Ch 32_ Medication Administration Flashcards
What are the Six Rights of Medication Administration?
- Right Patient 2. Right Drug 3. Right Dosage 4. Right Route 5. Right Time 6. Right Documentation
What are the three checks for Medication Administration?
- Order to MAR 2. Medication to MAR 3. Patient to MAR
Name and detail the first check of Medication Administration
• 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)
Name and detail the second check of Medication Administration
• 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
Name and detail the third check of Medication Administration
• 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?)
Define Generic drug name
The manufacturer who first develops the drug assigns the name, and it is then listed in the U.S. Pharmacopeia
Define Trade drug name
• Known as the brand or proprietary name. • Name a manufacturer markets the medication
What are the four phases of pharmacokinetics?
- Absorption 2. Distribution 3. Metabolism 4. Excretion
Define pharmacokinetic absorption.
The ability of a drug to be absorbed by cells, tissues, organs, systems and alter physiological functions
What are five factors that influence absorption?
- Route of administration 2. Ability to dissolve 3. Blood flow 4. Body surface area 5. Lipid solubility of medication
Pharmacokinetic distribution depends on what four factors?
- Chemical properties of the drug 2. Circulation 3. Membrane permeability 4. Protein binding
What are four factors to consider in drug metabolism?
- 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
What is drug excretion?
The method the body uses to rid the body of a drug.
Medications are excreted through:
• Kidney • Liver • Bowel • Lungs • Exocrine glands
What are the 7 types of medication action?
- Therapeutic effect 2. Side effect 3. Adverse effect 4. Toxic effect 5. Idiosyncratic reaction 6. Allergic reaction 7. Synergistic
Define: Therapeutic effect
Expected or predicted physiological response
Define: Side effect
Unavoidable secondary effect
Define: Adverse effect
Unintended, undesirable, often unpredictable drug effect
Define: Toxic effect
• Accumulation of medication in the bloodstream • Frequent use can cause accumulation
Define: Idiosyncratic reaction
• Over-reaction or under-reaction or different reaction from normal • Will require further follow up to discover why (mixed with other drugs, etc)
Define: Allergic reaction
Unpredictable response to a medication
Define: Synergistic effect
The combined effect of two medications is greater than the effect of the medications given separately.
What six factors make up a medication dose response?
- Onset 2. Trough 3. Plateau 4. Peak 5. Duration 6. Biological half-life
Define: Onset
Time it takes for a medication to produce a response
Define: Trough
Minimum blood serum concentration before the next scheduled dose
Define: Plateau
Point at which blood serum concentration is reached and maintained
Define: Peak
Time at which a medication reaches its highest effective concentration
Define: Duration
Time medication takes to produce greatest result
Define: Biological half-life
Time for serum medication concentration to be halved
What are the 5 routes fo medication administration?
- Oral 2. Topical 3. Inhalation 4. Parenteral 5. Intraocular
What are three methods of administration for inhalation?
• Inhale/sniff • Nebulizer (drop in vapor) • Endotracheal
What are the four parenteral methods of administration?
- ID; Intradermal 2. Sub-Q; Subcutaneous 3. IM; Intramuscular 4. IV; Intravenous
Name the sites and angle for an IM injection. Sites:
• Ventrogluteal (side of butt) • Vastus Lateralis (top of thigh) • Deltoid (shoulder) Angle: • 90°
entrogluteal site is is recommended for volumes greater than __ mL
2
Sub-Q injections are are absorbed more _____ than IM injections. slowly
due to low blood supply
Where are the sub-q injection sites located?
• 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
What are the angles of entry for IM, Sub-Q, and ID shots?
• IM = 90° • Sub-Q = 45° - 90° • ID = 5 - 15°
Regarding IM and Sub-Q injections, which do you pinch and which to you spread?
Sub-Q = pinch IM = spread
Give the typical volume amounts for the following injections: ID IM
Sub-Q • ID = < 0.5mL • IM = < 2mL for small muscles, <5mL for large muschles • Sub-Q = < 1mL, (but up to 2mL is safe)
What are the 6 types of orders MD’s use for medication administration?
- Standing/Routine 2. Single 3. Now 4. PRN 5. STAT 6. Prescriptions
Define: Single order
One time administration given for a specific reason
Define: Now order
• When a medication is needed right away, but not STAT • w/in 90 minutes
Define: PRN order
• Given when a patient requires it • Will still need to refer to timing to see when it can be administered
Define: STAT order
Given immediately in an emergency
