ATI CH 1

Question 1

What vital sign should be monitored when using morphine?

Answer 1

Respirations are important to watch. Morphine is notorious for causing respiratory depression.

Question 2

What should you be cautious of when administering gentamicin?

Answer 2

Be cautious of the pt. c/o hearing loss.
Gentamicin is a antibiotic of the amino-glycoside family. Amino glycosides are known for being ototoxic & nephrotoxic.

Question 3

Any drug with the suffix “cet” contains what?

Answer 3

Any drug with the suffix CET contains tylenol

Percocet, darvocet

Question 4

How can you tell if a drug is a ace inhibitor?

Answer 4

Ace inhibitors end in PRIL

Lisinopril.

Question 5

Angiotensin receptor blockers end in what suffix?

Answer 5

Sartan

Question 6

Beta blockers prefix is what?

Answer 6

Olol

Ex….Metoprolol

Question 7

Furosemide is known as what?

Answer 7

Lasix, a potent loop diuretic that lasts up to 6 hours.

Question 8

Gabapentin is also known as what?

Answer 8

Neurontin

An anticonvulsant indicated for diabetic neuropathy.

Question 9

Dilaudid

Answer 9

Hydromorphone hydrochloride

An opiod analgesic indicated for severe pain.

Question 10

What is the only form of insulin that can be given via IV?

Answer 10

Regular insulin

Question 11

When administering eye drops, what are appropriate nursing interventions?

Answer 11

Ask client to look at ceiling
Drop med into center of pt. conjunctival sac
Instruct client to close eye gently

Question 12

Medication doses need to be DECREASED for what reasons?

Answer 12

Liver failure

Concurrent use of meds metabolized by the same pathway.

Question 13

Is a pt. trough level needs to be checked, what is an appropriate nursing intervention?

Answer 13

Have a blood specimen obtained immediately prior to the next dose.

Question 14

Phenobarbital sodium

Answer 14

Luminal

Has a half life of 4 days. Most likely prescribed once per day because of 4 day half life.

Question 15

Catheter

Answer 15

A catheter is advanced through a needle that is inserted into the epidural space at the level of 4th or 5th vertebrae.

Question 16

Z track

Answer 16

Type of IM injection that prevents meds from leaking back into subcutaneous tissue.

Question 17

Intramuscular injections

Answer 17

Appropriate for irritating medications, solutions in oil, & aqueous suspensions.

Question 18

What needle sizes are used for intramuscular injections?

Answer 18

18-27 gauge typically 22-25 guage.
1 to 1.5 inches long. Inject at 90 degree angle
Volume injected is usually 1-3ml. If greater amts is required, uses to syringes at two different sites.

Question 19

What are common sites for IM injections?

Answer 19

Ventrogluteal, deltoid & vastus lateralis (pediatric)

Dorsogluteal is not recommended due to close proximity to sciatic nerve.

Question 20

Subcutaneous injections are appropriate

For what?

Answer 20

Appropriate for small doses of non irritating, water soluble medications and is commonly used for insulin and heparin.

Question 21

If giving a subcutaneous injection what needle would you use?

Answer 21

3/8 to 5/8 inch
25 to 27 guage needle or
Insulin syringe of 28- 31 guage. Inject no more than 1.5ml of solution.
For average sized ppl pinch skin and inject 45-90 degree angle. Fat ppl use 90 degree angle

Question 22

Intradermal injections

Answer 22

Usually used for tuberculin testing or checking for medication/ allergy sensitivities.
May be used for some cancer immunotherapy

Question 23

What is important to remember

When giving intradermal injections?

Answer 23

Use small amounts of solution (0.01- 0.1 ml) in tuberculin syringe with fine guage needle (26-27) in lightly pigmented, thin skinned hairless sites( inner surface of mid forearm or scapular area of back) at a 5- 15 degree angle bevel up.

Question 24

Parenteral medications

Answer 24

Vastus lateralis is recommended for infants & children younger than 2. After 2 yrs old the ventral gluteal site can be used.
Both sites can hold up to ml of fluid.
Deltoid muscle has smaller muscle mass and can only hold 1ml of fluid.

Question 25

For parenteral medications what would you do with a volume to be injected that is less than 1ml.

Answer 25

Use a tuberculin syringe for volumes less than 0.5ml.

Question 26

What is true of a MDI?

Metered dose inhaler

Answer 26

Shake inhaler 5-6 times
Hold approx 2-4cm (1-2in) from front of
Hold med in for 10sec.

Question 27

For a dry powder inhaler

(DPI) what should the nurse intruct the client not to do?

Answer 27

Avoid shaking the device

Question 28

What is true of rectal suppositories?

Answer 28

Position client in left lateral position
Insert just beyond internal sphincter
Instruct client to retain meds for 20-30 min for stimulation of defacation & 60 min for systemic absorption.

Question 29

What is true when instilling eye drops?

Answer 29

Use surgical technique
Apply gentle pressure with finger and a clean tissue on nasolacrimal duct for 30-60 sec to prevent systemic absorption of medication.

Question 30

What would a nurse educate a client to do after instilling a medication through the nose?

Answer 30

Use aseptic technique
Instruct client to breath through mouth, stay in a supine position and avoid blowing nose for 5 min after drop insertion.

Question 31

When giving ear drops, what must a nurse keep in mind?

Answer 31

Straighten ear canal by pulling auricle upward and outward for adults, or down and back for kids. Hold dropper 1cm above ear, instill med the. Gently apply pressure with finger to Tragus of ear.

Question 32

What is a agonist?

Answer 32

Is a medication that binds to a receptor to produce a biological response.
Morphine is considered a agonist because it activates the receptors to produce analgesia, sedation, constipation, and other effects.

Question 33

What is an antagonist?

Answer 33

A med that interferes with , or inhibits the action of another med.

Question 34

Losartan

Cozaar

Answer 34

Angiotensin II receptor blocker that is classified as a antagonist because it blocks the angiotensin II receptors on blood vessels , which prevents vasoconstriction.

Question 35

What is true of medications with a high therapeutic index?

Answer 35

They have a wide safety margin, therefore no need for routine serum med level monitoring.
Meds with a low TI should have med levels monitored closely
Monitor peak levels based on route of administration

Question 36

What are the outcomes of metabolism?

Answer 36

Increased renal excretion of medication
Inactivation of medications
Increased therapeutic effect
Activation of pro meds into active forms
Decreased toxicity when active forms r converted to inactive forms
Increased toxicity when inactive forms are converted to active forms.

Question 37

What is the hallmark sign of hypoglycemia?

Answer 37

Cold, clammy,sweaty skin (diaphoresis)

Other signs include confusion, unsteadiness, & loss of consciousness.