazard container hazardous things and different things go into there it'll tell you pharmaceutical this is a white container pills injectables antibiotics and radio after most of the time you're going to just see the sharps container and the buyer has but sure with these you do not want to over full or place your hand inside okay so especially for your Sharps container if it is full do not place your hand inside trying to push disarrange or whatever down because you can potentially stick yourself Comfort safties considerations um when giving a medication or injecting a patient you want to distract the patient okay um some patients may have anxiety about getting an injection or or MK you want to you know calm them down you want to provide therapeutic communication you want to relieve any anxiety by explaining the seizure and you want to ask ask them why or what they know about the medication if given an injection sometimes you can apply gentle pressure gentle you want to minimize pain especially for kids if a patient is to rebleed you want to make sure you apply pressure to the sight until the bleeding stops do not want to massage you don't want to give any additional dosages um you want to make sure when it's time to give a certain medication um you want to know the type of medication giv um what size needle you should be using for that particular patient um for an example we may have an obese patient no okay we're going to do both may have an obese patient that's getting um a subq Hein or right let's do that okay um you want to make sure you know where to give that injection right most of the time some patients like that injection in the stomach behind that behind your arm that fatty part of your arm um you want to know the situation can it get it behind the arm right so you want to make sure that the volume is correct you want to put that medication in the wrong tissue you want to give that Heine I am you don't want to give a give that medication in the wrong sight so even with giving that medication you need to know what needle was size to use it's different for an obese patient um and it's different for if you had a thinner patient you want to use the smallest needle suit for that sight and when you're injecting a dosage you want to make sure you're using one hand and that it is steady and when you go in you come out the same way when drawing up that medication you want to use two needles to draw it up because you want to switch out after you draw up that medication you want to switch out that needle the actual needle that you're inserting into the patient and when you do give that medication you want to make sure it is slow and steady all right so let's get into those sites intradermal sites um these are the sites that you can give right at the inoda so inas this is literally right under the skin um this is for allergy testing or what TB testing you want to use a 26 to 28 gauge needle um it should be 3/8 to 34 in length this is a one M syringe and what angle it should be at I have a little picture on here it should be 5 to 15° angle do not apply pressure or massage with this injection because at this site the capillaries and the Derma tissue will absor absorb that m quickly all right so here is the subcutaneous sights you have the back of your arm your abdomen your vestus L muscle the back of your back and more so of the hips all right the angle with this well with the with this sight subcutaneously you can give these injections uh you know these are for like insulin insulin injections um in the arm 0.3 Ms no more than 0.3 m in the arm no more than 0.5 m in the abdomen no more than one m in the thigh you're going to use a 28 to 31 gauge needle the length should be 3 by 16 to 1 in and the arm 5 eight or 0.3 to 0.5 in R what degree angle you should be in 45 to 90° angle sub Q is normally 35° angle we only pretty much inject at a 903 90° angle is when I was talking about before when you have a patient that is thicker or obese with a longer needle as well you can also use a 25 to 27 gauge 3x8 to 58 in 1 to 3 m syringe at a 45 to 90° angle with this um site is slower absorption what do you want to avoid you want to avoid um the skin with Burns burp marks scars inflamed tissues lesions bony pinises large underlying vessels or nerves and when it's time to inject this medication in the abdomen you want to make sure you're 2 in around the the unb likeus which is your belly button repeated injections should be at least 1 inch apart and you want to make sure you rotate sights to minimize scoring and hardening of the fatty tissue special considerations insulin um insulin uh the doctor provides you a time uh they have different categories and different injectors okay also with heid is different as well um but with insulin you have a um sliding scale specific times is based on the patient's glucose level you have your basil insulins you have mph your lantis your Le those the Le is long acting um p is M time and that pre is regular humin or noin art rapid human log Nova log um it depends on the patient their condition and what the The Physician prescribes with these medications this is a two Nur check you have to have two nurses checking this with Heine um is giv IV subq only if you make a mistake and give it I M intramuscular it will cause hematoma and pain so normally this medication happing is given in the abdomen for school level one purposes we're giving in the abdomen okay two inches away from the umbilicus umbilicus uh love handles for herin only can um do Hein you know in AB too and this is a tun n check as well also I'll show you a picture uh maybe in class um this pen how you draw up the insulin um they have like the units the bar and you just pretty much stick prick and give the shots um some of these can be in combinations as well so you know intramuscular injections um you have delto V lad is I just realized I say lad is on that um the but I mean for something else but okay intramuscular injections Delo vus letter is and ventral glal okay um delto injection is given at a 90° angle all I injections is given at a 90° angle U FID deltoid which is in the arm is 0.5 to 1 mil you're going to use a 22 to 25 gauge 1 to 1 and 1/2 in and length 1 M syring okay fastest lad is 3 to 5 Ms can be administer 22 to 25 gauge range 1 to 1 and 1 12 to 3 in length in needle and a 1 to 3 m syringe can be used vro glut Glu 2.5 to 3 m can be a minister 20 to 25 gauge to range a half in to 3 in 3 m to rench I mean 1 and A2 in to 3 in 3 m Ren 90° angle uh based on the medication given you can aspirate to prevent uh blood vessels but it's based on the medication and U you have to follow your hospital policy um this is not used in vases lad is Del or children so you do not aspirate at those sites and um in children the z track I have a picture you're going to use your the side of the nine dominant hand you're going to displace the skin away wait a few seconds the book says 10 remove the needle then let go of the skin so I'll show you and clap right with the the Del mention um I'll show you you know you have a clavical next to that is the chromating process and from there you're going to use your fingers to locate that deltoid you know and make that little triangle um angle or whatever we don't use this site on infants okay but then after you find that location we're going to use that z track method