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Nursing #107 > Chapter 17 > Flashcards

Chapter 17 Flashcards

1
Q

(Meds)

As a nurse you are responsible for,

A
  1. Evaluating the effects of medications on a PTs health stats,
  2. teaching a PT about medications and their side effects,
  3. ensuring that PTs follow medication regimens,
  4. and evaluating PTs medication administration techniques
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2
Q

(Meds)

Pharmacokinetics is

A

The movement of drugs in the human body

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3
Q

(Meds)

Institutional policy’s are often more … than governmental controls

A

Restrictive

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4
Q

(Meds)

The primary intent of state nursing practice acts is to,

A

Protect the public from

  1. unskilled,
  2. undereducated,
  3. and unlicensed nurses
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5
Q

(Meds)

Opioids are,

A

a kind of medication that is controlled through federal and state guidelines

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6
Q

(Meds)

Medication misuse includes

A
  1. Overuse,
  2. underuse,
  3. erratic use,
  4. contradicted use
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7
Q

(Meds)
Medication abuse is,
Medication dependence is,

A
  1. When PT repeatedly use an addictive substance

2. When a PT experiences withdrawal

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8
Q

(Meds)

Enteric coated medications are meant to be absorbed in the,

A

Intensities

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9
Q

(Meds)

Elixirs are made of,

A
  1. Medication,
  2. water,
  3. alcohol
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10
Q

(Meds)

Solutions and powders are,

A

Sterile

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11
Q

(Meds)

Pharmacokinetics is the study of,

A
  1. Absorption,
  2. distribution,
  3. metabolism,
  4. and excretion of medications
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12
Q

(Meds)

Medication is,

A

A substance used in the

  1. diagnosis,
  2. treatment,
  3. relief,
  4. or prevention of health problems
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13
Q

(Meds)

Medication absorbtion depends on,

A
  1. Route of administration,
  2. ability of medication to dissolve,
  3. blood flow to area of absorption,
  4. body surface area,
  5. lipid solubility of the medication
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14
Q

(Meds)
Acidic medication are absorbed in the,
Alkaline medications are absorbed in the,

A

Gastric mucosa

Small intestine

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15
Q

(Meds)

If the surface area is … the medication will be absorbed quicker

A

Large

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16
Q

(Meds)

Distribution of medication depends on,

A
  1. Circulation,
  2. membrane permeability,
  3. protein binding
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17
Q

(Meds)

The blood brain barrier allows only … medications to pass into the … and …

A

Lipid soluble
Brain
Cerebrospinal fluid

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18
Q

(Meds)

With CNS infections antibiotics often have to be injected into the …

A

Subarachnoid

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19
Q

(Meds)

Bio transformation is,

A

What occurs when enzymes

  1. detoxify,
  2. degrade,
  3. and remove biologically active chemicals
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20
Q

(Meds)

Bio transformation most often occurs in the … but also occurs in the …

A

1.Liver

  1. Lungs,
  2. kidneys,
  3. blood,
  4. intestines
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21
Q

(Meds)

Medications exit the body through the …

A
  1. Kidneys,
  2. liver,
  3. bowel,
  4. lungs,
  5. and exocrineglands
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22
Q

(Meds)

Therapeutic effect is,

A

The intended of desired physiological response of a medication

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23
Q

(Meds)

Adverse effect

A
  1. Undesired,
  2. unintended,
  3. often unpredictable responses
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24
Q

(Meds)

Who is more at risk for adverse effects?

