Ch. 3 & 7-13 - Medication Safety, Ethical Considerations, Research, Nursing Process, Drug Administration, Cultural, Genetic & Age-related Considerations & Community Settings Flashcards
1
Q
Assessment
A
The phase of the nursing process that is characterized by systematic validation & documation of information
2
Q
Nursing Diagnosis
A
A determination made based on the analysis of assessment data
3
Q
Planning
A
The phase of the nursing process characterized by goal setting including the development of nursing interventions that be used to assist the patient in meeting the goals
4
Q
Goal Setting
A
Stating expected outcomes
5
Q
Implementation
A
The phase of the nursing process in which the nurse provides education, medication, care & other interventions
6
Q
Culturally Sensitive
A
The awareness of the implications of culture for the patient & his/her family
7
Q
Evaluation
A
The phase of the nursing process in which the nurse determines how well goals are obtained, revises interventions & teaches patient focusing on goal attainment
8
Q
“Five-Plus-Five” Rights of Medication Administration
A
(1) RIGHT patient (2) RIGHT drug (3) RIGHT dose (4) RIGHT route (5) RIGHT time (6) RIGHT assessment (7) RIGHT documentation (8) RIGHT to education (9) RIGHT evaluation (10) RIGHT to refuse
9
Q
The Joint Commission (TJC)
A
Accredation company that regulates healthcare administration…requires patient be identified by two unique forms of ID
10
Q
Unit Dose Method
A
Method in which drugs are individually wrapped & labeled for single doses for each patient
11
Q
Institute of Medicine (IOM)
A
a 1999 report that spurred work on changes to decrease medication errors
12
Q
Sublingual
A
medication placed under the tongue to dissolve
13
Q
Buccal
A
medication placed between the cheek & gum to dissolve
14
Q
Inhalation
A
medication inhaled orally into the lungs
15
Q
Transdermal
A
medication placed on the skin (patch) & absorbed
16
Q
Topical
A
medication applied to skin surface
17
Q
Intillations
A
liquid medication given as drops, ointments or sprays
18
Q
Suppositories
A
medication inserted into the vagina or rectum
19
Q
Parenteral
A
medication given via injection
20
Q
Intradermal Injection
A
injection given between epidermis & dermis layers of skin (EX: TB test)
21
Q
Subcutaneous Injection
A
injection given under the skin in the tissue (EX: insulin, heparin)
22
Q
Intramuscular Injection
A
injection given under the skin & tissue, in the muscle (EX: vaccines)
23
Q
Z-track Technique
A
technique used to prevent medication from leaking back through site into subcutaneous tissue
24
Q
Intravenous Injection
A
injection given into a vein
25
Metered Dose Inhalers (MDI)
handheld devices that deliver medication to the lower respiratory tract when inhaled into the lungs
26
Intraosseous Injection
injection given into the bone marrow
27
Biocultural Ecology
area of study that looks at variations in biological characteristics that are inconsistent for an ethnic group that might pose a concern for a nurse
28
Hereditary
genetic characteristics transferred from parent to offspring
29
Genetic
pertaining to genetics & reproduction
30
Nonadherence
not following medication directions; "noncompliance" (frequent in older adults)
31
Adherence
following prescribed medication regimens; "complicane"
32
Polypharmacy
administration of many drugs together to the same patient (frequent in older adults)
33
Holistic Nursing Approach
a patient-centered approach to healing that strives to meet cognitive, emotional, physical, social & spiritual needs of patients
34
Three Checks of Medication Administration
(1) Before taking it out of the package (2) As placing it in the medicine cup (3) Again before giving it to patient
35
Safety Risks for Medication Administration
New drugs, distractions, fatigue, sleep deprivation, confusing packaging, equipment failures, poor communication, transcription errors, handwriting issues
36
Institute of Medicine (IOM) Report of 1999 "To Err is Human: Building a Safer Healthcare System"
report that spurred changes in healthcare system changes to decrease errors
37
FDA 2002 Rule "Bar Code Label Requirements for Human Drug Products & Blood"
rule implemented by the FDA to increase the prominence of coding...at a minimum, the bar code contains the drug's national drug code that uniquely identifies the drug, its strength and its dosage form
38
The Joint Commission 2013 Patient Safety Goals
(1) Improve staff communication (2) Identify patients correctly (3) Use medicines safely
39
Institute for Safe Medication Practices (ISMP)
organization that puts out monthly newsletter about safety in medication practices...issues a list of error prone abbreviations, symbols & dose designations
40
Quality and Safety in Education in Nursing (QSEN)
Robert Woods Johnson Foundation...addressing and all about safety in nursing
41
Basic Ethical Principles in Medication Administration
Respect for person (autonomy), Beneficence, Justice, Veracity, Informed Consent
42
Phase I of Human Clinical Experimentation
phase of HCE determining human dosage range based on healthy subjects and identifying pharmacokinetics
43
Phase II of Human Clinical Experimentation
phase of HCE demonstrating safety and efficacy of drug in a limited number of subjects with disease to be treated
44
Phase III & IV of Human Clinical Experimentation
phase of HCE demonstrating safety and efficacy of drug for well client population (including long-term data if chronic regimen)
45
Role of the Nurse in Human Clinical Experimentation
(1) Recruit & assess study subjects (2) Understand protocols including inclusion & exclusion criteria (3) Know validity & reliability of measurement instruments (4) Communicate & work with other healthcare providers & sponsors
46
FDA Pregnancy Categories
a classification system related to the effects of drugs on a fetus used to optimize informed decision making for pregnant patients
47
Pregnancy Category A
No risk to the fetus. Studies have not shown evidence of fetal harm.