where we uh pull the skin to the side and insert your needle at a 90° angle um as far as the anterior thigh the site prefer is vast as L is for adults and children and you want to pinch up when injecting that needle because you want to make sure you know we preventing the needle from penetrating into the bone okay here we have this table in your book table 264 you want to learn these route sights volume max volumes the gauge the length the syringe and importantly the angle of an injection how to hold an injection um ventral gluteal you want to use your index f finger on anterior superior iliac spite Palm on G True cancer the other fingers on the ilc crest thumb towards belly belly button inject in that triangle area deltoid um you know we did the two to three finger breits below a chromium process make a c inject in the middle vastus latus one Palm on greater tro chancer one on the lateral femoral kindal visualize a rectangle and insert here is the picture of your intramuscular injection site these are easier done when you actually do them and place your hand in each injection site ad Ministry of medication education you want to use the smallest needle suited for sighted medication use two needles when drawing up a medication do not administer too much solution into an injection site assist patient to relax relax those muscles use z track method pull skin T and insert needle quickly but give the medication what slowly and steady okay steady syringe with one hand inject medication slowly H distract patient acknowledge their pain use distraction methods to decrease pain like you can tap on the arm before injecting a medication you know it sends some type of signal to the brain and it's still like they still remember that tapping and then you just insert the medication and then that's supposed to feel it as much never massage an injection site okay never massage an injection site all right let's get into these questions question one which aspects are a part of the six rights of the medication administration select all that apply a right to refuse B right to Patient C right medication d right training e right certification give you some time the answer is right medication right dose right Pati right r r frequency documentation question number two a patient is prescribed a dating medication withn side effect of driness when is the time for theur to administer this medication a in the morning B in the afternoon C in the evening d as needed for pain the answer is C in the evening a nurse is parent to administer medication to a pediatric patient the child weighs 22 PBS the UT dose is 0 Mig per kilog how many milligrams should the nurse administer so I'm going give you a little time to figure this out all right so I'mma help you since we going you know doing this on video so the answer is B and uh you want to make sure you convert pounds to kilog right so after you convert um so you should be doing 22 / 2.2 you should get 10 and then the rest is hisory you multiply that by 0.5 and the answer is 5 Mig our nurses question four a nurse is preparent to administer medication to a patient the medication is ordered as 50 mg but the available vowel contains 100 Mig per me how many milliliters should the nurse administer this one is easier as well um because you don't have to convert anything milligrams for milligram Time Mill so you have desire over have right d over H time M um you desire what 50 which is the order you have 100 so 50 / 100 = 0.5 time one so it's eight eight 0.5 mil question five a patient is prescribed a subcutaneous injection of a medication what Factor should the nurse consider When selecting the injection site a choose a site close to a major blood vessel B avoid areas with increased subcutaneous fat C rotate injection site to prevent tissue damage D administer the injection directly over a bony prominence so we can exclude the already right because we say we can't do anything shouldn't be injecting anything over bony pin right the answer is C rotate injection state to prevent tissue damage you want to prevent scarring and hardening that uh tissue so it don't interfere with absorb absorbing those medication question six a nurse's preparing administer medications to a group of patients which actions are essential for ensuring safe medication Administration select all that apply a verify patient allergies B administer medications without checking the patient identification C use the six rights when administering medications D Crush intered tablets for patients with difficulty swallowing I see inter rck R okay e administer medications from unlabeled containers f encourage patients to self administer all medications the answer is a and C verify patients allergies choose the six rights question seven a nurse is assessing a patient ability to swallow which action would the nurse perform to ensure the patient can swallow a give the patient a sip of water from a spoon B assess the patient vital for hypertension C ask the patient for their name and dat sucessful horseness D ask the prev visitors how to Pati ate dinner e ask the patient to lick their lips the answer is a and c and e give the patient a sip of water from a spoon ask the patient for the name date of birth and assess for heness and E ask the patient to lick their lips question eight a nurse is fast in morning medications which action is most appropriate for the nurse to provide appropriate care according to the guidelines for perinal medication administration I'm give you some time to read each one the answer is c p p the injection site before deciding to use it question n which admin medication order written at 0800 or 8 a.m. by Dr auso should the nurse question and Miss be smart a have torside 20 mg stat B penicillin 1 G intramuscular 1 C hydrocon acetoin 5 mg to 325 Mig every 4 hours by m it's needed for pain the humin L insulin 35 units subq AC and H HS the answer is a this diuretic is used tree sing right but what's the problem it's missing a rout so it's eight question 10 a patient vs 15 minutes after ministering the morning oral medications what is the priority nursing action a give the patient an additional dose for each medication B notify the healthare provider C administer PRN anti-me medication the allow the patient to brush their te the answer is B notify the healthare provider question 11 a nurse must administer a medication that is supplied in ampute what should the nurse do first to access the medication a break the constricted neck of the amp you using a gauze B wipe the constricted neck with with an alcohol T C insert the needle into the center of the Rubber seal D inject the same amount of air as the fluid to be removed the answer is a breath the constricted NE of the ampu using the GS question 12 a nurse is guar for a patient with a Hyer hypertension when administering a patients daily morning 9:00 a.m. low certain the nurse notes that the 8:00 blood pressure is 115 over 75 what should the nurse do next a rake the patient V signs including the post B hold the medication because the blood pressure is normal C notify the health provider of the vitals the give the morning medications is prescrib the answer is D and you should know why but if not we'll discuss it all right life short who's ready to take a shot at it any questions thank you this concludes our medication administration lecture thank you