FINALSW1- ORAL MEDICATION ADMINISTRATION Flashcards
most common least expensive and most convenient route for clients. The drug being swallowed and because skin is not broken as it is for an injection, it is also a safe method
ORAL MEDICATION ADMINISTRATION
examples of medications that are given by enteral routes include which of the following: SELECT ALL THAT APPLY
a. total parenteral nutrition (TPN) solutions
b. oral tablets
c. oral capsules
d. rectal suppositories
e. liquid medications.
everything except A
The nurse checking the MAR finds that an order for an antibiotic is now 8 days old. The nurse should:
a. check the medications, performing three medication checks
b. give the ordered medication
c. contact the physician for a new order.
d. give the medication, then notify the physician
C. contact the physician for a new order
A patient on the long-term care unit receives the wrong medication. The charge nurse should instruct which staff member to complete the incident report?
a. the nurse who administered the wrong drug
b. the nursing supervisor for the day
c. the nurse who discovered the error
d. no one, because the charge nurse should do it.
c. the nurse who discovered the error
when administering medications to a patient with a feeding tube, the nurse should dissolve each crushed medication in at least ___ mL of water.
b. 20 to 30
For an adult patient who has an order to receive an otic medication, the nurse should plan to administer it by pulling the pinna:
a. down and forward
b. up and forward
c. down and back
d. up and back.
d. up and back.
To reduce the systemic absorption of eye drops, the nurse should:
a. use finger pressure to close the eyelid tightly
b. apply slight finger pressure over the lacrimal duct
c. request the patient tilt the head slightly to the side of the unaffected eye
d. instruct the patient to widen the eyes in order to increase access to the lacrimal duct.
b. apply slight finger pressure over the lacrimal duct
A patient complains about the taste of the the sublingual nitroglycerin and admits that the swallows it rather then holding it under his tongue. The nurse explains that sublingual medications.
a. should not be swallowed because it alters the absorption potential.
b. can be inserted rectally without loss of absorption potential
c. can be held against the roof of the mouth with the tongue to reduce taste.
d. can be taken between the cheek and tongue to diminish taste.
a. should not be swallowed because it alters the absorption potential.
Before the nurse administers a dose of digoxin (Lanoxin) to a patient, the nurse should assess:
a. blood pressure
b. respiratory rate
c. apical heart rate
d. level of consciousness
c. apical heart rate
The licensed nurse who is responsible for doing the narcotic count for the shift should count the drugs.
a. alone for accuracy.
b. with any licensed person
c. with another nurse working on the shift
d. with a nurse coming on duty for the next shift.
d. with a nurse coming on duty for the next shift
The nurse receives an order to give vitamin D 10 mcg bid. The nurse recognizes that the abbreviation mcg refers to a measurement in:
a. milligrams
b. milliequivalents
c. milliliters
d. micrograms
d. micrograms
Before the nurse administers a liquid medication to an 83 yr old male patient, the nurse should:
a. assess the swallowing reflex by offering a sip of water
b. ask the patient if he would prefer to give the medication to himself.
c. mix thoroughly in applesauce or pudding
d. assess the ability to understand information relative to the drug
a. assess the swallowing reflex by offering a sip of water
Metered-dose inhalers are used to deliver specific amounts of medication. The nurse gives the patient which of the following instructions?
a. never shake the inhaler medication before use.
b. exhale while squeezing the canister to deliver the medication.
c. sit upright, exhale, then activate he inhaler as the next inhalation begins.
d. hold the head back while inhaling the medication.
c. sit upright, exhale, then activate he inhaler as the next inhalation begins.
An elderly patient is scheduled to take six medications each morning. The nurse administering these medications knows to do which of the following?
a. allow extra time to administer all of the medications
b. allow the patient to take only the medications she can swallow.
c. crush all of the medications before giving them
d. leave the medication at the bedside so the patient can take them slowly.
a. allow extra time to administer all of the medications
When applying a topical nitroglycerin ointment, the nurse will do which of the following?
a. massage it thoroughly into the skin.
b. squeeze it onto the applicator paper and place it on the skin
c. apply it to the medial aspect of the thigh
d. shave the skin prior to application
b. squeeze it onto the applicator paper and place it on the skin
if an IV has become infiltrated, the nurse will observe which of the following assessment findings?
a. Pallor, pain
b. Erythema, warmth
c. Erythema, swelling
d. Warmth, swelling
c. Erythema, swelling
Which of the following principles of medication administration will be taught to a patient who will be administering his own subcutaneous (SC) injections?
a. Use a 22 G, 5/8 in needle
b. Rotate sites among the upper arm, abdomen, and anterior thigh
c. Avoid injecting within 3 in of a previous injection site
d. insert the needle at a 30 degree angle to the skin
b. Rotate sites among the upper arm, abdomen, and anterior thigh
which of the following is the correct needle for an intramuscular (Im) injection?
a. 18 G, 1-in
b. 20 G, 1/2 in
c. 25 G, 2-in
d. 21 G, 1 1/2 in
d. 21 G, 1 1/2 in
In which of the following ways can a nurse prevent injury from a needlestick?