A
  1. Very young,
  2. very old,
  3. women,
  4. PTs taking multiple meds,
  5. PTs under or over weight,
  6. and PTs with renal or liver disease
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25
(Meds) | Side effect is a,
Predictable and often unavoidable adverse effect produced at a usual therapeutic dose
26
(Meds) | Toxic effects are,
Capable of causing injury or death
27
(Meds) | Factions influencing medication action,
1. Genetic differences, 2. physiological variables, 3. environmental conditions, 4. psychological factors, 5. diet
28
(Meds) | Mild allergic reactions
1. Urticaria (hives), 2. eczema (rash), 3. pruritus (itching), 4. rhinitis (inflammation of the mucous membranes), 5. wheezing (constriction of smooth muscles that surround bronchioles), 6. angioedema (short term subcutaneous or submucosal swellings)
29
(Meds) | Idiosyncratic reaction,
Unpredictable effects in which the PT over or under reacts to medication or has a reaction different from what is expected
30
(Meds) | Allergic reaction,
When a PT becomes immunologically sensitive after taking atleast one dose
31
(Meds) | Medication allergy,
When a PTs immune system causes abnormal reactions to a medication
32
(Meds) | Anaphylactic reactions
1. Sudden constriction of bronchiolar muscles, 2. edema of the pharynx and larynx, 3. and severe wheezing and shortness of breath
33
(Meds) | Synergistic effect,
When two medications combined effect is greater than their effects separately
34
(Meds) | MEC
Minimum effective concentration
35
(Meds) The peak is the, The trough is the,
Highest plasma level | Lowest plasma level
36
(Meds) | Time critical medications,
Need to be administered 30 minutes before or after the scheduled does inorder to not cause harm
37
(Meds) | Non time critical medications,
Need to be given 1-2 hours before or after scheduled dose to not cause harm
38
(Meds) Oral, buccal, sublingual 1. Pros 2. Cons
1. Convenient, comfortable, economjc, rarely cause anxiety 2. Avoided when PT have any changes in GI function, motility, suction, or surgical resectioning, or if the can't swallow. Sometimes irritate lining of GI, discor teeth, unpleasant taste
39
(Meds) Parenteral 1. Pros 2. Cons
1. Rapid absorbtion, excellent pain control, used when oral is contraindicated. 2. Not used in PTs w/ bleeding problems, expensive, risk of infection, tissue damage, may increase drug reaction, anxiety, pain
40
(Meds) Topical 1. Pros 2. Cons
1. Local effect, painless, limited side effects | 2. Absorption rapid if over a wound, otherwise slowly absorbed
41
(Meds) Transdermal 1. Pro 2. Con
1. Prolonged systemic effects, limited side effects | 2. Oily or pasty substance
42
(Meds) Mucous membranes 1. Pro 2. Con
1. Ready absorbed, cause systemic effects, when oral meds are contradicted 2. Mucous membranes are highly sensitive, rectal/vaginal medication cause embarrassment, contradicted with rectal bleeding or surgery
43
(Meds) Inhalation 1. Pros 2. Cons
1. Rapid relief for respiratory problems, easily used | 2. Can cause serious systemic effects
44
(Meds) Intraocular disk 1. Pros 2. Cons
1. Does not require frequent administration | 2. Local reaction possible, PT must be taught, expensive, contradicted w/ eye infections
45
``` (Meds) Metric to (apothecary) and (household) 1. 1 mL 2. 5 mL 3. 15 mL 4. 30 mL 5. 240 mL 6. 480 mL 7. 960 mL 8. 3840 mL ```
1. (15-16 minims) (15 drops gtt) 2. (1 dram) (1 teaspoon tsp) 3. (4 drams) (1 tablespoon tbsp) 4. (1 fluid ounce oz) (2 tablespoons tbsp) 5. (8 fluid ounces oz) (1 cup c) 6. (1 pint pt) (1 pint pt) 7. (1 quart qt) (1 quart qt) 8. (1 gallon gal) (1 gallon gal)
46
(Meds) | The formula method
Dose ordered divided by dose on hand multiplied by amount on hand equals amount to administer
47
(Meds) | Children are ... at risk for experiencing a medication error than adults
3 times more
48
(Meds) | When taking a TO the nurse needs to,
1. Write the order and name of the prescriber, 2. sign the order, 3. and follow agency policy to indicate that the order was read back. The prescriber counter signs within 24 hours
49
(Meds) | What cancels a PTs medication orders?
1. Transfer from general unit to ICU, 2. having surgery. 3. Being transferred from another health care facility, different unit, or is discharged requires the provider to review all orders
50
(Meds) | Standing order
Is carried out until the order is canceled or a prescribed number of days elapses
51
(Meds) | PRN orders require the nurse to,
Document the assessment data used to decide to give medication as well as the time administration
52
(Meds) | A NOW order is given,
