Fund. Success Ch. 31

Question 1

Federal government

Answer 1

Protects the health of the people by ensuring that medications are safe and effective. Currently, the Food and Drug Administration ensures that all medications undergo vigorous testing before they are sold.

Question 2

State government

Answer 2

Conform to federal legislation but also have additional controls such as alcohol and tobacco.

Question 3

Health care institutions

Answer 3

Have individual policies to meet federal and state regulations.

Question 4

Nurse Practice Act

Answer 4

Defines the scope of a nurse’s professional functions and responsibilities.

Question 5

Define chemical name.

Answer 5

Provides an exact description of the medication’s composition and molecular structure.

Question 6

Define generic name.

Answer 6

Is created by the manufacturer who first develops the medication; this becomes the official name.

Question 7

Define trade name.

Answer 7

Is one that the manufacturer has trademarked to identify the particular version they manufacture.

Question 8

A medication classification indicates:

Answer 8

the effect of the medication on a body system, the symptoms the medication relieves, or the medication’s desired effect.

Question 9

The form of the medication determines its:

Answer 9

Route.

Question 10

Pharmacokinetics is:

Answer 10

The study of how medications enter the body, reach their site of action, metabolize, and exit the body.

Question 11

Absorption is:

Answer 11

Refers to the passage of medication molecules into the blood from the site of administration.

Question 12

Identify factors that influence drug absorption.

Answer 12

Route of administration, ability of the medication to dissolve, blood flow to the site of administration, body surface area, lipid solubility.

Question 13

Identify the factors that affect the rate and extent of medication distribution.

Answer 13

Circulation, membrane permeability, protein binding, metabolism, excretion.

Question 14

Explain the role of metabolism.

Answer 14

After a medication reaches its site of action, it becomes metabolized into a less active or inactive form that is easier to excrete.

Question 15

Identify the primary organ for drug excretion, and explain what happens if this organ’s function declines.

Answer 15

The kidneys are the primary organ for drug excretion. When renal function declines, a patient is at risk for medication toxicity.

Question 16

Define therapeutic effects.

Answer 16

Are the expected or predictable physiological response to a medication.

Question 17

Define side effects.

Answer 17

Are predictable and often unavoidable secondary effects a medication predictably will cause.

Question 18

Define adverse effects.

Answer 18

Are unintended, undesirable, and often unpredictable severe responses to a medication.

Question 19

Define toxic effects.

Answer 19

Develops after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion.

Question 20

Define idiosyncratic reactions.

Answer 20

Are unpredictable effects in which a patient overreacts or underreacts to a medication or has a reaction that is different from normal.

Question 21

Define allergic reactions.

Answer 21

Are unpredictable responses to a medication.

Question 22

Define anaphylactic reactions.

Answer 22

Are allergic reactions that are life threatening and characterized by sudden constriction of bronchiolar muscles, edema of the pharynx and larynx, and severe wheezing and shortness of breath.

Question 23

Define medication interaction.

Answer 23

Occurs when one medication modifies the action of another medication; it may alter the way another medication is absorbed, metabolized, or eliminated from the body.

Question 24

Define synergistic effect.

Answer 24

Is when the combined effect of the two medications is greater than the effect of the medications when given separately.

Question 25

Define effective concentration (MEC).

Answer 25

Is the plasma level of a medication below when the medication’s effect will not occur.

Question 26

Define peak concentration.

Answer 26

Is the highest serum level concentration.

Question 27

Define trough concentration.

Answer 27

Is the lowest serum level concentration.

Question 28

Define biological half life.

Answer 28

Is the time it takes for excretion processes to lower the serum medication concentration by half.

Question 29

Identify the three types of oral routes.

Answer 29

Oral, buccal, sublingual.

Question 30

List the four major sites for parenteral injections.

Answer 30

Intradermal, subcutaneous, intramuscular, intravenous.

Question 31

Define epidural.

