Lilley: Pharmacology and the Nursing Process, 9th Edition

Chapter 02: Pharmacologic Principles

Answer Key—Textbook Critical Thinking Exercises

1. Intravenous therapy would be most appropriate because it allows immediate access by the
drug to the bloodstream. With intramuscular (IM) or subcutaneous injectable forms of
medications, absorption of the drug from the vascular area within a muscle or within
subcutaneous tissues is required before absorption into the bloodstream. In a patient who is in
shock or has decreased cardiac output or decreased peripheral circulation, the IM forms would
not be as well absorbed. Lastly, oral forms may not be appropriate because of the longer
absorption time via the gastrointestinal tract, and the patient may not be conscious enough to take
oral drugs because of his critical condition.

2. Crushing an enteric-coated tablet may cause disruption of the coating that is designed to
protect the stomach lining from the local effects of the medication, or it may cause the drug to be
prematurely destroyed by stomach acid. The nurse needs to consult the pharmacist to ask about
the availability of the drug in a liquid form that can be given safely through the enteric tube. If
necessary, the licensed prescriber may have to be contacted to adjust the medication order to an
appropriate form.

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