A resident in a long-term care facility reports difficulty swallowing enteric coated aspirin and asks the nurse to crush it prior to administration. The most appropriate action for the nurse to take is to
a. crush the tablet and mix with applesauce.
b. encourage the resident to swallow the tablet with a full glass of water.
c. hold the medication and notify the physician.
d. substitute a regular aspirin for the enteric coated tablet.
ANS: C
The medication should be held and the physician notified. The physician has the authority to determine how to proceed in this situation. Enteric coated tablets should not be crushed because this will increase the absorption rate and the potential for toxicity. Geriatric patients may have difficulty swallowing and are at risk for choking and aspiration. They should not be encouraged to swallow medications if they report difficulty swallowing. The physician must determine if a substitution can be ordered. Prescribing is not in the nurse's scope of practice.
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