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NUR 202 > Chapter 3: Principles of Drug Administration > Flashcards

Chapter 3: Principles of Drug Administration Flashcards

1
Q

Rights of Drug Administration

A

1) Right Patient
2) Right Medication
3) Right Dose
4) Right Route
5) Right Time/Frequency

Others:
Right to Refuse
Right Education
Right Documentation

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2
Q

Why do we need the Rights of Drug Administration?

A

-simple, practical guidelines for drug preparation, delivery, administration
-prevent medication error
-nurses are last safety net because they are administering the drugs
-operational basis for safe delivery of medication
recognized by Institution for Safe Medication Practices (ISMP)

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3
Q

Checks of Drug Administration

A

Used in conjunction with the 5 rights
1) Check the drug with the MAR (Medication Administration Record) when removing it from the medication drawee, refrigerator, or controlled substance container
2) Check the drug when preparing it, pouring it, taking it out of the unit-dose container, or connecting the tubing to the IV bag
3) Check the drub before administering to the patient

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4
Q

Nursing Process: Assessment in regards to medication

A

accuracy of Dr’s orders, collect data– Subjective (allergies) Objective (Vital Signs), health literacy,
health history

systemic collection of patient data
assessment of patient receiving medications
-health history, physical assessment, lab values,
assessment of medication effects (therapeutic and side effects)

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5
Q

Nursing Process: Diagnosis in regards to medication

A

-knowledge deficient to medicine regimen (follow up, reasons for use)
-any risk for falls, injury SE
-non adherence (health literacy issues) or no compliance (knows but doesn’t do)

analysis of assessment data, focused on patient problem

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6
Q

Nursing Process: Planning in regards to medication

A

setting goals what patient is able to achieve
outcomes, that you are looking for; measurable things; used to measure goal attainment

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7
Q

Nursing Process: Interventions in regards to medication

A

Administering medications (5 rights, 3 checks), documenting medications and teaching patients

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8
Q

Nursing Process: Evaluation in regards to medication

A

therapeutic effectiveness, monitor adverse effects
compares patient current health status to desired outcome
if the plan of care is appropriate, met or needs revision

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9
Q

Adverse Effect

A

any undesirable experience from the use of a medical product in patient;
described in terms of intensity: mild, moderate, severe, life-threatening
any AE is preventable

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10
Q

Side Effect

A

non-therapeutic reaction to drug; includes allergic and anaphylactic reactions

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11
Q

Demographic at risk for AE

A

very young, old, ill, or people taking multiple medications

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12
Q

Routes of Administration

A

1) Enteral
2)Topical
3)Parenteral

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13
Q

ac

A

before meals

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14
Q

ad lib

A

as desired

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15
Q

AM

A

morning

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16
Q

bid

A

twice a day

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17
Q

cap

A

capsule

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18
Q

gtt

A

drop

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19
Q

h or hr

A

hour

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20
Q

IM

A

intramuscular

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21
Q

IV

A

intravenous

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22
Q

no

A

number

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23
Q

pc

A

after meals

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24
Q

po

A

by mouth

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25
Q

prn

A

as needed

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26
Q

qid

A

four times a day

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27
Q

q2h

A

every two hours

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28
Q

q6h

A

every six hours

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29
Q

q8h

A

every eight hours

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30
Q

Rx

A

take

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31
Q

STAT

A

immediately; within 5 minutes

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32
Q

tab

A

tablet

33
Q

tid

A

three times a day

34
Q

PM

A

afternoon/evening

35
Q

q4h

A

every four hours

36
Q

q12h

A

every twelve hours

37
Q

ASAP

A

within 30 minutes of written order

38
Q

Single Order

A

pre op? drug given once at specific time

39
Q

Standing order

A

written order to use under certain circumstances

40
Q

Allergic Reaction

A

side effect
acquired response of the body defense to a foreign substance (allergen)

i.e.skin rash w/ or w/o itching, red eyes with tearing, edema, runny nose

41
Q

Anaphylactic reaction

A

side effect
severe allergic reaction that produces a massive systemic release of histamine and other mediating factors that will cause inflammation that is life-threatening