Answer 31

Are administered in the epidural space via a catheter, usually used for post operative analgesia.

Question 32

Define intrathecal.

Answer 32

Is via a catheter that is in the subarachnoid space or one of the ventricles of the brain.

Question 33

Define intraosseous.

Answer 33

Is administered directly into the bone marrow, it is commonly used in infants and toddlers.

Question 34

Define intraperitoneal.

Answer 34

Such as chemotherapeutics, are administered directly into the peritoneal cavity.

Question 35

Define intrapleural.

Answer 35

Commonly chemotherapeutics, are administered directly into the pleural space.

Question 36

Define intraarterial.

Answer 36

Administered into the arteries.

Question 37

Define intracardiac.

Answer 37

Directly into cardiac tissue.

Question 38

Define intraarticular.

Answer 38

Injected into a joint.

Question 39

Identify the five methods for applying medications to mucous membranes.

Answer 39

Directly applying a liquid or ointment, inserting a medication into a body cavity, instilling fluid into a body cavity, irrigating a body cavity, spraying.

Question 40

Identify the benefit of the inhalation route.

Answer 40

Are readily absorbed and work rapidly because of the rich vascular alveolar capillary network present in the pulmonary tissue.

Question 41

Identify the three types of measurements used in medication therapy.

Answer 41

Metric, apothecary, household.

Question 42

A solution is:

Answer 42

Is a given mass of solid substance dissolved in a known volume of fluid or a given volume of liquid dissolved in a known volume of another fluid.

Question 43

Write out the formula used to determine the correct dose when preparing solid or liquid forms of medications.

Answer 43

Dose ordered/dose on hand x amount on hand = amount to administer.

Question 44

List the medication distribution systems.

Answer 44

Unit dose and automated medication dispensing systems

Question 45

Identify the common medication errors that can cause patient harm.

Answer 45

Inaccurate prescribing, administration of the wrong medication, giving the medication using the wrong route or time interval, administering extra doses, failing to administer a medication.

Question 46

Identify the process for medication reconciliation.

Answer 46

verify, clarify, reconcile, transmit.

Question 47

List the six rights of medication administration.

Answer 47

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

Question 48

Identify the areas the nurse needs to assess to determine the need for and potential response to medication therapy.

Answer 48

History, history of allergies, medication data, diet history, patient’s perceptual coordination problems, patient’s current condition, attitude about medication use, knowledge and understanding of medication therapy, and learning needs.

Question 49

Identify seven of the potential nursing diagnoses used during the administration of medications.

Answer 49

Anxiety, ineffective health maintenance, readiness for enhanced immunization status, deficient knowledge, noncompliance, effective therapeutic regimen management, impaired swallowing.

Question 50

Identify the outcomes for a patient with newly diagnosed type 2 diabetes.

Answer 50

Will verbalize understanding of desired effects and adverse effects of medications, will state signs, symptoms, and treatment of hypoglycemia, will monitor blood sugar to determine if medication is appropriate to take, will establish a daily routine that will coordinate timing of medication with meal times.

Question 51

Identify factors that can influence the patient’s compliance with the medication regimen.

Answer 51

Health beliefs, personal motivatinos, socioeconomic factors, habits.

Question 52

Identify the components of medication orders.

Answer 52

Patient’s full name, date and time that the order is written, medication name, dose, route of administration, time and frequency of administration, signature of provider.

Question 53

The recording of medication includes:

Answer 53

The name of the medication, dose, route, exact time of administration, site.

Question 54

Explain the reasons why polypharmacy happens to a patient.

Answer 54

When patients needs to take several medications to treat their illnesses, take two or more medications from the same chemical class, use two or more medications with the same or similar actions or mix nutritional supplements or herbal products with medications, polypharmacy happens.

Question 55

Identify two goals for safe and effective medication administration.

Answer 55

Patient responds to therapy, patient has the ability to assume responsibility for self-care.

