Ch 32_ Medication Administration

Question 1

What are the Six Rights of Medication Administration?

Answer 1

1. Right Patient 2. Right Drug 3. Right Dosage 4. Right Route 5. Right Time 6. Right Documentation

Question 2

What are the three checks for Medication Administration?

Answer 2

1. Order to MAR 2. Medication to MAR 3. Patient to MAR

Question 3

Name and detail the first check of Medication Administration

Answer 3

• First step is compare Order to MAR • When you do this, apply the six rights • Patient • Drug • Dosage • Route • Time • Documentation (confirms that all match)

Question 4

Name and detail the second check of Medication Administration

Answer 4

• Second check is comparing the medication to the MAR • Confirm that the medication, dosage, route, and time are match • At this point note any special conciderations for the drug such as vitals/allergies, etc • ex. special direction to not give drug if BP is <60. Must check pulse and if lower, withhold, if above, proceed • Confirm that the medication is sealed • Confirm that it is not expired

Question 5

Name and detail the third check of Medication Administration

Answer 5

• The third check is Patient to MAR • Confirm that the patient is correct w/ Bracelet IDx2 • Ask for allergies (Do you have any allergies to any medication, food, latex or anything else?)

Question 6

Define Generic drug name

Answer 6

The manufacturer who first develops the drug assigns the name, and it is then listed in the U.S. Pharmacopeia

Question 7

Define Trade drug name

Answer 7

• Known as the brand or proprietary name. • Name a manufacturer markets the medication

Question 8

What are the four phases of pharmacokinetics?

Answer 8

1. Absorption 2. Distribution 3. Metabolism 4. Excretion

Question 9

Define pharmacokinetic absorption.

Answer 9

The ability of a drug to be absorbed by cells, tissues, organs, systems and alter physiological functions

Question 10

What are five factors that influence absorption?

Answer 10

1. Route of administration 2. Ability to dissolve 3. Blood flow 4. Body surface area 5. Lipid solubility of medication

Question 11

Pharmacokinetic distribution depends on what four factors?

Answer 11

1. Chemical properties of the drug 2. Circulation 3. Membrane permeability 4. Protein binding

Question 12

What are four factors to consider in drug metabolism?

Answer 12

1. Medications are metabolized into a less potent or an inactive form 2. Biotransformation occurs under the influence of enxymes that detoxify, break down and remove active chemicals 3. Most biotransformation occurs in the liver 4. Kidneys, blood, intestines and lungs all play a role

Question 13

What is drug excretion?

Answer 13

The method the body uses to rid the body of a drug.

Question 14

Medications are excreted through:

Answer 14

• Kidney • Liver • Bowel • Lungs • Exocrine glands

Question 15

What are the 7 types of medication action?

Answer 15

1. Therapeutic effect 2. Side effect 3. Adverse effect 4. Toxic effect 5. Idiosyncratic reaction 6. Allergic reaction 7. Synergistic

Question 16

Define: Therapeutic effect

Answer 16

Expected or predicted physiological response

Question 17

Define: Side effect

Answer 17

Unavoidable secondary effect

Question 18

Define: Adverse effect

Answer 18

Unintended, undesirable, often unpredictable drug effect

Question 19

Define: Toxic effect

Answer 19

• Accumulation of medication in the bloodstream • Frequent use can cause accumulation

Question 20

Define: Idiosyncratic reaction

Answer 20

• Over-reaction or under-reaction or different reaction from normal • Will require further follow up to discover why (mixed with other drugs, etc)

Question 21

Define: Allergic reaction

Answer 21

Unpredictable response to a medication

Question 22

Define: Synergistic effect

Answer 22

The combined effect of two medications is greater than the effect of the medications given separately.

Question 23

What six factors make up a medication dose response?

Answer 23

1. Onset 2. Trough 3. Plateau 4. Peak 5. Duration 6. Biological half-life

Question 24

Define: Onset

Answer 24

Time it takes for a medication to produce a response

Question 25

Define: Trough

Answer 25

Minimum blood serum concentration before the next scheduled dose

Question 26

Define: Plateau

Answer 26

Point at which blood serum concentration is reached and maintained

Question 27

Define: Peak

Answer 27

Time at which a medication reaches its highest effective concentration

Question 28

Define: Duration

Answer 28

Time medication takes to produce greatest result

Question 29

Define: Biological half-life

Answer 29

Time for serum medication concentration to be halved

Question 30

What are the 5 routes fo medication administration?

Answer 30

1. Oral 2. Topical 3. Inhalation 4. Parenteral 5. Intraocular

Question 31

What are three methods of administration for inhalation?

Answer 31

• Inhale/sniff • Nebulizer (drop in vapor) • Endotracheal

Question 32

What are the four parenteral methods of administration?

Answer 32

1. ID; Intradermal 2. Sub-Q; Subcutaneous 3. IM; Intramuscular 4. IV; Intravenous

Question 33

Name the sites and angle for an IM injection. Sites:

Answer 33

• Ventrogluteal (side of butt) • Vastus Lateralis (top of thigh) • Deltoid (shoulder) Angle: • 90°

Question 34

entrogluteal site is is recommended for volumes greater than __ mL

Answer 34

2

Question 35

Sub-Q injections are are absorbed more _____ than IM injections. slowly

Answer 35

due to low blood supply

Question 36

Where are the sub-q injection sites located?

Answer 36

• Lateral surface of the upper arm • Upper back at the lower end of the scapula and down about 6” • upper ventral/dorsal gluteal areas (top of butt) • Belly under naval area

Question 37

What are the angles of entry for IM, Sub-Q, and ID shots?

Answer 37

• IM = 90° • Sub-Q = 45° - 90° • ID = 5 - 15°

Question 38

Regarding IM and Sub-Q injections, which do you pinch and which to you spread?

Answer 38

Sub-Q = pinch IM = spread

Question 39

Give the typical volume amounts for the following injections: ID IM

Answer 39

Sub-Q • ID = < 0.5mL • IM = < 2mL for small muscles, <5mL for large muschles • Sub-Q = < 1mL, (but up to 2mL is safe)

Question 40

What are the 6 types of orders MD’s use for medication administration?

Answer 40

1. Standing/Routine 2. Single 3. Now 4. PRN 5. STAT 6. Prescriptions

Question 41

Define: Single order

Answer 41

One time administration given for a specific reason

Question 42

Define: Now order

Answer 42

• When a medication is needed right away, but not STAT • w/in 90 minutes

Question 43

Define: PRN order

Answer 43

• Given when a patient requires it • Will still need to refer to timing to see when it can be administered

Question 44

Define: STAT order

Answer 44

Given immediately in an emergency