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PCC2 > Final exam review > Flashcards

Final exam review Flashcards

1
Q

what are the rights of medication administration

A

right patient, dose, route, time, medication, documentation

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2
Q

What is the oral route of administration

A

swallowed by mouth

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3
Q

Sublingual route of administration

A

under the tongue (ex. zofran)

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4
Q

Buccal route of administration

A

between the cheek and teeth

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5
Q

What are the parenteral routes of administration

A

intradermal, subcutaneous, intramuscular, intravenous

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6
Q

What are the two ways to administer topical medications

A

absorb through skin, on mucous membranes

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7
Q

What are considered topical medications that go on mucous membranes?

A

suppositories , vaginal creams

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8
Q

What is the inhalation route

A

inhaled into lungs

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9
Q

What is the intraocular route

A

absorbs in the eye (eye drops)

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10
Q

Verbal medication orders from the provider should be?

A

repeated back. provider must confirm it is correct

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11
Q

If a nurse questions an order, who should they go to?

A

the physician that wrote it

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12
Q

Can insulin ‘units’ be abbreviated?

A

no

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13
Q

What is a routine/standing order

A

given until it is changed or discontinue d

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14
Q

What is a single/one-time order

A

given one time only for a specific reason

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15
Q

What is a now order

A

give within 90 minutes

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16
Q

what is a prn order

A

given when patient requires it (must state reason why they need it)

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17
Q

what is a STAT order

A

given immediately ; used in emergencies

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18
Q

what is a prescription order

A

medication to be taken outside of hospital

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19
Q

Can the nurse use the patients room as an identifier before administering medications

A

no

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20
Q

Why is a medication reconciliation helpful

A

reduces likelihood of medication error

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21
Q

Who must report an error?

A

whoever discovers it

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22
Q

If a nurse knows they have made a medication error, must they report it?

A

YES

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23
Q

Why should nurses report medication errors and near misses

A

maintains safety and reduces chance of reoccurrence

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24
Q

All sharps must be placed in?

A

biohazard container

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25
Q

If the sharps container is 2/3 full, can we put more in there

A

NO

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26
Q

least invasive route of medication

A

oral

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27
Q

How to prevent aspiration when taking oral meds

A

chin to chest, sit up 90 degrees

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28
Q

When administering small-bore / enteral feedings, the best practice is to?

A

use liquids or mix with water to prevent blockages

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29
Q

When our client has a enteral or small bore feeding, it is important to verify?

A

placement ; tube location is compatible with medication absorption (stomach vs jejunum)

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30
Q

Risk of drug-drug interactions is higher with tube feedings, so it is important to?

A

administer one at a time and flush between each meds

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31
Q

Are enteral feedings tubers luerlocking or non-luer locking

A

non

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32
Q

If our skin is warm, will topical administration absorb faster or slower

A

faster

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33
Q

When administering topical medications/ patches, the nurse should?

A

wear gloves

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34
Q

What should we do with transdermal patches after placement?

A

label date, time, initial ; document where new placement is

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35
Q

Is nasal spray clean or sterile?

A

clean

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36
Q

Are nasal drops clean or sterile

A

sterile (should not touch patient)

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37
Q

How long should we wait in between administering different eye drops?

A

five minutes

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38
Q

Are eye drops clean or sterile?

A

sterile

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39
Q

When instilling eye drops, the nurse should wear

A

gloves

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40
Q

When administering eye drops, how can we prevent systemic effects

A

apply macular pressure

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41
Q

What is intraocular instillation

A

disk resembling contact lens and stays in the eye

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42
Q

For adults, pull the pinna

A

up and back

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43
Q

for kids, pull the pinna

A

down and back

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44
Q

Why should eardrops be instilled at room temperature

A

reduce vertigo

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45
Q

Are ear medication solutions sterile or clean

A

sterile

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46
Q

If the patient has ear drainage, should we administer drops?

A

no, can indicate ruptured eardrum

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47
Q

What allows vaginal meds to be broken down and absorbed

A

vaginal pH

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48
Q

If patients cannot administer their own vaginal meds, what should nurses do?