Question 56

Identify the precautions to take when administering any oral preparation to prevent aspiration.

Answer 56

Determine the patient’s ability to swallow and cough and check for gag reflex, prepare oral medications in the form that is easiest to swallow, allow the patient to self-administer medications if possible, if the patient has unilateral weakness, place the medication in the stronger side of the mouth, administer pills one at a time, ensuring that each medication is properly swallowed before the next one is introduced, thicken regular liquids or offer fruit nectars if the patient cannot tolerate thin liquids, avoid straws because they decrease the control the patient has over volume intake, which increases the risk of aspiration, have the patient hold the cup and drink it if possible, time medications to coincide with meal times or when the patient is well rested and awake if possible, administer medications using another route if risk of aspiration is severe.

Question 57

Identify the guidelines to ensure safe administration of transdermal or topical medications.

Answer 57

Document where the medication was placed in the MAR, assess if patient has an existing patch before application, medications history and reconciling medications, apply a noticeable label to the patch, document removal of medication on the MAR.

Question 58

The most commons form of nasal instillation is:

Answer 58

Decongestant spray or drops.

Question 59

List four principles for administering eye instillations.

Answer 59

Avoid instilling any eye medication directly onto the cornea, avoid touching the eyelids or other eye structures with eye droppers or ointment tubes, use medication only for the patient’s affected eye, never allow a patient to use another patient’s eye medications.

Question 60

Failure to instill ear drops at room temperature causes:

Answer 60

Vertigo, dizziness, nausea.

Question 61

Vaginal medications are available as:

Answer 61

Suppositories, foam, jellies, creams.

Question 62

Rectal suppositories are used for:

Answer 62

Exerting local effects (promoting defecation) or systemic effects (reducing nausea)

Question 63

Explain pressurized metered-dose inhalers (pMDIs)

Answer 63

Delivers a measured dose of medication with each push of a canister often used with a spacer.

Question 64

Explain breath-actuated metered-dose inhalers (BAIs)

Answer 64

Releases medication when a patient raises a level and then inhales.

Question 65

Explain dry powder inhalers (DPIs)

Answer 65

Hold dry, powdered medication and create an aerosol when the patient inhales through a reservoir that contains the medication.

Question 66

Identify the aseptic techniques to use to prevent an infection during an injection.

Answer 66

Draw medication from ampule quickly; do not allow it to stand open, avoid letting the needle touch contaminated surface, avoid touching the length of the plunger or inner part of the barrel, prepare the skin, use friction and a circular motion while cleaning with an antiseptic swab, and start from the center and move outward.

Question 67

Identify the factors that must be considered when selecting a needle for an injection.

Answer 67

Patient’s size and weight, type of tissue into which the medication is to be injected.

Question 68

Describe an ampule.

Answer 68

Contain single doses of medications in a liquid

Question 69

Describe a vial.

Answer 69

a single dose or multidose container with a rubber seal at the top.

Question 70

List the three principles to follow when mixing medications from two vials.

Answer 70

Do not contaminate one medication with another, ensure that the final dose is accurate, maintain aseptic technique.

Question 71

Insulin is classified by:

Answer 71

Rate of action (rapid, short, intermediate, and long acting); each has a different onset, peak, and duration of action.

Question 72

Identify the principles to follow when mixing two types of insulin in the same syringe.

Answer 72

Need to maintain their individual routine when preparing and administering their insulin, do not mix insulin with any other medication or diluents, never mix insulin glargine or insulin detemir with other types of insulin, inject rapid acting insulin mixed with NPH within 15 minutes before a meal, verify insulin dosages with another nurse while preparing them.

Question 73

List the techniques used to minimize patient discomfort that is associated with injections.

