Fund. Success Ch. 31 Flashcards
Federal government
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.
State government
Conform to federal legislation but also have additional controls such as alcohol and tobacco.
Health care institutions
Have individual policies to meet federal and state regulations.
Nurse Practice Act
Defines the scope of a nurse’s professional functions and responsibilities.
Define chemical name.
Provides an exact description of the medication’s composition and molecular structure.
Define generic name.
Is created by the manufacturer who first develops the medication; this becomes the official name.
Define trade name.
Is one that the manufacturer has trademarked to identify the particular version they manufacture.
A medication classification indicates:
the effect of the medication on a body system, the symptoms the medication relieves, or the medication’s desired effect.
The form of the medication determines its:
Route.
Pharmacokinetics is:
The study of how medications enter the body, reach their site of action, metabolize, and exit the body.
Absorption is:
Refers to the passage of medication molecules into the blood from the site of administration.
Identify factors that influence drug absorption.
Route of administration, ability of the medication to dissolve, blood flow to the site of administration, body surface area, lipid solubility.
Identify the factors that affect the rate and extent of medication distribution.
Circulation, membrane permeability, protein binding, metabolism, excretion.
Explain the role of metabolism.
After a medication reaches its site of action, it becomes metabolized into a less active or inactive form that is easier to excrete.
Identify the primary organ for drug excretion, and explain what happens if this organ’s function declines.
The kidneys are the primary organ for drug excretion. When renal function declines, a patient is at risk for medication toxicity.
Define therapeutic effects.
Are the expected or predictable physiological response to a medication.
Define side effects.
Are predictable and often unavoidable secondary effects a medication predictably will cause.
Define adverse effects.
Are unintended, undesirable, and often unpredictable severe responses to a medication.
Define toxic effects.
Develops after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion.
Define idiosyncratic reactions.
Are unpredictable effects in which a patient overreacts or underreacts to a medication or has a reaction that is different from normal.
Define allergic reactions.
Are unpredictable responses to a medication.
Define anaphylactic reactions.
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.
Define medication interaction.
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.
Define synergistic effect.
Is when the combined effect of the two medications is greater than the effect of the medications when given separately.
Define effective concentration (MEC).
Is the plasma level of a medication below when the medication’s effect will not occur.
Define peak concentration.
Is the highest serum level concentration.
Define trough concentration.
Is the lowest serum level concentration.
Define biological half life.
Is the time it takes for excretion processes to lower the serum medication concentration by half.
Identify the three types of oral routes.
Oral, buccal, sublingual.
List the four major sites for parenteral injections.
Intradermal, subcutaneous, intramuscular, intravenous.
Define epidural.
Are administered in the epidural space via a catheter, usually used for post operative analgesia.
Define intrathecal.
Is via a catheter that is in the subarachnoid space or one of the ventricles of the brain.
Define intraosseous.
Is administered directly into the bone marrow, it is commonly used in infants and toddlers.
Define intraperitoneal.
Such as chemotherapeutics, are administered directly into the peritoneal cavity.
Define intrapleural.
Commonly chemotherapeutics, are administered directly into the pleural space.
Define intraarterial.
Administered into the arteries.
Define intracardiac.
Directly into cardiac tissue.
Define intraarticular.
Injected into a joint.
Identify the five methods for applying medications to mucous membranes.
Directly applying a liquid or ointment, inserting a medication into a body cavity, instilling fluid into a body cavity, irrigating a body cavity, spraying.
Identify the benefit of the inhalation route.
Are readily absorbed and work rapidly because of the rich vascular alveolar capillary network present in the pulmonary tissue.
Identify the three types of measurements used in medication therapy.
Metric, apothecary, household.
A solution is:
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.
Write out the formula used to determine the correct dose when preparing solid or liquid forms of medications.
Dose ordered/dose on hand x amount on hand = amount to administer.
List the medication distribution systems.
Unit dose and automated medication dispensing systems
Identify the common medication errors that can cause patient harm.
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.
Identify the process for medication reconciliation.
verify, clarify, reconcile, transmit.
List the six rights of medication administration.
The right medication, dose, patient, route, time, documentation.
Identify the areas the nurse needs to assess to determine the need for and potential response to medication therapy.
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.
Identify seven of the potential nursing diagnoses used during the administration of medications.
Anxiety, ineffective health maintenance, readiness for enhanced immunization status, deficient knowledge, noncompliance, effective therapeutic regimen management, impaired swallowing.
Identify the outcomes for a patient with newly diagnosed type 2 diabetes.
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.
Identify factors that can influence the patient’s compliance with the medication regimen.
Health beliefs, personal motivatinos, socioeconomic factors, habits.
