220-medication Flashcards
nurses should know
generic name
trade name
classification
indications
pharmakinetics
effects
tolerence
toxic
Idiosyncratic(unintended effects)
therapeutic range
concentration of drug in the blood serum that produces the desired effect without causing toxicity
peak level
the point the drug is at the highest (60 mins after given)
trough level
the point when the drug is at its lowest concentration, indicating the rate of elimination (30 mins before the next dose)
half life
amount of time it takes for 50% of blood concentration of a drug to be eliminated from the body
admission assessment
comparing prior to admission drugs to drugs prescribed
allergies
pregnancy and lactation status
dietary and herbal supplements taken
how does aging effect drug response?
decreased
gastic mobility
total body eater
lipid content in skin
liver function
kidney function
adverse CNS effects
altered peripheral vascular tone
PRN orders
as needed
standing order
in chart
5 rights
patient
medication
dose
route
time
daily
daily
BID
x2
TID
x3
QID
x4
ac
before meals
pc
after meal
HS
Hour of sleep
Identifying patients (need two to identify patients)
name
birthdate
Medical record number
and compare with EMR
Medications that must be given 30 mins before or after scheduled time
Q1, Q2, Q3, Q4, rapid short acting insulin(regular aspart/novolog)
medication that must be given 60 mins before or after scheduled time
Q6, Q8, Q12
medications that must be given 2 hours before or after scheduled time
daily, weekly, monthly
Enteral
mouth (PO)
Enteral administration
feeding tubes
sublingual and buccal routes
solid
liquid
scored
SR, XL, CR (no crush-deadly)
enteric coated (no crush)
topical medications
lotions, cream, ointments and medicated powders
transdermal patches
eye drops
nosedrops/mist
ear drops
rectal- suppositories
vaginal-creams and suppositories
transdermal patches go where on the body
upper arm
upper chest
upper back
side of chest
eye drops go where in the eye
bottom sack then dap the inner corner to avoid it dripping out
parenteral medications
Intradermal
Subcutaneous administration
Intramuscular administration
intradermal
TB test
Subcutaneous
insulin administration
heparin
Intramuscular
deltoid
ventral gluteal (side butt)
vastus lateralis (side leg)
the needle get smaller as
the gauge get larger
Intramuscular is administer at
72 and 90 degrees
intradermal is administered at
15 degree
Subcutaneous is administered at
90 and 45 degree
intradermal perimeters
1/4-1/2 inch
25G, 27G
less then 0.5 ML
5-15 degree angle
subQ perimeters
drug specific syringes
3/8-5/8 inch
25G-30G
1ML max volume
45-90 degree angle
sub Q sites
lower stomach
front thighs
back of arms
upper back
upper butt
intramuscular perimeters
5/8-1.5 inch
20G-25G
up to 3ML in large muscles
gentle pressure
Z-track it
what is Z-track?
pushing the muscle to the side and injecting it to prevent the large volume from leaking out of the injection site
controlled substances
locked
counted
record partial doses
report any discrepancy
What to document
dose given: site and parameters
doses missed
refused medications
incident reports for medication errors (SHARE)
patient teaching and education
medication errors process
check the patients condition watch for adverse effects
obtain a set of VS
notify nurse manager and PCP
Complete a SHARE but do not indicate that the form was filled out in the patient chart
