Question

a nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. which of the following information should the nurse include in the teaching?

chew on the medication stick to release the medication.
leave the medication stick in one location of the mouth until melted.
allow the medication 1 hr for analgesia effects to begin.
store unused medication sticks in a storage container.

Explanation:

Analyze oral transmucosal fentanyl administration

Using the Fentanyl Patch Education knowledge point, we evaluate the proper administration of oral transmucosal fentanyl citrate (lozenges on a stick). The medication must be placed between the cheek and lower gum and sucked, not chewed or swallowed, to allow absorption through the oral mucosa. It should be moved occasionally from one side of the mouth to the other rather than left in a single spot.

Evaluate onset of action

Oral transmucosal fentanyl is designed for rapid absorption through the mucous membranes, providing fast-acting relief for breakthrough pain. Analgesic effects typically begin within 10 to 15 minutes, not 1 hour.

Determine safe storage and disposal

Fentanyl is a highly potent Schedule II opioid. Unused, partially used, or completed medication sticks present a severe risk of accidental ingestion or fatal overdose, especially to children. Therefore, any unused or partially consumed medication sticks must be stored securely out of reach and disposed of safely (often using the provided storage/disposal container or flushing down the toilet as per specific guidelines).

Identify the correct teaching point

• Chewing: Incorrect. Chewing or swallowing the lozenge reduces its effectiveness due to first-pass metabolism.
• One location: Incorrect. The stick should be moved around the mouth to facilitate absorption and prevent localized mucosal irritation.
• 1 hr onset: Incorrect. Onset is rapid (10–15 minutes).
• Store unused sticks: Correct. Storing unused medication sticks securely in their original child-resistant packaging or designated storage container is vital for safety.

Answer:

• Chew on the medication stick to release the medication.
• Leave the medication stick in one location of the mouth until melted.
• Allow the medication 1 hr for analgesia effects to begin.
• Store unused medication sticks in a storage container. (Correct answer)