Answer 73

Use a sharp beveled needle in the smallest suitable length and gauge, position the patient as comfortably as possible to reduce muscle tension, select the proper injection site, apply a vapocoolant spray or topical anesthetic to the site if possible, divert the patient’s attention from the injection, inset the needle quickly and smoothly, hold the syringe while the needle remains in the tissues, inject the medication slowly and steadily.

Question 74

Identify the best sites for subcutaneous injections.

Answer 74

The outer posterior aspect of the upper arms, the abdomen, the anterior aspects of the thighs.

Question 75

What is the maximum amount of water-soluble medication given by the subcutaneous route?

Answer 75

0.5-1 mL

Question 76

What angles should be used when administering a subcutaneous injections, and with which needle should they be using?

Answer 76

25 G 5/8” needle= 45 degree angle

1/2” needle= 90 degree angle

Question 77

What is the angle of insertion for an intramuscular injection?

Answer 77

90 degrees

Question 78

Indicate the maximum volume of medication for an IM injection in well-developed adults.

Answer 78

2-5 mL into a large muscle

Question 79

Indicate the maximum volume of medication for an IM injection in older children, older adults, and thin adults.

Answer 79

2 mL

Question 80

Indicate the maximum volume of medication for an IM injection in older infants and small children.

Answer 80

1 mL

Question 81

Explain the rationale for the Ztrack method in IM injections.

Answer 81

Minimizes local skin irritation by sealing the medication in muscle tissues.

Question 82

Explain the rationale for intradermal injections.

Answer 82

Skin testing; injected into the dermis where medication is absorbed slowly.

Question 83

List the methods a nurse can use to administer medications intravenously.

Answer 83

As mixtures within large volumes of IV fluids, injection of a bolus or small volume of medication, piggyback infusion.

Question 84

Identify the advantages of the intravenous route of administration.

Answer 84

fast acting medications must be delivered quickly, it provides constant therapeutic blood levels,it can be used when medications are highly alkaline and irritating to the muscle and subcutaneous tissue.

Question 85

The disadvantages of IV bolus medications are:

Answer 85

It is the most dangerous method because there is no time to correct errors, a bolus may cause direct irritation to the lining of blood vessels.

Question 86

List the advantages of using volume-controlled infusions.

Answer 86

The reduce risk of rapid infusion by IV push, they allow for administration of medications that are stable for a limited time in solution, they allow for control of IV fluid intake.

Question 87

What is a piggyback set?

Answer 87

A small (25-250 mL) IV bag connected to short tubing lines that connects to the upper Y port of a primary infusion line.

Question 88

What is a volume control administration set?

Answer 88

A small (50-150mL) container that attaches below the primary infusion bag.

Question 89

What is a mini infusion pump?

Answer 89

A battery operated machine that allows medications to be given in very small amounts of fluid (5-60mL)

Question 90

List the five advantages of using intermittent venous access devices.

Answer 90

Cost saving, convenience, increased mobility, safety, patient comfort.

Question 91

The study of how drugs enter the body, reach their sites of actions, are metabolized, and exit from the body is called:

1. Pharmacology
2. Pharmacopoeia
3. Pharmacokinetics
4. Biopharmaceutical

Answer 91

3

Question 92

What statement correctly characterizes drug absorption?

1. Most drugs must enter the systemic circulation to have a therapeutic effect.
2. Oral medications are absorbed more quickly when administered with meals.
3. Mucous membranes are relatively impermeable to chemicals, making absorption slow.
4. Drugs administered subcutaneously are absorbed more quickly than those injected intramuscularly.

Answer 92

1, Absorption refers to the passage of medication molecules into the blood from the site of administration.

Question 93

The onset of drug actions is the time it takes for a drug to:

1. Produce a response
2. Accelerate the cellular process
3. Reach its highest effective concentration
4. Produce blood serum concentration and maintenance

Answer 93

1

Question 94

Which of the following is not a parenteral route of administration?

1. Buccal
2. Intradermal
3. Intramuscular
4. Subcutaneous

Answer 94

1, Oral route.