Quickly, but not necessarily right away like with a STAT order
53
(Meds) | Unit dose system,
Portable carts containing a drawer with a 24 hour supply of medications for each PT
54
(Meds) | AMDSs
Automated medication dispensing systems. Control the dispensing of all medications
55
(Meds) | Never delegate ... to a NAP,
Patient and family teaching on medication administration
56
When a medication error occurs and you are involved, who is responsible for preparing an incident report, and in what timeframe?
You are responsible, and within twenty four hours
57
(Meds) | Medication reconciliation is a proces in which you,
Compare the medications that your PT took in the previous setting with the current medication orders whenever you admit a PT to a new health care setting
58
(Meds) | The six rights of medication are,
1. Right medication 2. Right dose 3. Right PT 4. Right route 5. Right time 6. Right documentation
59
(Meds) | MAR
Medication administration record
60
(Meds) | When should you check the medication container?
1. While removing the container from the shelf 2. As you remove the amount of medication ordered 3. At the bedside before administering the medication
61
(Meds) In the first step of the nursing process you should consider what seven things when trying to ensure safe medication administration?
1. History (allergies, diet and medication history) 2. Perceptual or coordination problems 3. Current condition 4. Attitude about medication use 5. Considerations involving older adults (often lack of knowledge) 6. Knowledge and understanding of medication therapy 7. Expectations
62
(Meds) | The goal of medication administration is,
Better control of the PTs disease, improved health, and adherence to a medication regimen
63
(Meds) | What kinds of drugs are often of high priority?
1. Anti hypertensives, 2. cardiac medications, 3. And antiseizure drugs
64
(Meds) | Medication orders have to include,
1. PTs full name 2. Date and time of order 3. Drug name 4. Dosage 5. Route 6. Time and frequency 7. Signature of prescriber
65
(Meds) | Children's dosages are usually,
Lower than adults, although they may be higher due to metabolism
66
(Meds) | Poly pharmacy
When a PT uses two or more Meds to treat the same illness, takes two or more Meds from the same chemical class, or two or more drugs with the same or similar purpose
67
(Meds) | ADRs
Adverse drug reactions
68
(Meds) | The goal of safe PT care includes doing what?
1. Carefully evaluating the PTs response to therapy | 2. And ability to assume responsibility for self care
69
(Meds) | How much water should ideally be taken with tablets
60-240 ml
70
(Meds) | When giving Meds to a PT what position should you ideally place them in?
Seated or fowlers
71
(Meds) | If your PT is having a hard time swallowing who should you contact?
The speech therapist
72
(Meds) | Turning the head in which direction helps the med move down the PTs stronger side of the esophagus?
Toward the weaker side
73
(Meds) | Should PTs use straws?
Noooo
74
(Meds) | Never add Meds to what?
Tube feeding
75
(Meds) | Flush ng tube with how much water between Meds?
15-30 mL of sterile water
76
(Meds) | When should you be sure to remove a med patch?
Before placing a new one or before sending a PT to have a MRI
77
(Meds) | Instill ear drops at ... to prevent ...
1. Room temp | 2. Vertigo and nausea
78
(Meds) | What should you do when a PT wants to administer their own vaginal medication?
Be sure that they know how to properly do it and then give them privacy.
79
(Meds) How should you straighten the ear canal? 1. Younger than 3 2. Older then 3
1. Down and back | 2. Up and out
80
(Meds) | When administering a vaginal med, what position should the PT assume?
Dorsal recumbent
81
(Meds) | How long should Meds stay in the vagina?
Preferably for at least ten minutes
82
(Meds) | pMDIs
Pressurized meter-dose inhalers
83
(Meds) | BAIs
Breath actuated metered dose inhalers
84
(Meds) | DPIs
Dry powder inhalers
85
(Meds) | How should you insert an anal med?
Past internal sphincter and against rectal wall, ten cm (four inches) in adults, five cm (two inches) in children and infants
86
(Meds) | How long should med stay in anus?
Atleast five minutes
87
(Meds) | An injection is,
An aseptic procedure
88
(Meds) | Luer-Lok syringes have,
Needles that twist into place
89
(Meds) when preparing a syringe you should hold it by the,
Barrel and handle
90
(Meds) | When preparing Meds from an ample you should,
Use a filter needle to prevent glass particles from being drawn into the syringe
91