48
Pregnancy Category B
No risk to fetus in animal studies but well-controlled studies in pregnant women is not available. It is assumed there is little to no risk in pregnant women.
49
Pregnancy Category C
Animal studies indicate a risk to the fetus but controlled studies in pregnant women is not available. Risk vs. benefit must be determined.
50
Pregnancy Category D
A risk to the human fetus has been proved. Risk vs. benefit of the drug must be determined. It could be used in life-threatening conditions.
51
Pregnancy Category X
A risk to the human fetus has been proved. Risk outweighs the benefit & the drug should be avoided during pregnancy.
52
Physiologic Changes in GI System of Geriatric Patient
increased pH gastric secretions, decreased peristalsis with delayed gastric emptying time, decreased motility, decreased first-pass effect---\>SLOWER ABSORPTION OF ORAL DRUGS
53
Physiologic Changes in Cardiac & Circulatory Systems of Geriatric Patient
decreased cardiac output, decreased blood flow ---\>DELAYS TRANSPORTATION OF DRUGS TO TISSUE
54
Physiological Changes in Hepatic System of Geriatric Patient
decreased enzyme function, decreased blood flow---\>DRUGS METABOLIZED MORE SLOWLY & LESS COMPLETELY
55
Physiological Changes in Renal System of Geriatric Patient
decreased blood flow, decreased nephron function, decreased glomerular filtration rate---\>DRUGS EXCRETED LESS COMPLETELY
56
Strategies to Increase Geriatric Patient Compliance with Drug Therapy
(1) Education of patients & families (2) Help cut costs of medications (3) Be available for questions (4) Review medications with patient (5) Advise patient to use one pharmacy
57
# Reversed
The phase of the nursing process that is characterized by systematic validation & documation of information
Assessment
58
# Reversed
A determination made based on the analysis of assessment data
Nursing Diagnosis
59
# Reversed
The phase of the nursing process characterized by goal setting including the development of nursing interventions that be used to assist the patient in meeting the goals
Planning
60
# Reversed
Stating expected outcomes
Goal Setting
61
# Reversed
The phase of the nursing process in which the nurse provides education, medication, care & other interventions
Implementation
62
# Reversed
The awareness of the implications of culture for the patient & his/her family
Culturally Sensitive
63
# Reversed
The phase of the nursing process in which the nurse determines how well goals are obtained, revises interventions & teaches patient focusing on goal attainment
Evaluation
64
# Reversed
(1) RIGHT patient (2) RIGHT drug (3) RIGHT dose (4) RIGHT route (5) RIGHT time (6) RIGHT assessment (7) RIGHT documentation (8) RIGHT to education (9) RIGHT evaluation (10) RIGHT to refuse
"Five-Plus-Five" Rights of Medication Administration
65
# Reversed
Accredation company that regulates healthcare administration...requires patient be identified by two unique forms of ID
The Joint Commission (TJC)
66
# Reversed
Method in which drugs are individually wrapped & labeled for single doses for each patient
Unit Dose Method
67
# Reversed
a 1999 report that spurred work on changes to decrease medication errors
Institute of Medicine (IOM)
68
# Reversed
medication placed under the tongue to dissolve
Sublingual
69
# Reversed
medication placed between the cheek & gum to dissolve
Buccal
70
# Reversed
medication inhaled orally into the lungs
Inhalation
71
# Reversed
medication placed on the skin (patch) & absorbed
Transdermal
72
# Reversed
medication applied to skin surface
Topical
73
# Reversed
liquid medication given as drops, ointments or sprays
Intillations
74
# Reversed
medication inserted into the vagina or rectum
Suppositories
75
# Reversed
medication given via injection
Parenteral
76
# Reversed
injection given between epidermis & dermis layers of skin (EX: TB test)
Intradermal Injection
77
# Reversed
injection given under the skin in the tissue (EX: insulin, heparin)
Subcutaneous Injection
78
# Reversed
injection given under the skin & tissue, in the muscle (EX: vaccines)
Intramuscular Injection
79
# Reversed
technique used to prevent medication from leaking back through site into subcutaneous tissue
Z-track Technique
80
# Reversed
injection given into a vein
Intravenous Injection
81
# Reversed
handheld devices that deliver medication to the lower respiratory tract when inhaled into the lungs
Metered Dose Inhalers (MDI)
82
# Reversed
injection given into the bone marrow
Intraosseous Injection
83
# Reversed
area of study that looks at variations in biological characteristics that are inconsistent for an ethnic group that might pose a concern for a nurse
Biocultural Ecology
84
# Reversed
genetic characteristics transferred from parent to offspring
Hereditary
85
# Reversed
pertaining to genetics & reproduction
Genetic
86