a. recap the needle before disposal
b. remove the needle from the syringe
c. immediately discard the needle and syringe in a puncture-proof container
d. stick it into the patient’s mattress until it can be disposed of.
c. immediately discard the needle and syringe in a puncture-proof container
Which of the following is done after giving medication through a nasogastric tube that is connected to suction?
a. the tube is reconnected to the suction
b. the tube is clamped for 10 min then reconnected to suction
c. the tube is clamped for 30min then reconnected to suction
d. the suction is left off for 4 hrs then reconnected to suction
c. the tube is clamped for 30min then reconnected to suction
When giving a medicine through a nasogastric (NG) tube, the nurse will first do which of the following?
a. flush the tube with 30 mL of water
b. Check placement of the tube
c. take the vital signs
d. ask the patient if the tube is painful
b. Check placement of the tube
The nurse instructs a clinic patient on using an inhaler for his asthma attacks. Which of the following is correct about the use of an inhaler?
a. the medication must go into the back of the nose
b. the medication must go directly into the throat
c. the medication must get to the ears
d. the medication must go into the lungs.
d. the medication must go into the lungs.
Which of the following represents the proper way for a nurse to administer an oral capsule?
a. tell the patient to swallow it whole
b. pierce it with a needle and squeeze into the mouth
c. crush and dilute it in warm water.
d. tell the patient to chew it completely
a. tell the patient to swallow it whole
Which statement by the nurse is more likely to motivate a patient to adhere to a drug therapy regimen for hypertension?
a. your doctor prescribed this drug and your doctor knows what is best for your health.
b. if you do not take this drug you are at greater risk to die of stroke or heart attack within the next 10 yrs.
c. as an artist, your eyes are important, and taking this drug daily helps prevent eye damage from high blood pressure.
d. if you are not taking this drug because you are to poor to afford it, I can call a social worker so you can get financial aid.
c. as an artist, your eyes are important, and taking this drug daily helps prevent eye damage from high blood pressure.
The nurse is preparing to teach a patient about a newly prescribed drug therapy. What time is best for improving teaching effectiveness?
a. during lunch so that the patient is not too hungry to learn
b. after the patient wakes up from a nap and no visitors are present.
c. right after the health care provider has told the patient that the health problem cannot be cured.
d. when the patient’s spouse and 3 adult children are present so that the family can reinforce the teaching.
b. after the patient wakes up from a nap and no visitors are present.
The nurse is interviewing a patient. Which action by the nurse indicates active listening?
a. asking interview questions while starting an IV
b. correcting the patient’s use of the word “free bleeder” for hemophilia
c. asking the spouse to verify the patient’s responses to family history questions
d. restating what the patient said to ensure the nurse understands what the patient meant.
d. restating what the patient said to ensure the nurse understands what the patient meant.
when giving a drug to a patient who is awake but confused, what is the best way for the nurse to identify the patient?
a. check the room and bed number that the patient occupies.
b. ask the patient to state his or her name and birth date.
c. check the name on the patient’s wristband.
d. ask the patient if he or she is Mr. or Ms. (name).
c. check the name on the patient’s wristband.
What must the nurse be sure to tell the patient after a vaginal drug is administered?
a. this drug should be refrigerated
b. you may take this drug at home while sitting on the toilet.
c. be sure to empty your bladder after receiving this drug.
d. remain lying down for 10 to 15 mins after taking this drug.
d. remain lying down for 10 to 15 mins after taking this drug.
What administration technique does the nurse use to give a 2 yr old child ear drops?
a. pull the earlobe down and back
b. pull the earlobe up and out
c. keep the earlobe straight
d. hang the patient’s head over the side of the bed.
a. pull the earlobe down and back
A sublingual drug is administered by placing the drug in what part of the body?
a. between the cheek and the upper jaw
b. under the tongue
c. in the nose
d. in the eyes
b. under the tongue
A patient is to receive nitroglycerin ointment, 1 inch STAT, for elevated blood pressure. What must the nurse do before giving this drug?
a. shave the hair off the patient’s chest
b. place the patient on a heart monitor
c. put on a pair of disposable gloves
d. measure the dose directly on the patient’s skin.
c. put on a pair of disposable gloves
what is the most important role of the nurse in preventing drug errors?
a. always checking the patient’s diagnosis before giving a drug
b. always following the “six rights” of drug administration
c. being the one defense for detecting and preventing drug errors
d. being most likely to detect a drug error that has occurred.
b. always following the “six rights” of drug administration
The nurse is giving morning medications to patient who refuses to take an oral dose of docusate (Colace).What is the nurse’s best response?
a. your prescriber ordered that you must take this drug twice a day.
b. docusate will soften your bowel movements so that you do not strain
c. this drug will help prevent constipation while you are on bed rest.
d. can you tell me why you do not want to take the docusate?
d. can you tell me why you do not want to take the docusate?
when is it acceptable for the nurse to take a verbal order from the prescriber before giving a drug to a patient?