Identify the components of medication orders.
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.
The recording of medication includes:
The name of the medication, dose, route, exact time of administration, site.
Explain the reasons why polypharmacy happens to a patient.
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.
Identify two goals for safe and effective medication administration.
Patient responds to therapy, patient has the ability to assume responsibility for self-care.
Identify the precautions to take when administering any oral preparation to prevent aspiration.
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.
Identify the guidelines to ensure safe administration of transdermal or topical medications.
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.
The most commons form of nasal instillation is:
Decongestant spray or drops.
List four principles for administering eye instillations.
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.
Failure to instill ear drops at room temperature causes:
Vertigo, dizziness, nausea.
Vaginal medications are available as:
Suppositories, foam, jellies, creams.
Rectal suppositories are used for:
Exerting local effects (promoting defecation) or systemic effects (reducing nausea)
Explain pressurized metered-dose inhalers (pMDIs)
Delivers a measured dose of medication with each push of a canister often used with a spacer.
Explain breath-actuated metered-dose inhalers (BAIs)
Releases medication when a patient raises a level and then inhales.
Explain dry powder inhalers (DPIs)
Hold dry, powdered medication and create an aerosol when the patient inhales through a reservoir that contains the medication.
Identify the aseptic techniques to use to prevent an infection during an injection.
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.
Identify the factors that must be considered when selecting a needle for an injection.
Patient’s size and weight, type of tissue into which the medication is to be injected.
Describe an ampule.
Contain single doses of medications in a liquid
Describe a vial.
a single dose or multidose container with a rubber seal at the top.
List the three principles to follow when mixing medications from two vials.
Do not contaminate one medication with another, ensure that the final dose is accurate, maintain aseptic technique.
Insulin is classified by:
Rate of action (rapid, short, intermediate, and long acting); each has a different onset, peak, and duration of action.
Identify the principles to follow when mixing two types of insulin in the same syringe.
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.
List the techniques used to minimize patient discomfort that is associated with injections.
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.
Identify the best sites for subcutaneous injections.
The outer posterior aspect of the upper arms, the abdomen, the anterior aspects of the thighs.
What is the maximum amount of water-soluble medication given by the subcutaneous route?
0.5-1 mL
What angles should be used when administering a subcutaneous injections, and with which needle should they be using?
25 G 5/8” needle= 45 degree angle
1/2” needle= 90 degree angle
What is the angle of insertion for an intramuscular injection?
90 degrees
Indicate the maximum volume of medication for an IM injection in well-developed adults.
2-5 mL into a large muscle
Indicate the maximum volume of medication for an IM injection in older children, older adults, and thin adults.
2 mL
Indicate the maximum volume of medication for an IM injection in older infants and small children.
1 mL
Explain the rationale for the Ztrack method in IM injections.
Minimizes local skin irritation by sealing the medication in muscle tissues.
Explain the rationale for intradermal injections.
Skin testing; injected into the dermis where medication is absorbed slowly.
List the methods a nurse can use to administer medications intravenously.
As mixtures within large volumes of IV fluids, injection of a bolus or small volume of medication, piggyback infusion.
Identify the advantages of the intravenous route of administration.
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.
The disadvantages of IV bolus medications are:
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.
List the advantages of using volume-controlled infusions.
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.
What is a piggyback set?
A small (25-250 mL) IV bag connected to short tubing lines that connects to the upper Y port of a primary infusion line.
What is a volume control administration set?
A small (50-150mL) container that attaches below the primary infusion bag.
What is a mini infusion pump?
A battery operated machine that allows medications to be given in very small amounts of fluid (5-60mL)
List the five advantages of using intermittent venous access devices.
Cost saving, convenience, increased mobility, safety, patient comfort.
The study of how drugs enter the body, reach their sites of actions, are metabolized, and exit from the body is called:
- Pharmacology
- Pharmacopoeia
- Pharmacokinetics
- Biopharmaceutical
3
What statement correctly characterizes drug absorption?
- Most drugs must enter the systemic circulation to have a therapeutic effect.
- Oral medications are absorbed more quickly when administered with meals.
- Mucous membranes are relatively impermeable to chemicals, making absorption slow.
- Drugs administered subcutaneously are absorbed more quickly than those injected intramuscularly.
1, Absorption refers to the passage of medication molecules into the blood from the site of administration.
The onset of drug actions is the time it takes for a drug to:
- Produce a response
- Accelerate the cellular process
- Reach its highest effective concentration
- Produce blood serum concentration and maintenance
1
Which of the following is not a parenteral route of administration?
- Buccal
- Intradermal
- Intramuscular
- Subcutaneous
1, Oral route.
