Chapter 21 - Nonparenteral Medications

Question 1

What are some contraindications to receiving oral medication?

Answer 1

-NPO status
-N&V
-bowel inflammation
-reduced peristalsis
-recent GI surgery
-gastric suction
-decreased LOC

Question 2

Sublingual medications act in ____ mins

Answer 2

15

Question 3

Most oral medications act in __-__ mins

Answer 3

30-60

Question 4

What do you do is an adverse effect occurs?

Answer 4

-notify HCP and pharmacy immediately
-withhold further doses
-assess vital signs
-add allergy information to medical record

Question 5

What do you do if a patient refuses a drug?

Answer 5

-assess why they are refusing
-provide further instruction
-do not force
-notify HCP

Question 6

Where do you record a patients response to medication?

Answer 6

nurses notes

Question 7

What do you educate patients about for medication?

Answer 7

-purspose
-action
-dose
-dosage interval
-side effects
-foods to avoid or take
-what to do if missed dose or ae occurs

Question 8

Never administer medications into a NG tube inserted for _____________

Answer 8

decompression

Question 9

What medications can you not crush?

Answer 9

-sublingual
-sustained-release
-chewable
-long-acting
-enteric-coated

Question 10

What are contraindications of enteral medications?

Answer 10

-bowel inflammation
-reduced peristalsis
-recent GI surgery
-gastric suction that can’t be turned off

Question 11

What is important to asses about absorption when giving meds through feeding tube?

Answer 11

is the point of absorption bypassed by the feeding tube?

Question 12

If medication interacts with enteral feedings stop feeding at least ____ mins before admin

Answer 12

20

Question 13

How much tepid water do you use for enteral med admin?

Answer 13

50-100mL

Question 14

What is tepid water? Why do we use it?

Answer 14

lukewarm; prevents abdominal cramping that can occur with cold water

Question 15

Use _______ water for critically ill or immunocompromised patients

Answer 15

sterile

Question 16

If you have to crush tablets and give enterally what should you do first?

Answer 16

flush the tubing before and after and dilute the medication

Question 17

How much water do you dissolve a tablet into for enteral admin?

Answer 17

30mL

Question 18

What should asses before administering enteral meds?

Answer 18

-auscultate for bowel sound
-verify placement of feeding tube by observing gastric contents and checking pH

Question 19

What is a good gastric pH?

Answer 19

<5.0

Question 20

How do you check for gastric residual volume?

Answer 20

draw up 10-30mL of air into a 60mL syringe and connect syringe to tube, flush tube with air and pull back slowly to aspirate gastric contents, return contents to stomach after measuring

Question 21

If GRV exceeds _____ ML, hold meds and contact HCP

Answer 21

250

Question 22

If administering more than one dose enterally…

Answer 22

flush in between with 15 to 30 mL of water

Question 23

Follow the last dose of medication with ____ to ___ ML of water

Answer 23

30-60

Question 24

What do you do if a patient shows signs of aspiration during enteral feeding?

Answer 24

-stop medications
-elevate head of bed and stay with patient
-assess vitals while another HCP notifies dr

Question 25

What are signs of aspiration?

Answer 25

-respiratory distress
-changes in vital signs
-changes in o2 sats

Question 26

If irrigation with water is not effective in unblocking an ng tube what do you do?

Answer 26

obtain order for pancrelipase tablet or use declogging stylus

Question 27

What do you record after enteral med admin?

Answer 27

-method used to check tube placement, GRV, and pH or aspirate
-drug name
-dose
-route
-time immediately after admin
-total amount of water used

Question 28

When should you use sterile gloves when applying topical medication?

Answer 28

when the skin is broken

Question 29

Where can you apply a transdermal patch?

Answer 29

-chest
-back
-abdomen
-anterior thigh
-over non hairy or scarred skin

Question 30

Never apply a an estrogen patch on…

Answer 30

breast tissue, or waist line

Question 31

No not apply a patch to a previously used site for at least…

Answer 31

1 week