When yоu аre plаnning yоur methоd of prompting, you need to be аware of the number of prompts the method you select will need. Which of the following methods require more than one prompt to be used?
The nurse reseаrcher is interested in describing аnd summаrizing the characteristics оf the sample used in the research study. In оrder fоr this to occur, the researcher should use:
PARENTERAL ROUTES OF ADMINISTRATION Intrаvenоus (IV) Injectiоn Mechаnism Drug is directly intrоduced into systemic circulаtion Bypasses all absorption barriers (GI tract, skin, tissue interstitium) Immediate systemic distribution Advantages No first-pass metabolism Avoids hepatic enzymatic degradation before systemic circulation No GI influence Not affected by pH, enzymes, or food interactions Protein drug compatibility Proteins bypass GI enzymatic degradation Immediate effect Direct vascular entry → rapid pharmacodynamic response Use in critical states Effective when GI absorption is unreliable (coma, seizures) 100% bioavailability Entire dose reaches circulation Large volume administration Venous system tolerates higher fluid loads Disadvantages Irreversibility Cannot stop absorption once administered Sterility requirement Direct bloodstream access → high infection risk Requires technical skill Vascular access needed Local vascular injury Endothelial irritation → inflammation (phlebitis) Possible pain, bleeding, tissue irritation Intramuscular (IM) Injection Mechanism Drug deposited into skeletal muscle Absorption occurs via: Capillary diffusion (fast component) Lymphatic uptake (slow component) Advantages Relatively rapid absorption Slower than IV due to tissue diffusion barrier Useful in emergencies/unconscious patients Easier access than IV No venous cannulation required High bioavailability But less than IV due to partial tissue uptake variability Depot formulations Oily preparations form tissue reservoirs → sustained release Disadvantages Volume limitation (≤ 5 mL) Limited muscle capacity and diffusion area Bleeding risk in anticoagulated patients Muscle hematoma due to vascular injury Local tissue injury Pain, inflammation Fibrosis with repeated injections Possible sterile abscess formation Intradermal (ID) Site Dermis (highly vascular but small volume capacity) Uses Vaccines Allergy/sensitivity testing Limitations Very small volume (≤ 0.5 mL) Local inflammatory reactions common Subcutaneous (SC) Site Subcutaneous connective/adipose tissue Example Insulin (slow, predictable absorption) Advantages (SC & ID) Easier than IV access Suitable when slow systemic absorption is desired Can be used when IV access is not necessary Disadvantages Limited volume SC ≤ 2 mL, ID ≤ 0.5 mL Local tissue reactions Pain, irritation Inflammation and fibrosis from repeated exposure Variable absorption Influenced by local blood flow Inhalation Route Mechanism Drug delivered to respiratory tract Absorbed across: Nasal mucosa Bronchial epithelium Alveolar-capillary membrane (systemic delivery) Advantages Rapid onset Large surface area + high vascularity (alveoli) Local effects Bronchodilation (e.g., airway smooth muscle relaxation) Nasal decongestion Systemic delivery Volatile anesthetics absorbed via lungs Disadvantages Irregular absorption Variable ventilation/perfusion matching Airway irritation Triggers cough reflex and bronchospasm Swallowing loss 일부 drug enters GI tract → altered absorption pathway Transdermal Administration Mechanism Drug diffuses through: Stratum corneum → epidermis → dermis → systemic circulation Lipophilic drugs favored due to skin barrier properties Advantages Non-invasive and convenient Controlled systemic delivery Steady absorption over time Reversible Drug exposure stops upon patch removal Disadvantages Variable absorption Affected by: Skin thickness Temperature (increases perfusion) Local blood flow Skin irritation Contact dermatitis Local inflammation at application site Question: A patient in shock requires a medication that provides immediate effect with 100% bioavailability and bypasses first-pass metabolism; which route of administration is most appropriate?