Chapter 15 Medication Administration Flashcards
consists of written directions for a specific medication or procedure, signed by a physician, and used only under the specific conditions stated in the order.
standing order
strong laxative
cathartic
route indicates administration of medication directly into the gastrointestinal tract via oral or rectal sites or via a nasogastric (NG) tube.
Enteral
route of administration refers to the application of medication to the surface of the skin or mucous membranes.
Topical
Other topical medications are used for a systemic effect, and this type of administration is termed
Transdermal
Drugs placed under the tongue
sublingual
**can be absorbed into the blood through the oral mucosa and are immediately available without having to be digested and absorbed through the stomach or bowel.
Drugs placed inside the cheek
Buccal
**can be absorbed into the blood through the oral mucosa and are immediately available without having to be digested and absorbed through the stomach or bowel.
When coronary arteries are unable to supply the heart muscle with sufficient nutrients and oxygen, this results in a crushing pain called
Angina Pectoris
medications are injected directly into the body and bypass the gastrointestinal tract.
Parentral
into a vein)
Intravenous (IV
injections are the most common type of intravascular administration.
Intravenous
refers to parenteral injections into the spinal canal
intrathecal
when does medication administration become a radiographers responsibility
INJECTED IODINATED MEDIA
INGESTED CONTRAST MEDIA
These types of MEDICATIONS ARE
ADMINISTERED TO PATIENTS SO THEY CAN TOLERATE
IMAGING PROCEDURES.
ANTIANXIETY AND ANESTHETIC
List a few of radiographers roles when it comes to medication administration
CHECK ALLERGIC HISTORY OF PATIENTS.
- PREPARE MEDICATION FOR ADMINISTRATION.
- VERIFY PATIENT ID.
- ASSIST THE PHYSICIAN.
- MONITOR THE PATIENT AFTER ADMINISTRATION.
- IF STATE REGULATIONS AND HOSPITAL POLICIES PERMIT:
- MIGHT ALSO ADMINISTER AND CHART THE MEDICATION OR
CONTRAST MEDIUM
Medication Orders:
written
verbal
standing
what medical order is not permitted in all states and not permitted in some institutions
Verbal
- WRITTEN DIRECTIONS FOR A SPECIFIC
MEDICATION/PROCEDURE - SIGNED BY A PROVIDER
- USED FOR SPECIFIC CONDITIONS STATED IN THE ORDER
Standing Order
SIX RIGHTS OF MEDICATION
ADMINISTRATION
- THE RIGHT DOSE
- OF THE RIGHT MEDICATION
- TO THE RIGHT PATIENT
- AT THE RIGHT TIME
- BY THE RIGHT ROUTE
- WITH THE RIGHT DOCUMENTATION
Routes of administration:
- ENTERAL ROUTE
- ORAL
- RECTAL
- NASOGASTRIC (NG) TUBE
- MEDICATION INHALATION
- TOPICAL ROUTE
- SUBLINGUAL AND BUCCAL ROUTES
- PARENTERAL INJECTIONS
- INTRAVENOUS (IV)
- COMMON AND FAMILIAR ADMINISTRATION
- DIGESTIVE PROCESS CAN REDUCE THERAPEUTIC EFFECT
Oral
Enteral Route
oral
Rectal
Nasogastric NG tube
- ALTERNATIVE FOR THOSE UNABLE TO SWALLOW OR WITH
AN UNRETENTIVE STOMACH - DOSAGE MAY BE UNRELIABLE BECAUSE OF EARLY
EXPULSION.
Rectal
ALSO AN ALTERNATIVE TO ORAL ADMINISTRATION
* MORE RELIABLE AND MORE EASILY CONTROLLED
Nasogastric NG tube
- PROVIDE THERAPY DIRECTLY TO LUNGS/RESPIRATORY
SYSTEM - USED IN NUCLEAR MEDICINE FOR ADMINISTRATION OF
RADIOACTIVE GASES FOR LUNG VENTILATION STUDIES
Medication Inhalation
- MAY BE USED TO PROVIDE LOCAL THERAPY, SUCH AS
CREAMS FOR RASHES - TRANSDERMAL PATCHES PROVIDE THERAPY BY
ADHERING MEDICATION TO THE SKIN, WHICH IS
EVENTUALLY ABSORBED INTO THE BLOODSTREAM.
ex. nicotine patches
Topical Route
- USED TO DELIVER DRUGS THAT:
- CAUSE IRRITATION OF THE GI TRACT
- CANNOT BE ABSORBED BY THE GI TRACT
- ARE NEEDED RAPIDLY TO SITE OF ACTION
PARENTERAL INJECTIONS
PARENTERAL ROUTES
- INTRADERMAL
- SUBCUTANEOUS
(SC) - INTRAMUSCULAR
(IM) - INTRA-ARTERIAL
- INTRAVENOUS
(IV) - INTRATHECAL
STEPS FOR PARENTERAL INJECTION
PROCEDURE
- GREET THE PATIENT. CHECK PATIENT IDENTIFICATION AND EXPLAIN THE PROCEDURE.