42
Q

Treatment for allergies

A

diphenhydramine (Benadryl)

43
Q

Symptoms of Anaphylactic Shock

A

i.e acute dyspnea (labored or difficult breathing); sudden tachycardia or hypotension following drug administration shortly after
-swelling of face, eyes, mouth, throat
-wheezing
-extremely low BP
-cardiac arrest

44
Q

Treatment of Anaphylactic Shock

A

reestablishment of airway and oxygen therapy
administer epinephrine to raise blood pressure and dilate the respiratory bronchi; give Benadryl to stop additional release of histamine

45
Q

Enteral (Broad)

A

ingestion and absorption in the digestive tract

46
Q

Topical (Broad)

A

passive transfer through porous tissue
i.e. skin, alveoli in lungs, mucous membranes

47
Q

Parenteral (Broad)

A

insertion directly to inferior tissues
intramuscular (muscle), intravenous(veins), subcutaneous

48
Q

Which route is the safest

A

Enteral-ORAL; skin barrier is not compromised

49
Q

Roles and Responsibilities of nurses regarding safe drug administration

A

legal and ethical

50
Q

Types of Enteral Routes

A

A. Oral (tablets, capsules, liquids)
B. Buccal
C. Sublingual
D. Nasogastric and gastrostomy

51
Q

Advantages and Disadvantages of Enteral Drug Administration

A

Advantages: Convenient, doesn’t compromise skin barrier, OVERDOSE–> vomit unabsorbed medication, vast absorptive surfaces skin, stomach, small intestine

Disadvantages: depends on their gastrointestinal mobility and motility, First pass effect: inactivation of drug by processing in liver; inactivated by enzymes, may be difficult to swallow by some patients, may be inactivated if capsules and tablets are crushed

52
Q

Enteric-coated tablets

A

CANT BE CRUSHED
has hard waxy coating that resists acidity in the stomach
target= small intestine

53
Q

Sustained release tablets or capsules/extended release (XR) or Long -acting (LA) medication

A

DO NOT CRUSH
designed for a longer duration; dissolves slowly
helps increase compliance by reducing frequency of dosage

54
Q

ODT

A

ONDANSETRON
place on tongue and will dissolve within 30 min; eliminates need for external water; aids compliance

55
Q

Sublingual

A

tablet is kept in mouth under tongue
rapid onset because rich blood supply
taken after other oral methods
do not eat or drink anything until completely dissolved

56
Q

Buccal

A

tablet or capsule placed in oral cavity between gum and cheek; Buccal mucosa is less permeable than sublingual providing slower absorption; do not generally cause irritation

57
Q

NG tube

A

Nasogastric
soft flexible tube inserted through nose (nasopharynx) to stomach
can use crushed or dissolved drugs (liquid form) but can clog DO NOT USE SUSTAINED RELEASE

58
Q

G tube

A

Gastrotomy
surgically placed in stomach
can use crushed or dissolved drugs (liquid form) but can clog DO NOT USE SUSTAINED RELEASE

59
Q

Applications of Topical Drug Administration

A

1) Dermatologic Preparation
2) Instillation and Irrigation
3) Inhalation

60
Q

Applications of Topical Drug Administration

A

1) Dermatologic Preparation
-drugs applied on skin
-lotions, gels, power, spray, cream

2) Instillation and Irrigation
-applied to oral cavities or orifices
-eyes, nose, ears, urinary bladder, vagina, rectum

3) Inhalation
-applied to respiratory tract
-inhalation, nebulizers

61
Q

Advantages and Disadvantages of Topical Drug Administration

A

Advantages:
-many used for local effect; can be use for systemic effect too
-fewer SE

