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Funds II Lab > Final Lab Quiz > Flashcards

Final Lab Quiz Flashcards

1
Q

6 Rights of Medication Administration

A

right patient
right medication
right dose
right route
right time (frequency)
right documentation

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2
Q

Preparation of Meds: at bedside vs. outside of room

A

at bedside unless there is a specific reason to prepare outside of room (i.e. multi-dose preparations for infection control purposes)

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3
Q

Where is a multi-dose vial prepared?

A

outside of room

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4
Q

How long can a multi-dose vial be used after it is opened?

A

28 days, check expiration date

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5
Q

What are the three checks of medication administration?

A

1st: when taking med out of drawer
2nd: when prepping med
3rd: in room right before administration

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6
Q

If medications from a vial/ampule are prepared outside of the room:

A

they must be properly labeled

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7
Q

Med Order: furosemide 40 mg IVP daily

A

complete

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8
Q

Med Order: enoxaparin sodium 1mg/kg SC daily

A

complete

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9
Q

Med Order: acetaminophen 2 tabs po every 4 hours prn

A

incomplete: missing dose and reason for prn

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10
Q

Med Order: ambien 5mg po hs

A

complete

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11
Q

Med Order: hydrocodone/acetaminophen 5mg/326 mg 1-2 tabs every 4-6 hours prn pain

A

incomplete: missing route and cannot have 2 ranges in one order

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12
Q

Med Order: morphine 2mg x1

A

incomplete: missing route

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13
Q

MDI vs DPI inhalers

A

MDI: liquid medication that must be shaken before using
DPI: medication is in a capsule; no need for shaking

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14
Q

What does the patient need to do after using a steroid inhaler?

A

rinse mouth out because the steroid can cause a yeast infection in the mouth

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15
Q

Should the patient use a bronchodilator or steroid medication first?

A

bronchodilator because it dilates the bronchioles and opens the airway before giving the steroid inhaler

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16
Q

What is an example of a very common bronchodilator?

A

albuterol

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17
Q

What are the two routes for oral/topical meds?

A

sublingual (under tongue) and buccal (in cheek)

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18
Q

Where does absorption occur for oral/topical meds?

A

in mucous membranes in mouth - very quick absorption

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19
Q

Can you give oral/topical meds to NPO patient?

A

yes

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20
Q

What medications do you NOT crush whatsoever?

A

extended-release, enteric coated, sublingual, buccal

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21
Q

What are contraindications for giving oral meds?

A

vomiting, suction (ex: NG tube connected to suction), unconscious, NPO

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22
Q

What do liquid elixirs consist of?

A

alcohol (ex: nyquil)

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23
Q

Who should you not give liquid elixirs to?

A

children, pregnant women, alcoholics, liver disease pts

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24
Q

How do you pour a liquid medication?

