Chapter 4 - Medication Preparation And Supplies

Question 1

Before administering injections or giving any medications, what are the six rights of Proper Drug Administration?

Answer 1

• right drug
• right dose
• right route
• right time
• right patient
• right documentation

Question 2

The injection site should be free of:

Answer 2

• lesions
• bruises
• inflammation
• edema
• masses
• tenderness
• sites of previous injections

Question 3

What are the three injection routes?

Answer 3

• Intradermal (ID)
• Subcutaneous (SC)
• Intramuscular (IM)

Question 4

Capsule

P. 44

Answer 4

Drug contained within a gelatin-type container.

• easier to swallow than non coated tablets.
• double chamber may be pulled apart to add drug powder to soft foods or beverages for patients who have difficulty swallowing (unless specifically contraindicated for absorption).

Question 5

Drug form

P. 42

Answer 5

Refers to the type of preparation in which the drug is supplied.

Question 6

Elixir

P. 45; 587

Answer 6

Usually sweetened, aromatic liquid used in the compounding of oral medicines.

-Or fluid extract. Liquid drug forms with alcohol base.

• should be tightly capped to prevent alcohol evaporation.
• should not be available to alcoholics.
• caution use in small children.

Question 7

Enema

P. 45; 587

Answer 7

The introduction of a solution into the rectum and colon to stimulate bowel activity and cause emptying of the lower intestine.

• drug may be either a suspension (needs to be shaken before administration) or a solution to be administered as an enema.

Question 8

Emulsion

P. 45

Answer 8

Liquid drug preparation that contains oils and fats in water.

Question 9

Enteric-coated tablet

P. 44

Answer 9

Tablet with a special coating that resists disintegration by gastric juices. The coating dissolves further down the GI tract in the enteric, or intestinal, region.

Question 10

Inhalation drug forms

P. 52; 590

Answer 10

Forms of a drug to be inhaled by the respiratory system usually through a specialized device such as a metered-dose inhaler (MDI).

• Spray
• Mist

Question 11

Injectable drug forms

P. 45-49

Answer 11

Forms of drugs manufactured to be given via injection such as intravenous (IV) or intramuscular (IM).

• liquid: drug suspended (suspension) or dissolved (solution) in a sterile vehicle.
• powder: dry particles of drugs. The powder itself cannot be injected. It must be mixed with a sterile diluting solution (sterile water or saline solution) to render an injectable solution.

Question 12

Oral drug forms

P. 44; 591

Answer 12

Drugs manufactured to be given via the oral route such as pills, solutions, and capsules.

• tablet
• enteric-coated
• capsule
• lozenge
• suspension

Question 13

Lozenge (troche)

P. 44

Answer 13

Tablet containing a palatable flavoring, indicated for a local (often soothing) effect on the throat or mouth.

Question 14

Parenteral

P. 43

Answer 14

Refers to any route not involving the GI tract, including injection, topical (skin or mucosal), transdermal and the inhalation route.

Question 15

Reconstitution

P. 46; 593

Answer 15

The return of a substance previously altered for preservation and storage to its original state, as is done with dried blood plasma and powdered medications.

Question 16

Rectal drug forms

P. 45; 593

Answer 16

Drugs manufactured to be administered via the rectal route, such as suppositories.

• suppository
• enema

Question 17

Route of delivery

P. 42; 593

Answer 17

The way that drugs are taken into the body.

• intramuscular
• intravenous
• topical
• oral
• rectal
• subcutaneous

Question 18

Solution

P. 45

Answer 18

Liquid drug form in which the drug is totally and evenly dissolved.

• Appearance is clear rather than cloudy or settled (as with a suspension).

Question 19

Suppository

P. 45

Answer 19

Drug suspended in a substance, such as cocoa butter, that melts at body temperature.

Used:
• rectal
• vagial
• urethral

Question 20

Suspension

P. 44

Answer 20

Liquid form of medication that must be shaken well before administration because the drug particles settle at the bottom of the bottle. The drug is not evenly dissolved in the liquid until properly shaking the mixture.