a. during the night shift when the prescriber is not at the hospital
b. in an emergency situation such as a cardiac arrest
c. when a patient is experiencing severe pain
d. at any time it is necessary
b. in an emergency situation such as a cardiac arrest
What is the best way for the nurse to make sure that the right patient is receiving a prescribed drug when the patient is alert and oriented?
a. ask the patient to state his or her name
b. check the patient’s wrist band
c. look at the patients chart
d. have the patient state his or her name and birth date.
d. have the patient state his or her name and birth date.
oral medication administration delivers medication for absorption through which tract?
alimentary
- It means “pertaining to the cheek”. , a medication is held in the mouth against the
mucous membranes of the cheek until the drug dissolves. The drug may act locally on the mucous membranes of the
mouth or systematically when it is swallowed in the saliva.
BUCCAL
Defined as other than through the alimentary or respiratory tract; that is by needle.
PARENTERAL
a. _______ – into the subcutaneous tissue, just below the skin
b. _______– into the muscle
c. _______– under the epidermis (into the dermis)
d. _______– into the vein
Subcutaneous (hypodermic)
Intramuscular
Intradermal
Intravenous
Medications that are applied to a circumscribed surface areas of the body. They affect only the area to which
they are applied.
TOPICAL
applied to the skin
Dermatologic preparations
applied into the body cavities or orifices, such as the urinary bladder, eyes, ears, nose, rectum, or vagina.
Instillation and irrigations
– administered into the respiratory tract by a nebulizer or positive pressure breathing apparatus. Air, oxygen, and vapor are generally used to
carry the drug into the lungs.
Inhalations
Medications may be administered to the eye using irrigations or instillations. instilled in the form of liquids or ointments.
OPTHALMIC MEDICATIONS
Instillations or irrigations of the external auditory canal are referred to as _____ and are generally carried out for cleaning purposes.
otic
usually are instilled for their astringent effect (to shrink swollen mucous membranes), to
loosen secretions and facilitates drainage, or to treat infections of the nasal cavity or sinuses.
Nasal instillations (nose drops and sprays)- NASAL MEDICATIONs
are the most common nasal instillations.
Nasal decongestants
Chronic use of nasal decongestants may lead to a _______, that is, an increase in nasal congestion.
rebound effect
- Check the name on the prescription and wristband.
* Ideally, use 2 or more identifiers and ask the patient to identify themselves.
- Right patient
- Check the name of the medication, brand names should be avoided.
- Check the expiry date.
- Check the prescription.
- Make sure medications, especially antibiotics, are reviewed regularly.
- Right medication
- Check the prescription.
- Confirm appropriateness of the dose using the BNF or local guidelines.
- If necessary, calculate the dose and have another nurse calculate the dose as well.
- Right dose
- Again, check the order and appropriateness of the route prescribed.
- Confirm that the patient can take or receive the medication by the ordered route.
- Right route
- Check the frequency of the prescribed medication.
- Double-check that you are giving the prescribed at the correct time.
- Confirm when the last dose was given.
- Right time
- Check if the patient understands what the medication is for.
- Make them aware they should contact a healthcare professional if they experience side-effects or reactions.
- Right patient education
- Ensure you have signed for the medication AFTER it has been administered.
- Ensure the medication is prescribed correctly with a start and end date if appropriate.
- Right documentation
- Ensure you have the patient consent to administer medications.
- Be aware that patients do have a right to refuse medication if they have the capacity to do so.
- Right to refuse
- Check if your patient actually needs the medication.
- Check for contraindications.
- Baseline observations if required.
- Right assessment
- Ensure the medication is working the way it should.
- Ensure medications are reviewed regularly.
- Ongoing observations if required.
- Right evaluation
indicates that the medication is to be given immediately and only once.
A stat order
is for medication to be given once at a specified time.
single order or one-time order
may or may not have a termination date. It may be carried out indefinitely until an order is written to cancel it, or it may be carried out for a specified number of days.
standing order
permits the nurse to give a medication when, in the nurse’s judgment, the client requires it. The nurse must use good judgment about when the medication is needed and when it can be safely administered.
prn order, or as needed order,
what are the 7 essential parts for administration of drugs/medication order
- patient’s full name
- date and time
- drug name
- dosage
- route administration
- time and frequency of administration
- signature of physician
these are routes of administration, give their abbreviations intramuscular intravenous by mouth, oral subcutaneous
IM- IV- PO- SL Sub-Q
drug dosages cc g mg mcg mL oc tbsp tsp
cubic centimeter gram milligram microgram milliliter ounce tablespoon teaspoon
times of drug administration: as desired as needed every 4h immediately
ad lib
PRN
q4h
stat
important medical abbreviations: once a day twice a day three times a day four times a day as needed as much as desired nothing by mouth intradermal intramuscular intraosseous intraperitoneal subcutaneous
SID- once a day BID twice a day TID three times a day QID four times a day PRN as needed Ad lib- as much as desired NPO- nothing by mouth ID- intradermal IM- intramuscular IO- intraosseous IP-intraperitoneal SC OR SQ- subcutaneous