A

have second provider present

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49
Q

What shape are rectal suppositories

A

cone shaped

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50
Q

Do rectal and vaginal suppositories need refrigeration

A

rectal suppositories do, vaginal suppositories do not (remember vaginal suppositories have the protective coating)

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51
Q

What allows rectal medications to be broken down and absorbed

A

body heat

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52
Q

Why should nurses immediately administer rectal suppositories

A

they will melt by body heat

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53
Q

When administering rectal suppositories, what should the nurse do to ensure ease of use

A

lubricate it

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54
Q

Rectal suppositories should be placed against

A

rectal wall

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55
Q

pMDIs should be used with

A

a spacer

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56
Q

what does a spacer do

A

increase medication amount in the lungs

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57
Q

Nursing considerations for our clients using pMDIs

A

asses coordination and hand strength

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58
Q

BAIs have no set dose, so their medication release depends on

A

the client’s breath

59
Q

DPIs are activated by

A

clients breath

60
Q

do DPIs have a standardized dose?

A

yes

61
Q

Special considerations for steroid inhalers

A

rinse and clean mouth after to prevent infection

62
Q

If we are irrigating an open wound, the nurse should use?

A

sterile technique

63
Q

If there is no break non the skin, irrigation should be?

A

aseptic technique

64
Q

IV tubing uses luer-lok or non luer-lok

A

luer lok

65
Q

enteral feeding tubes use luer-lok or non luer-lok

A

non luer-lok

66
Q

When administering injections, the bevel should be

A

up

67
Q

The bigger the gauge, the

A

smaller the needle

68
Q

Viscous medications require a smaller or larger guage

A

smaller

69
Q

Considerations for drawing from an ampule

A

snap away and draw up with filter needle

70
Q

before injecting air into the vial, we should

A

clean the top

71
Q

When mixing medications from a vial and ampule, which do we draw first

A

vial

72
Q

How to mix insulin

A

air into NPH, air into regular, draw regular, draw NPH

73
Q

insulin syringe

A

100-unit insulin syringe

74
Q

Insulin is a _____ injection and we should?

A

subcutaneous ; rotate sites

75
Q

Classifications of insulin

A

rapid, short, intermediate, long

76
Q

What insulins cannot be mixed

A

glargine and determine

77
Q

Before administering insulin we must

A

verify the dose

78
Q

Rate of parenteral administration

A

1 ml / 10 seconds

79
Q

Subcutaneous injection site

A

bat wings and belly (abdomen and back of arms)

80
Q

Angle for subcutaneous; what determines this?

A

45 or 90 ; determined by body mass

81
Q

IM injection angle

A

90 always

82
Q

site of IM injection is determined by

A

amount and viscosity of medicine

83
Q

What are the IM injection sites

A

ventrogluteal, vastus lateralis, deltoid

84
Q

What IM injection site should be used for very viscous medications

A

ventrogluteal

85
Q

Indicator for ventrogluteal site

A

greater trochanter and iliac crest

86
Q

Where is the vastus lateralis

A

middle of the leg

87
Q

Vastus lateralis is used most often in

A

children receiving immunizations

88
Q

small amounts and noninvasive medications can be administered in the

A

deltoid muscle

89
Q

location indicator for deltoid IM injeciton

A

acromian process

90
Q

What is the safest IM injection spot for adults and children

A

ventrogluteal

91
Q

What is the Z-Track method

A

displacement of the skin to seal needle track (medication cannot escape)

92
Q

What angle is an intradermal injection

A

15

93
Q

Indications for intradermal injection

A

TB, allergies

94
Q

intradermal injections will form a ?

A

wheal or bleb

95
Q

Should we rotate insulin injection sites

A

yes

96
Q

What is the purpose of a capillary blood glucose

A

asses glucose levels

97
Q

Important reminders for POC glucose sticks

A

puncture OUTSIDE of finger, wipe away first drop of blood, strips should be replaced every month

98
Q

What is important to remove for MRIs

A

metal, jewelry, zippers, medicine patches

99
Q

Clients with titanium on their body should keep?

A

MRI safety card on their bodyI

100
Q

If a patient says their MRI safety card is valid, but they do not have it on them, can we do the MRI?

