1.5 Medication Administration (Part 1)

Question 1

Drug Nomeclature

Answer 1

• Generic/Trade Names

Generic - Name of medication assigned by the manufacturer who first developed it
(Lowercase - How its identified in official publications)

Trade - Name given by manufacturer.

Question 2

Drug Classifications

Answer 2

• Classified by the effect on body system
• Chemical composition, clinical indication, or therapeutic action

Class - Refers to Mechanism of Action, physiological effect, chemical structure of medication

Therapeutic Class - Clinical indication for the drug or therapeutic action

Question 3

Side Effects/Adverse Effects

Answer 3

Side effect - Non-therapeutic reaction to a drug. Usually uncomfortable

Adverse effect - Often require lowering a dose or discontinuing the drug.

Contraindications/precautions - Condition where drug should be given with caution or not given at all

Question 4

Pregnancy Categories

Answer 4

• Requires knowledge of gestational age
  Category A - No risk to fetus in any trimester
  Category B - No demonstrated adverse effects in animal studies
  Category C - Studies with animals show no risk but cannot rule out issues in humans. Benefits outweigh the risk. (Most medications are in this category)
  Category D - Definite Fetal Risk. Used only in life threatening condition. (Chemo-Therapy)
  Category X - Never given during pregnancy

Question 5

Mechanisms of Action

Answer 5

Action - How the drug works
Indication - Reason for using the drug
Allergic Reaction - Immunologically sensitive to medication so body releases antibodies. Severe allergies patient should wear medical alert bracelet

Question 6

Nursing Implications of Drug Administeration

Answer 6

• Monitor interactions (drug taken with food)
• Monitor vital signs or labs to see if drug should be withheld
• Lab values also show if drug is in therapeutic range

Question 7

Absorption

Answer 7

Factors that Effect Absorption

• Route of administration
• Ability for medication to dissolve
• Blood flow to site of administration
• Body surface area
• Lipid solubility

Question 8

Absorption (cont)

Answer 8

• Medication applied to skin is usually slowly absorbed
• Oral is also slow due to going through GI Tract
• Respiratory and mucous membrane is quick
• IV is quickest

Question 9

Distribution

Answer 9

• Depends on physical and chemical properties of medication
• Physiology of person using it (circulation, membrane permeability, protein binding)
• Rate/Extent of distribution depends on physical and chemical properties of medication and physiology of person

Question 10

Distribution

Answer 10

• Speed depends on vascularity of organ/tissue

- Degree of medication binding to serum proteins affect medical distribution

Question 11

Metabolism

Answer 11

Biotransformation - Influence of enzymes that break down and detoxify drugs. (Metabolism)

Question 12

Excretion

Answer 12

Chemical makeup of medication determines organ of excretion

• Medication that enter hepatic circulation are broken down in liver and secreted into bile.
• Exocrine glands excrete lipid-soluble medications

Question 13

Justice

Answer 13

Client has the right to receive
- Right Drug, Right Dose, Right Route, Right Time
In addition right to
- Nurse careful assessment, management, and evaluation of drug therapy
- Actions promoting clients safety and well-being
- Nurse obligation to maintain high standard of care

Question 14

Fidelity

Answer 14

• Nurse should always keep their promise

Question 15

Criminal Law

Answer 15

Offenses against the general public

• Unlawful use, possession, administration of controlled substance
• Alcohol/drug abuse

Question 16

Civil Law

Answer 16

• Legal rights and duties of a single person
  (Claims nurse has failed to meet required standards of care)
• Mistakes in administering medication

Question 17

Negligience

Answer 17

Medication error

• Assess the client
• Notify healthcare provider
• Error-in medication form or incident report
• Appropriate action taken under provider

Question 18

Malpractice

Answer 18

Duty - Claim that nurse owed client special duty of care
Breach of duty - Nurse failed to meet standards
Harm/Injury - Claim resulted in harm of patient nurse did not meet standards of care
Damages - Claim of damages where compensation is sought.

Question 19

Beneficence/Nonmaleficence

Answer 19

Beneficence - Nurse should act in patients best interest

Nonmaleficence - Nurse must not inflict harm or prevent whenever possible to patient.

Question 20

Conversions to Remember

Answer 20

1 oz = 30 mL
1 lb = 16 oz
1 cup = 8 oz
1 tsp = 5 mL
1 TBSP = 15 mL
1 kg = 2.2 lb

Question 21

Medical Reconciliation

Answer 21

• When patient is admitted to hospital you must compare medication of client has been taking before admission with medication organization will provide
• Gain thorough medication history to prevent interactions

Question 22

Safeguards of medication administration

Answer 22

Always start with hand hygiene and wear gloves for medication that can be absorbed through the hand
- Mask/eye protection may be needed for respiratory particles released into the air

Question 23

Controlled Substances

Answer 23

2 nurses must check medications to ensure they are administered correctly

Question 24

Required information for controlled substances

Answer 24

• Name of patient
• Name of provider
• Name of nurse administering
• Name of medication
• Hour narcotic was given
• Name of nurse who double checked

Question 25

Verify patient at bedside

Answer 25

• Verify Identification Bracelet
• Verify Name (First Identifier)
• Verify ID#, MRN#, Birth Date (Second Identifier)
• Comparing with MAR/CMAR

Question 26

Combination Medications

Answer 26

Single Trade Name
Multiple generic names with slashes between
(May be different strengths for same medication)

Question 27

Oral Medications

Answer 27

• Easiest way to administer
• 30 minutes before or after feeding if drug is given on empty stomach
• Drug-Drug interactions most risk
• Check with provider for NPO patients

Question 28

Transdermal Patches

Answer 28

• Remove old patch before applying new one

- (Date and time of patch)

Question 29

Eye instillation

Answer 29

• Pulldown conjunctival sac and apply drops
• Use gloves to avoid contaminating patient
• Avoid Cornea
• Avoid eyelid with dropper
• Never share medication with others

Question 30

Ear drops

Answer 30

Adult - Pull pinna up and back
Age 3 or younger - Pull pinna down and back
- Do not drop directly into ear canal
- Use sterile stolutions

Question 31

Rectal Instillation

Answer 31

1 1/2 inches