# Reversed
not following medication directions; "noncompliance" (frequent in older adults)
Nonadherence
87
# Reversed
following prescribed medication regimens; "complicane"
Adherence
88
# Reversed
administration of many drugs together to the same patient (frequent in older adults)
Polypharmacy
89
# Reversed
a patient-centered approach to healing that strives to meet cognitive, emotional, physical, social & spiritual needs of patients
Holistic Nursing Approach
90
# Reversed
(1) Before taking it out of the package (2) As placing it in the medicine cup (3) Again before giving it to patient
Three Checks of Medication Administration
91
# Reversed
New drugs, distractions, fatigue, sleep deprivation, confusing packaging, equipment failures, poor communication, transcription errors, handwriting issues
Safety Risks for Medication Administration
92
# Reversed
report that spurred changes in healthcare system changes to decrease errors
Institute of Medicine (IOM) Report of 1999 "To Err is Human: Building a Safer Healthcare System"
93
# Reversed
rule implemented by the FDA to increase the prominence of coding...at a minimum, the bar code contains the drug's national drug code that uniquely identifies the drug, its strength and its dosage form
FDA 2002 Rule "Bar Code Label Requirements for Human Drug Products & Blood"
94
# Reversed
(1) Improve staff communication (2) Identify patients correctly (3) Use medicines safely
The Joint Commission 2013 Patient Safety Goals
95
# Reversed
organization that puts out monthly newsletter about safety in medication practices...issues a list of error prone abbreviations, symbols & dose designations
Institute for Safe Medication Practices (ISMP)
96
# Reversed
Robert Woods Johnson Foundation...addressing and all about safety in nursing
Quality and Safety in Education in Nursing (QSEN)
97
# Reversed
Respect for person (autonomy), Beneficence, Justice, Veracity, Informed Consent
Basic Ethical Principles in Medication Administration
98
# Reversed
phase of HCE determining human dosage range based on healthy subjects and identifying pharmacokinetics
Phase I of Human Clinical Experimentation
99
# Reversed
phase of HCE demonstrating safety and efficacy of drug in a limited number of subjects with disease to be treated
Phase II of Human Clinical Experimentation
100
# Reversed
phase of HCE demonstrating safety and efficacy of drug for well client population (including long-term data if chronic regimen)
Phase III & IV of Human Clinical Experimentation
101
# Reversed
(1) Recruit & assess study subjects (2) Understand protocols including inclusion & exclusion criteria (3) Know validity & reliability of measurement instruments (4) Communicate & work with other healthcare providers & sponsors
Role of the Nurse in Human Clinical Experimentation
102
# Reversed
a classification system related to the effects of drugs on a fetus used to optimize informed decision making for pregnant patients
FDA Pregnancy Categories
103
# Reversed
No risk to the fetus. Studies have not shown evidence of fetal harm.
Pregnancy Category A
104
# Reversed
No risk to fetus in animal studies but well-controlled studies in pregnant women is not available. It is assumed there is little to no risk in pregnant women.
Pregnancy Category B
105
# Reversed
Animal studies indicate a risk to the fetus but controlled studies in pregnant women is not available. Risk vs. benefit must be determined.
Pregnancy Category C
106
# Reversed
A risk to the human fetus has been proved. Risk vs. benefit of the drug must be determined. It could be used in life-threatening conditions.
Pregnancy Category D
107
# Reversed
A risk to the human fetus has been proved. Risk outweighs the benefit & the drug should be avoided during pregnancy.
Pregnancy Category X
108
# Reversed
increased pH gastric secretions, decreased peristalsis with delayed gastric emptying time, decreased motility, decreased first-pass effect---\>SLOWER ABSORPTION OF ORAL DRUGS
Physiologic Changes in GI System of Geriatric Patient
109
# Reversed
decreased cardiac output, decreased blood flow ---\>DELAYS TRANSPORTATION OF DRUGS TO TISSUE
Physiologic Changes in Cardiac & Circulatory Systems of Geriatric Patient
110
# Reversed
decreased enzyme function, decreased blood flow---\>DRUGS METABOLIZED MORE SLOWLY & LESS COMPLETELY
Physiological Changes in Hepatic System of Geriatric Patient
111
# Reversed
decreased blood flow, decreased nephron function, decreased glomerular filtration rate---\>DRUGS EXCRETED LESS COMPLETELY
Physiological Changes in Renal System of Geriatric Patient
112
# Reversed
(1) Education of patients & families (2) Help cut costs of medications (3) Be available for questions (4) Review medications with patient (5) Advise patient to use one pharmacy
Strategies to Increase Geriatric Patient Compliance with Drug Therapy