A

NO

101
Q

Examples of meds that would be a subcutaneous injection

A

insulin, heparin, lovanox

102
Q

What is an NG tube

A

Short-term tube that ends in stomach and can administer feedings and medications

103
Q

Can NG tubes be inserted at the bedside

A

yes

104
Q

Why is it important to monitor the #’s on the nasogastric tube?

A

tell us the length inside patient, makes sure it is in the correct spot

105
Q

Nasogastric tubes NGT can have both continuous and bolus feedings. T or F

A

T

106
Q

What is a continuous tube feed

A

24 hours

107
Q

What is a bolus tube feed

A

short term; 30 mins

108
Q

Clients receiving tube feedings should sit up for _____ following to prevent

A

1 hr ; aspiration (can lead to pneumonia)

109
Q

Along with aspiration, what is another way tube feedings can cause pneumonia

A

the feedings are very high in sugar -> this attracts bacteria

110
Q

Enteral tube feeding should be room temperature to prevent

A

bloatedness and cramping

111
Q

What is the PEG tube

A

percutaneous endoscopic gastrostomy

112
Q

What is the PEJ tube

A

percutaneous endoscopic jejunostomy tube

113
Q

PEG and PEJ tubes are surgically implanted tubes

A

outside of the body (this makes them longterm)

114
Q

Small bore feedings tubes such as Dobbhoff/Nasojejunal end in the

A

jejunum (small intestine)

115
Q

Can we do bolus feeds with dobbhoff/nasojejunal tubing

A

no

116
Q

Why are dobbhoff tubes weighted

A

to push through the stomach sphincter

117
Q

If our client is receiving a continuous tube feeding, how many hours does this last

A

24 hrs

118
Q

Continuous feedings require a _____ while bolus doses can depend on _____

A

pump ; gravity

119
Q

If our client is on continuous feedings, the HOB must be ____ degrees ALWAYS

A

30

120
Q

What should tube feeding look like

A

coffee with cream

121
Q

Intestinal residual volume should be less than

A

10 ML ; if it is higher than this twice.. hold the medication

122
Q

Gastric residual volume should be less than

A

500 ml (if it is 500 ml once, or 250 ml twice –> hold the feeding)

123
Q

Can XR tablets go in our tube feedings

A

NO

124
Q

When administering meds through NG, PEG, and PEJ tubes, it is important to remember

A

to flush in between each and do a big flush at the end

125
Q

Bolus feeds are good for

A

8 hours

126
Q

Bolus feeds use an __ system

A

open system

127
Q

Bolus feeding clients need to sit up for

A

one hour

128
Q

Continuous feeding clients need to change tubing and feed every

A

24 hours

129
Q

Continuous feeds use a

A

closed system

130
Q

Patients with diabetes may require _____ amounts of nutrition

A

increased

131
Q

What should we monitor on all patients if they are receiving feedings

A

blood glucose

132
Q

A dobhoff tube requires ______ to confirm placement

A

scanning

133
Q

before unclamping feedings, the nurse should

A

pinch line (prevent it from spraying)

134
Q

If an NG tube is inserted with a brain shunt, the client is at risk of

A

disloding the tube. Leads to no breathing, no blood to the brain

135
Q

IF our client is immunocompromised, we should flush their lines with

A

sterile water

136
Q

Purpose of catheters

A

acute retention, acute bladder obstruction, urinary output in critically ill, open sacral/perineal wounds in incontinent client , end of life care, strict prolonged immobilization

137
Q

Catheters should be wiped down at least

A

once shift

138
Q

How to prevent infection in catheters

A

bag below the waist, do not put on floor, empty when 1/2 full, not using unless necessary, sterile technique, closed drainage system

139
Q

What is a clean catch ‘Mid stream” catch

A

for culture and sensitivity. clean, start urine, catch in middle

140
Q

T or F , we can touch the inside lid of a collection cup

A

FALSE, collection cups are sterile inside

141
Q

What is culture and what is sensitivity?

A

culture is the type of bacteria, sensitivity is what will kill it

142
Q

What is a random urine specimen

A

taken anytime, no special instructions

143
Q

What is first morning specimen

A

taken upon waking up

144
Q

rules of 24 hour urine collection:

A

start with empty bladder, keep on ice, MUST GET EVERY SINGLE DROP OR START OVER, immediately go to lab,time and date

PCC2 (4 decks)

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