Exam II - Medication Administration Flashcards
Nurse practice acts (NPAs)
Define the scope of nurses’ professional functions and responsibilities
Pharmacokinetics
The study of four major processes: medication absorption, distribution, metabolism, and excretion.
Absorption
The movement of medication molecules into the blood from the site of medication admin
Injection
IV injection produces the most rapid absorption because medications are available immediately when they enter the systemic circulation
Biotransformation
Occurs under the influence of enzymes that detoxify, break down, and remove biologically active chemicals. Most of this occurs in the liver, although the lungs, kidneys, blood, and intestines also metabolize medications.
Therapeutic effect
The intended or desired physiological response of a medication. Sometimes a single medication has many therapeutic effects.
Adverse drug effects (ADEs)
Unintended, undesirable, and often unpredictable responses to medication.
Side effects
Are predictable and often unavoidable secondary effects produced at a usual therapeutic drug dose.
Toxic effects
Develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion.
Idiosyncratic reaction
An unpredictable effect, in which a patient overreacts or under reacts to a medication or has a reaction different from normal.
Anaphylactic reactions
Life threatening. Characterized by sudden constriction of bronchiolar muscles, edema of the pharynx and larynx, severe wheezing, and shortness of breath.
Medication tolerance.
Occurs over time. It is usually clinically noted when patients receive more and more medication (higher doses) to achieve the same therapeutic effect.
Medication interaction
In a medication interaction, one medication modifies the action of another. Medication interactions are common in individuals who take several medications.
In a synergistic effect:
…the combined effect of two medications is greater than the effects when given separately.
Minimum effective concentration (MEC)
The plasma level of a medication below which the effect of the medication does not occur.
Safe Therapeutic Range
The plasma level between the MEC and the toxic concentration.
To determine a peak and trough level, a blood sample is collected ___ before administering the drug (trough) and at the time the drug is expected to reach its ___ concentration
30 Minutes; Peak
Sublingual Medication
Instruct patients not to swallow a sublingual medication or drink anything until the medication is completely dissolved to ensure that the medication will produce the desired effect.
A med is administered by this route by placing the solid medication in the mouth against the mucous membranes of the cheek until it dissolves.
Buccal route.
Parenteral Administration
In this administration, you inject a medication into body tissues and not by GI tract.
Intradermal (ID) injection
Injection into the dermis. 5 to 15 degrees. TB test.
Subcutaneous (SQ) Injection
Injection into tissues just below the dermis of the skin. 45 to 90 degree angle. Abdomen, lateral aspect of upper arm, thighs.
Intramuscular (IM) injection
Injection into the muscle. usually 90 degree angle. Sometimes a shorter needle if person has underdeveloped muscle or is emaciated. Deltoid muscle, Dorsogluteal (not recc), Ventrogluteal, Vastus lateralis (thigh).
Intravenous (IV) injection
Injection into a vein. 15 to 35 degree angle.
Transdermal Disk
or a patch has systemic effects. The disk secures the medicated ointment to the skin. The nurse may leave a topical application in place for 12 to 7 days.
Intraocular medication delivery
Involves administering medication into the eye by drops, ointment, or disks. Come in very high concentrations because of fluid lost through the eye.
Prescriptions
Orders for medication. It is sometimes possible for prescriptions to come in household measurements.
Metric System
Most logically organized and safest to use. Each basic unit of measurement is organized into units of 10.
A solution can be:
- A mass of solid substance dissolved into a known volume of fluid
- A given volume of fluid dissolved in a known volume of another fluid.
Verbal or telephone order precautions
Only used when written orders are not possible. Limit these to urgent situations. Health care facilities should provide guidelines for clear and effective communication of verbal orders.
Medication error
Can cause or lead to inappropriate medication use or harm to the patients. Med errors include inaccurate prescribing; administering the wrong meds, dose, route,, and time interval, person, and administering too many doses or not at all.
Medication reconciliation
You play an important role in reconciliating a patients list of medications during the transfer of discharge process.
List the six rights of medication administration:
- Right medication
- Right Dose
- Right patient
- Right route
- Right Time
- Right documentation
Motivational Interviewing (MI)
A direct, patient-centered counseling approach that aims to help people change problem behaviors (such as medication nonadherance, smoking, weight gain) by helping patients explore and resolve ambivalence to change.
Polypharmacy
The use of multiple medications, the use of potentially inappropriate or unnecessary medications, or the use of a medication that does not match a diagnosis. You suspect polypharmacy if your pt uses two or more medications with the same or similar actions to treat several illnesses simultaneously or mixes nutritional supplements or herbal products with medication.
Ophthalamic medications
…in the form of eyedrops and ointments are given for eye conditions such as glaucoma and conjunctivitis.
Pressurized metered-dose inhalers (pMDIs)
Deliver inhaled medications that produce local effects in the airway such as bronchodilation.
Z-track method
A technique for pulling the skin during an injection, is recommended for IM injections.