- SELECT THE APPROPRIATE INJECTION SITE.
- PERFORM HAND HYGIENE AND DON CLEAN GLOVES.
- CLEANSE THE SELECTED AREA WITH AN ALCOHOL WIPE.
- HOLD THE SKIN TAUT WITH YOUR NONDOMINANT HAND.
- INSERT THE NEEDLE AT THE CORRECT ANGLE, AND PULL BACK SLIGHTLY ON THE PLUNGER.
- IF NO BLOOD IS PRESENT, INJECT THE MEDICATION.
- WITHDRAW THE NEEDLE QUICKLY, AND WIPE THE INJECTION SITE.
- SEE TO THE PATIENT’S COMFORT.
- REMOVE YOUR GLOVES AND PERFORM HAND HYGIENE.
- CHART THE MEDICATION.
- DISCARD THE CONTAINER AND ANY REMAINING MEDICATION. PLACE THE SYRINGE WITH ATTACHED
NEEDLE IN A SHARPS CONTAINER.
- READ THE MEDICATION LABEL THREE TIMES BEFORE
ADMINISTRATION:
- WHEN SELECTING THE CONTAINER
- WHILE PREPARING THE DOSE
- JUST BEFORE INJECTION
THIS IS ESSENTIAL TO BE ABSOLUTELY CERTAIN THAT YOU
HAVE THE CORRECT DRUG AND THE PROPER STRENGTH,
AND THAT THE EXPIRATION DATE HAS NOT BEEN
EXCEEDED.
- PROVIDES MOST IMMEDIATE EFFECT
- USED FOR DELIVERING MOST EMERGENCY MEDICATIONS
WHEN AN IMMEDIATE RESPONSE IS CRITICAL - ALSO USED TO DELIVER PARENTERAL NUTRITION AND
CHEMOTHERAPY - USED TO INJECT CONTRAST MEDIA FOR RADIOGRAPHIC
EXAMINATIONS OF THE URINARY TRACT AND FOR SOME
COMPUTED TOMOGRAPHY (CT) STUDIES, AND TO PROVIDE
SEDATION DURING INVASIVE PROCEDURES AND MRI
EXAMINATIONS
IV ROUTE
what does the needleless system minimize
- MINIMIZES
NEEDLESTICK
HAZARDS
IS THE PRESENCE OF FLUID OUTSIDE
THE VESSEL
- EXTRAVASATION
REFERS TO DIFFUSION OF THE FLUID INTO
THE SURROUNDING TISSUES.
- INFILTRATION
- ALSO CALLED INFILTRATION
EXTRAVASATION
LEAKAGE OR INJECTION OF IV FLUIDS OUTSIDE OF THE
VESSEL
EXTRAVASATION
- PAINFUL AND OFTEN DANGEROUS CONDITION
- TREATMENT IS TO APPLY COLD PACKS TO THE SITE.
- INCIDENT REPORT MUST BE FILED.
EXTRAVASATION
materials needed for discontinuing an IV
- MATERIALS NEEDED:
- GLOVES
- A STERILE ADHESIVE BANDAGE
- BANDAGE SCISSORS
- COTTON BALLS OR GAUZE SPONGES
steps for DISCONTINUING AN IV
PERFORM HAND HYGIENE AND DON GLOVES.
* EXPLAIN PROCEDURE TO PATIENT.
* CLOSE THE DRIP CONTROL.
* GENTLY REMOVE ADHESIVE TAPE AROUND
CATHETER TO EXPOSE VEIN.
* REMOVE CATHETER WITH A SINGLE LONG,
SMOOTH PULL.
* CHECK TIP TO ENSURE IT IS INTACT.
* APPLY PRESSURE TO SITE WITH DRY COTTON
BALL OR GAUZE FOR 1 MINUTE.
* APPLY STERILE ADHESIVE BANDAGE OR TAPE
COTTON BALL TO SITE.
* DOCUMENT IV REMOVAL IN CHART
* REMOVE GLOVES AND PERFORM HAND
HYGIENE.
Monitoring IV fluids
TO AVOID PROBLEMS:
* CALL IN ADVANCE TO INFORM THE NURSE OF LENGTHY
PROCEDURES.
* PLUG IN THE PUMP RATHER THAN RELYING ON BATTERY
POWER.