A

palm label to protect label from getting medicine on it

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25
What do liquid syrups consist of?
sugar
26
What type of medication should you not give to diabetics?
liquid syrups because they contain sugar
27
What MUST be worn when giving medication patches?
gloves so it doesn't get on the skin
28
What needs to be changed frequently when using medication patches?
change sites frequently
29
Where shouldn't medication patches be placed?
places with hair
30
What needs to be written on med patches?
initials, date, and time
31
Process of administering eye drops
tilt head back pull down conjunctiva until you see conjunctival sac put drops on conjunctival sac have patient close eye hold pressure on lacrimal duct for 30 sec
32
Process of administering ointment in eye
squeeze a little and wipe it off (bc it's contaminated) tilt head back pull down conjunctiva until conjunctival sac is seen squeeze ointment on conjunctival sac close eye
33
How to administer ear drops
have patient lay on their side clean pinna straighten ear canal (down and back <3, up and back for >3) gently massage tragus (helps with absorption) have patient remain on side 5 min after insertion insert small piece of cotton loosely into ear prn 15-20 minutes
34
How to apply vaginal meds
applicator for creams privacy supine with HOB elevated lubrication if needed (water-based lube) remain supine for 5-10 min after
35
How to administer rectal meds
wear gloves left sims position (laying on left, right leg bent) water-soluble lubricant round end of suppository goes first
36
Why is aspiration done for injections?
to ensure med is not being administered into a blood vessel
37
What injection site requires aspiration?
only IM injections dorsogluteal HAS to be aspirated because of major vessels at site
38
How long do you have to pull back on the plunger when aspirating?
a minimum of 5 seconds, maybe more
39
What do you do if you see blood enter the syringe when aspirating?
start over and dispose of the current medication properly controlled substances disposed of by having another RN watch you waste it
40
How is the deltoid site landmarked for injection?
2 fingers under acromion process do not go below axillary line
41
When is the deltoid site best used?
immunizations
42
What is the max amt of med that can be administered in deltoid site?
1 mL
43
Needle size for deltoid injection
1", 22 to 25 gauge (based on med thickness)
44
Gauge sizes for needles
bigger the number, the smaller the hole is based on thickness of med
45
Ventrogluteal injection site landmarks
palm of hand on greater trochanter (hip) with fingers facing up towards head find iliac crest and make a "V" with fingers (index and middle) and insert between them
46
When is ventrogluteal site best used?
best practice/safest for a large vol IM injection bc not many large vessels or nerves run close to location antibiotics, some pain meds
47
Max amt allowed in ventrogluteal site
3 mL
48
Needle size for ventrogluteal inj
1.5" 20 to 25 gauge for aqueous fluids 18 to 21 gauge for viscous or oil-based solutions
49
How is vastus lateralis injection site landmarked?
on outside of leg divide into thirds, inject in MIDDLE,OUTER third
50
When is vastus lateralis best used?
used for infants bc it is biggest muscle they have until they become mobile
51
How is rectus femoris injection site landmarked?
divide upper leg into thirds, inject in ANTERIOR, MIDDLE third
52
When is rectus femoris best used?
self-administration epi-pen
53
How is NG tube measured to determine the correct length for insertion?
from tip of nose to earlobe and then to xiphoid process put a piece of tape on tubing to mark it
54
How is the patient's head positioned during NG tube insertion?
head back hyperextend head until tube is at posterior oropharynx bring head forward when tube is at posterior oropharynx, and then have patient drink and swallow use water-based lubricant
55
What is the best practice for confirming NG tube placement?
checking gastric pH, which should be between 1-5
56
What is Blessing Hospital Policy for confirming NG tube placement?
inject 30 mL of air and listen for bubbling over stomach
57
What is done to prevent aspiration when removing NG tube?
Nurse: inject air bolus into tube to get everything out of the tube prior to removing Patient: take deep breath and hold it so the epiglottis is closed to protect the airway
58
What types of medications cannot be crushed?
extended release enteric coated sublingual and buccal
59
Cleaning Process for Foley Insertion: Male
circumcised: circular motion from tip to base using separate swab for each stroke Uncircumcised: same as usual but pull back foreskin before and then replace
60
Cleaning Process for Foley Insertion: Female
spread labia, top to bottom, outer to inner, down the middle, different swab each swipe
61
Procedure for Foley - How far to insert in male/female?
male: insert until you see urine and go to the Y-bifurcation female: insert until you see urine then go 2 more inches
62
Key Principles of Sterile Technique
outer wrap/covering is not sterile sterile items that are out of sight are unsterile no coughing/sneezing over sterile field hands/objects must stay above waist/table height do not reach over sterile field when using forceps (tweezers), tips stay pointed down
63
Wound Cleansing: Saline
does not disinfect moves bacteria clean top to bottom, in to out
64
Wound Cleansing: Betadine
antimicrobial agent used to clean for Foley insertion clean top to bottom, out to in cleanest to dirtiest
65
Wound Cleansing: Chlorhexidine
antimicrobial agent friction scrub back and forth for 30 seconds
66
Telfa Dressing
slick/shiny surface that is absorbent (middle part of bandaid) non-adherent does not stick to wound, need to put adhesive dressing on top
67
Island Dressing
telfa with an adhesive border, eliminates need for outer dressing
68
Surgipad or Abdominal (ABD) Pads
very absorbent; often used over addition dressings blue stripe faces outward need to tape it down
69
Transparent Film (Tegaderm)
semipermeable, nonabsorbent used to cover IV sites (so you can see site) small = IV site large = central line
70
Impregnated Nonadherent (Vaseline Gauze)
material is impregnanted with petroleum jelly or other agents covers partial and full thickness wounds WITHOUT drainage requires outer dressing
71
Hydrocolloids (DuoDerm)
waterproof adhesive wafer gelatinous/rubbery absorbs drainage and forms an occlusive seal can stay on up to 7 days used for pressure ulcers
72
Alginate (Algiderm, Curasorb)
non-adherent dressing available in many forms very absorbent (up to 20x their weight) made from seaweed all previous alginate must be removed prior to adding new need something on top of it
73
Who should be the first person to change surgical dressing?
surgeon or doctor
74
Wound Assessment
signs of healing or infection (no redness, wound edges together) foreign bodies (glass, magnets, splinters, dirt, sand, etc)
75
Wound Drainage Assessment
location, color, consistency, odor, amount
76
Ileostomy
small intestine liquid consistency, mild odor more at risk for skin breakdown
77
Ascending Ostomy
liquid - pudding like more odor
78
Transverse Ostomy
mushy and stinky
79
Descending Ostomy
more formed/solid may not need appliance can regulate w/ diet and irrigation
80
Sigmoid Ostomy
formed stool may not need appliance
81
Assessment of Stoma: Peristomal skin should be what?
dry and intact
82
Stoma Appearance should be?
pink or red; moist; pt does not feel (getting blood flow)
83
How often should the ostomy appliance be changed?
once a week unless there is skin breakdown
84
Changing Ostomy Appliance
-determine need to change appliance -select appropriate time -position pt (sitting up) -empty the pouch and remove skin barrier (drain when half full) -clean and dry peristomal skin -assess stoma and peristomal skin (no breakdown or redness) -measure stoma (1/8” clearance around stoma) -cut skin barrier to appropriate size and apply -if two pieces, attach pouch to skin barrier
85
Enteral - how to administer
NG tube, etc Crush meds and mix with tap water Liquid meds are best Turn off suction Check placement (pH, air bolus; depending on agency policy) Flush with 30 mL of warm tap water Administer meds (best practice, one at a time) Flush with 30 mL of warm tap water after Turn tube feeding back on, turn on suction after 30 minutes
86
Subcutaneous Injection
lenth 5/8" gauge 25-27 insulin, heparin, Lovenox 45 degree, pinch up 90 degree for obese
87
Intradermal Injection
bevel up for the bleb TB/allergies 30 gauge 5/8" length 15 angle scapula/forearm

Funds II Lab (5 decks)

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