Question 21

Sustained-release capsule or tablet

P. 44

Answer 21

Capsule or tablet containing drug particles that have various coatings (often of different colors) that differ in the amount of time required before the coatings dissolve. This form of drug preparation is designed to deliver a dose of drug over an extended period of time.

Question 21

Sustained-release capsule or tablet

P. 44

Answer 21

Capsule or tablet containing drug particles that have various coatings (often of different colors) that differ in the amount of time required before the coatings dissolve. This form of drug preparation is designed to deliver a dose of drug over an extended period of time.

Question 22

Syrup

P. 45; 594

Answer 22

A concentrated solution of sugar in water to which specific medicinal substances are usually added.

• Sweetened, flavored liquid drug form. Cherry syrup drug preparations are common for children

Question 23

Tablet

P. 44

Answer 23

Disk of compressed drug.

Question 24

Topical drug forms | P. 49

Answer 24

Drugs for dermal application and drugs for mucosal application. -Those for dermal application include the following: * cream or ointment * lotion * liniment * transdermal patch ``` Those for mucosal application include the following: • eye, ear, and nose drops • eye ointment • vaginal creams • rectal and vaginal suppositories • douche solution • Buccal tablet • sublingual tablet • sandwiching the drug between very thin plastic membranes and then placing it under the patient's eyelid. ```

Question 25

Intramuscular injection | P. 46

Answer 25

Injected into the muscle by positioning the needle and syringe at a 90 degree angle from the skin. •Absorption is fairly rapid due to the vascularity (presence of many blood vessels) in the muscle

Question 26

Subcutaneous injection | P. 46

Answer 26

Injected into the fatty layer of tissue below the skin by positioning the needle and syringe at a 45 degree angle from the skin. • this may be the route of choice for drugs that should not be absorbed as rapidly as through the IV or IM routes.

Question 27

Intradermal injections | P. 46

Answer 27

Injected just beneath the skin by positioning the needle bevel up and the syringe at a 15 degree angle from the skin. * This route is used primarily for allergy skin testing. * because of the lack of vascularity in the dermis, absorption is slow.

Question 28

Intravenous injections | P. 46

Answer 28

Injected directly into a vein. Immediate absorption and availability to major organs renders this route a dangerous one. • IV drugs are usually administered by physicians, paramedics, or registered nurses. * Types of IV Injections: * IV Push * IV Infusion * IV piggyback (IVPB)

Question 29

Epidural injection | P. 48

Answer 29

Injected into a catheter that has been placed by an anesthesiologist in the epidural space of the spinal canal. • Medications for pain can be administered into the catheter by bolus a (measured amount of solution) in a syringe or by continuous infusion through the tubing attached to a bag of solution.

Question 30

Less common parenteral routes | P. 48-49

Answer 30

* Intraosseous - injected directly into the marrow of the long bones. This route may be used to administer medications during a cardiac arrest or other emergency situations when traditional IV access is not available. * intraventricular - drug injected directly into the brain via a catheter (called a ventriculostomy) to be placed in a brain ventricle. In critical care, antibiotics can be given via ventriculostomy tube. * intraspinal - injected into the subarachnoid space, which contains cerebrospinal fluid that surrounds the spinal cord. Drugs injected by this route are frequently anesthetics, which render a lack of sensation to those regions of the body distal to the intraspinal injection. * intracapsular (intra-articular) - injected into the capsule of a joint, usually to reduce inflammation, as in bursitis. Arthritic or bursitic joints often injected with anti-inflammatory drugs include shoulders, elbows, wrists, ankles, knees, and hips.

Question 31

Various supplies used for administering all different drug forms (P. 52-56)

Answer 31

* medicine cup * individual pill crusher and pill cutter * ampule * vial * needles * syringes * oral syringes

Question 32

Occupational Safety and Health Administration (OSHA) | P. 56

Answer 32

Have mandated that every effort be made to reduce the risk of needle-stick injuries that could lead to exposure to blood-borne pathogens, such as the human Immunodeficiency virus (HIV), Hepatitis B virus (HBV) or hepatitis C virus (HCV).