* WATCH IV FLUID LEVELS, AND ALLOW TIME FOR
REPLACEMENT BEFORE THE IV FLUID IS EXHAUSTED.
* IF AN IV SET RUNS OUT, OR IF THE ALARM SOUNDS, CALL
THE NURSING SERVICE IMMEDIATELY RATHER THAN
WAITING UNTIL THE PATIENT IS RETURNED TO THE
NURSING UNIT.
how high should an iv bag be above the vein
18 to 20 inches above
what happens if the bag is too high
AN IV SOLUTION THAT IS TOO HIGH MAY CAUSE FLUID TO INFILTRATE
INTO THE SURROUNDING TISSUES BECAUSE OF THE INCREASED
HYDROSTATIC PRESSURE.
what happens if the bag is placed too low
- IF THE BAG IS PLACED LOWER THAN THE VEIN, BLOOD WILL FLOW BACK
INTO THE CATHETER OR TUBING AND MAY CLOT, CAUSING THE FLUID TO
STOP FLOWING.
what do you do if there is infiltration /extravasation
apply cold packs
list some Precautions of all injections
- WEAR GLOVES
- DISPOSE OF ALL SYRINGES AND NEEDLES DIRECTLY INTO
A PUNCTURE-PROOF CONTAINER WITHOUT RECAPPING. - USE SAFETY-DESIGNED NEEDLES AND NEEDLELESS
DEVICES WHENEVER POSSIBLE. - ALWAYS FOLLOW ESTABLISHED RULES OF ASEPTIC
TECHNIQUE. - READ THE LABEL THREE TIMES: BEFORE DRAWING UP
THE MEDICATION, AFTER DRAWING IT UP, AND WITH THE
PHYSICIAN BEFORE ADMINISTRATION. - LABEL THE SYRINGE WITH THE MEDICATION NAME AND
STRENGTH (CONCENTRATION) IF THE MEDICATION WILL
NOT BE ADMINISTERED IMMEDIATELY. - CHECK PATIENT ID BEFORE ADMINISTRATION.
- CHECK FOR ALLERGIES.
- MONITOR PATIENT CAREFULLY FOR SIDE EFFECTS.
Charting medications
ROUTINE ENTRY MADE IN PROPER SECTION OF CHART:
* DATE
* TIME OF DAY
* DRUG NAME
* DOSAGE
* ROUTE OF ADMINISTRATION
* EACH ENTRY MUST BE SIGNED.
* CONTRAST MEDIA ARE CHARTED AS MEDICATION.
* CONTRAST AGENT’S NAME
* VOLUME ADMINISTERED
* DATE AND TIME OF ADMINISTRATION
collection of blood in tissues)
hematoma
are glass containers with narrow necks that are opened by breaking the glass.
ampules
injections deliver medications into the fatty tissue layer beneath the skin.
Subcutaneous Injections
are parenteral injections administered between the layers of the skin.
Intradermal Injections
IM; into the muscle) injections are sometimes given in larger amounts than SC injections, up to 5 mL, and the needle size is also larger, usually 22 gauge.
Intramuscular
involves percutaneous access to the artery by a needle, frequently followed by catheter placement to permit injection at a specific anatomic site.
Intraarterial Administration
is the parenteral method used when a contrast medium is to be injected through a spinal needle directly into the subarachnoid space.
Intrathecal Administration
sometimes called a drip infusion, is the administration of fluids or medications through an intravenous catheter by gravity flow.
infusion
a solution of 0.9% sodium chloride in water.
normal saline
that is, it has the same has the same concentration of solute as human body fluid.
isotonic
sometimes called a saline lock
intermittent injection port
diluting liquid
dilutent
the pressure exerted by fluid due to the force of gravity
hydrostatic pressure
example of an interdermal test
TB test
Range for BUN
7-21
above 21 kidneys are not functioning properly
Range for creatinine
0.7-1.5
too high kidneys are not functioning properly
what does GFR stand for
Globular filtration rate
Range for GFR
90-120
below 90 is not good
what type of relationship does BUN and Creatinine have with GFR
Inverse
normal drip rate
15-20 drips per minute is about 60mls an hour
how should certain exams be scheduled
no contrast studies first
-iodine studies
-lower gi
-upper gi
schedule these studies in order :
IVU , UGI, BE, KUB
- KUB
- IVU
- BE
4.UGI
rapid injection of contrast
Bolus
bolus injection is also known as
IV push
most common place for injection
anticutible
what side is cephalic on
thumb side
what side is basilic on
pinky side
concentration of solution
osmolarity
what happens with risk of reaction when osmolarity of contrast agent increases
as osmolarity of contrast agent increases risk of reaction increases
thickness
viscosity
how to reduce thickness of a medication
put in warmer