Disadvantages
-absorbed slower

62
Q

Local effect example

A

antibiotics on skin to treat skin infection

63
Q

Systemic effect example

A

suppository inserted rectally not to treat disease of rectum but to alleviate nausea; rectal and nasal

64
Q

Transdermal Delivery System

A

transdermal patch contains a specific amount of drug; rate of delivery is variable; AVOIDS FIRST PASS EFFECT of liver and enzyme; alternate spots of patches; document location

65
Q

Ophthalmic Administration

A

used to treat local conditions in the eye and surrounding structures
-Common indication of problems: dry, dilation of pupil during eye exam, infection, glaucoma

Available in drops, irrigation, ointments, medicated disks

66
Q

Otic Administration

A

treat local conditions in the ear such as infections and soft blockages in auditory canal
- irrigation or drops
-used for cleaning purposes

67
Q

Nasal Administration

A

BOTH LOCAL AND SYSTEMIC EFFECT
excellent absorptive surface
bypasses digestive enzymes
high safety margin even though some may cause cilia damage or mucosal irritation
proper positioning
local astringent effect: shrink swollen mucous membranes or loosen secretions and facilitate drainage
drops or sprays are used to shrink swollen mucous

68
Q

Vaginal Administration

A

used to treat local infection; vaginal pain or itching
-creams, suppositories, foam, jellies
-need to explain what you are going to do and purpose of treatment FIRST; ALWAYS provide privacy
-ask patient to empty out bladder to prevent more discomfort; injury to vaginal lining
-should always offer perineal pad after administration

69
Q

Rectal Administration

A

USED FOR BOTH SYSTEMIC AND LOCAL ADMINISTRATION
-safe and effective administration is using when patient is comatose or vomited
-slow and steady absorption
-usually is suppository form; laxative given as enema
avoid first pass effect

70
Q

Which route is more invasive

A

PARENTERAL route is most invasive; ASPETIC TECHNIQUE must be used to prevent pathogens of being introduced into blood or body tissue

71
Q

Precaution for nurses to know for parenteral route

A

Know the anatomical location and how to safety dispose/handle hazardous material

72
Q

Types of Parenteral Administration

A

1) Intradermal
2) Subcutaneous
3) Intramuscular
4)Intravenous

73
Q

Intradermal

A

Administered to dermis of skin; absorbed more than subcutaneous; used for allergy, local anesthetic, or disease screening

74
Q

Subcutaneous

A

injection to deepest part of the skin
-used for easy access and rapid absorption; ID absorbed faster
-Vaccines, Heparin
-important to rotate injection sites
-aspiration is not necessary but depends on drug

75
Q

Intramuscular

A

delivers meds to specific muscles
more rapid onset compared to Subcutaneous, ID, and Oral
injection site is important: needs to avoid bone, nerves, blood vessels
-can accept a larger volume of medication that subcutaneous

76
Q

Intravenous

A

Fastest onset of drug
medication or fluids administered directly into bloodstream; immediate use by the body
DANGEROUS because:
once inject cant be received
potential risk for pathogens to enter at injection site

77
Q

Parenteral Advantages and Disadvantages

A

advantages
-bypass first pass effect and enzymes
-patients who are unable to take medications orally

disadvantages
-only small doses can be used
-possible pain and swelling at injection site area

78
Q

HIGH TO LOW ONSET

A

Parenteral: IV, IM, ID, SUBQ,
oral
topical

79
Q

Types of Intravenous Administration

A

1) large volume infusion
used for fluid maintenance, replacement, or supplementation
2)intermittent infusion
small volume of IV SOLUTION used in tandem with or piggy backed to primary large volume bag; instill adjunct medications
i.e. antibiotics or analgesics for a short period of time
3)bolus(push) administration
concentrated dose administered directly into bloodstream via syringe to administer single dose medications

NUR 202 (7 decks)

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