(Meds) | When mixing meds and one is from a vial and the other is from an ampule, which should you prepare first?
The med from the ampule. Prevents glass from getting into vial
92
(Meds) | How do you mix two Meds from two vials?
1. Aspirated the volume of air equivent to first med into the syringe 2. Inject air into vial A 3. Withdraw needle and repeat 1. with vial B. 3. Draw med into syringe from vial B 4. Repeat 3. With vial A. making sure not to inject vial A with vial Bs med
93
(Meds) | What kind of insulin can you administer intravenously?
ONLY regular insulin
94
(Meds) | NPH
Intermediate insulin
95
(Meds) | Correction insulin,
Small amounts of rapid or short acting insulin to correct blood sugars quickly
96
(Meds) | Never mix what kinds of insulins with other insulin?
1. Glargine (lantus) | 2. Detemir (levemir)
97
(Meds) | When mixing a fast and an intermediate insulin, which should you withdraw first?
The short term. Short term can bind to intermediate and reduce the effectiveness
98
(Meds) | Do you need to aspirate when giving subQ injections?
No!
99
(Meds) SubQ. How large of a dose should you give to 1. Adults 2. Children
1. 0.5-1.5 | 2.
100
(Meds) | The most common site for heparin is?
The abdomen
101
(Meds) | The ... has the quickest absorbtion rate, followed by the ... the ... and the ...
1. Abdomen 2. Arms 3. Thighs 4. Butt
102
(Meds) | IM. An adult can usually tolerate ... mL of medication in a large muscle without pain
2-5
103
(Meds) | IM. Children, older adults, and thin PTs can only tolerate ... ml
2
104
(Meds) | Venterogluteal,
This site involves the gluteus medius. | Side of the butt cheek
105
(Meds) | Vastus lateralis,
Anterior lateral aspect of the thigh
106
(Meds) | Deltoid,
Shoulder. Risk for injury
107
(Meds) | Z-track method,
Seals the medication into the muscle. Slide tissue away, give injection, withdraw needle, remove hand
108
(Meds) | ID. Why are potent Meds administered into the dermis?
Because the blood supply is reduced and medication absorbtion occurs slowly
109
(Meds) | IV bolus,
Introduces a concentrated dose into the systemic circulation. The most dangerous way of administering medications
110
(Meds) | Avoid ... whenever possible to reduce sharps injury
Needles
111
(Meds) | LPNs and LVNs can usually administer ...
Oral, subcutaneous, IM, and IS Meds
112
(Meds) | nurses should not ... when ever possible to reduce risk of inaccurate dosage
Split pills
113
(Meds) 1. Give time critical Meds ... 2. Give nontime critical Meds ...
1. 30 minutes before or after | 2. 1-2 hours before or after
114
(Meds) | Remaining seated for ... help the medication ...
1. 30 minutes | 2. Move through the stomach
115
(Meds) | When giving eye drops place dropper ... above conjunctival sac
1-2 cm, 1/2 to 3/4 in
116
(Meds) | How long should you wait before giving a second medication in the same eye?
Five minutes
117
(Meds) | when giving inhaled Meds, how long should the PT breath in for and how long should they hold their breath?
1. 3-5 seconds | 2. Up to 10 seconds
118
(Meds) | Never shake what kind of inhaler?
DPI
119
(Meds) How long should PT wait between puffs on the same med? Puffs of different med?
1. 20-30 seconds | 2. 2-5 minutes
120
(Meds) | Paroxysm
Seizure like spasm thing?
121
(Meds) | SubQ contraindications
1. Circulatory shock | 2. Reduced tissue perfusion
122
(Meds) | IM contraindications
1. Muscle atrophy 2. Reduced blood flow 3. Circulatory shock
123
(Meds) | ID contraindications
Necrosis after previous ID injection
124
``` (Meds) SubQ. 1. Needle should be how long 2. Younger the 1 year injection site 3. Older than 1 year injection site ```
1. Half of skin fold 2. Thigh 3. Upper arm
125
(Meds) IM 1. Use ... site in younger than 1 year 2. Use ... site in older than 1 year
1. Vastus lateralis 2. Deltoid 3. 1. For immunization up to three years, 2. For immunization after three years
126
(Meds) ID What site should preferable be used?
Three to four finger widths below anticubital space and one hand width above wrist
127
(Meds) | Lipohypertrophy
Increases growth in fatty tissue
128
(Meds) SubQ What degree?
45-90 degree
129
(Meds) IM What degree
90
130
(Meds) | There is no need to ... when administering vaccines
Aspirate
131
(Meds) ID What degree?
5-15
132
(Meds) | Never administer IV Meds through tubing that is,
Infusing blood, blood products, or parenteral nutrition
133
(Meds) | thrombocytopenia
Decrease in platelets. Associated with heparin flushes
134
(Meds) | The use of stopcocks is,
Not recommend because of the risk for infection

Nursing #107 (4 decks)

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