Fundamentals Chap 31 Med Adm Flashcards
What is the federal government’s role in the regulation of medication?
- protects the health of the people by ensuring that medications are safe and effective
- currently, the FDA ensures that all medications undergo vigorous testing before they are sold
What is the state government’s role in the regulation of medication?
*conform to federal legislation but also have additional controls such as alcohol and tobacco
What is the health care institution’s role in the regulation of medication?
*have individual policies to meet federal and state regulations
What is the nurse practice act’s role in the regulation of medication?
*defines the scope of a nurse’s professional functions and responsibilities
What is a chemical name of medication?
*provides an exact description of the medication’s composition and molecular structure
What is a generic name?
- created by the manufacturer who first develops the medication
- this becomes the official name
What is a trade name?
*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 of administration
Pharmacokinetics is:
*the study of how medications enter the body, reach their site of auction, metabolize, and exit the body
Absorption is:
*refers to the passage of medication molecules into the blood from the site of administration
Identify the 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:
- kidneys are the primary organ for drug excretion.
* when renal function declines, a pt is at risk for medication toxicity
Therapeutic effects of drugs:
*the expected or predictable physiological response to a medication
Side effects of drugs:
*predictable and often unavoidable secondary effects a medication predictably will cause
Adverse effects of drugs:
*unintended, undesirable, and often unpredictable severe responses to medication
Toxic effects of drugs:
*develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion
Idiosyncratic reactions of drugs:
*unpredictable effects in which a pt overreacts or underreacts to a medication or has a reaction that is different from normal
Allergic reactions of drugs:
*unpredictable responses to a medication
Anaphylactic reactions of drugs:
*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
Medication interaction of drugs:
- 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
Synergistic effect of drugs:
when the combined effect of the 2 medications is greater than the effect of the medications when given separately
Minimum effective concentration (MEC) of medication dose responses:
*the plasma level of a medication below which the medication’s effect will not occur
Peak concentration of medication dose responses:
*the highest serum level concentration
Trough concentration of medication dose responses:
*the lowest serum level concentration
Biological half-life of medication dose responses:
*the time it takes for excretion processes to lower the serum medication concentration by half
Identify the 3 types of oral routes:
- oral
- buccal
- sublingual
List the 4 major sites for parenteral injections:
- intradermal
- subcutaneous
- intramuscular
- intravenous
Identify 5 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:
*readily absorbed and work rapidly because of the rich vascular alveolar capillary network present in the pulmonary tissue
Identify the 3 types of measurements used in medication therapy:
- metric
- apothecary
- household
A solution 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
What is 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
What is a verbal medication order?
*if the order is given verbally to the nurse by the provider
What is the standing or routine medication order?
*carried out until the prescriber cancels it by another order or until a prescribed number of days elapse
What is a prn medication order?
*a medication that is given only when a pt requires it
What is a single (one-time) medication order?
*given only once at a specified time
What is a STAT medication order?
*describes a single dose of a medication to be given immediately and only once
What is a now medication order?
- used when a pt needs a medication quickly but not right away
- the nurse has up to 90 mins to administer
List the medication distribution systems:
- unit dose
* automated medication dispensing systems (AMDS)
Identify the common medication errors that can cause pt harm:
- inaccurate prescribing
- administration of the wrong medicine
- 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 6 rights of medication administration:
- right medication
- right dose
- right pt
- right route
- right time
- right documentation
Briefly summarize The Pt Care Partnership related to medication administration:
- be informed of the medication’s name, purpose, action, and potential undesired effects
- refuse a medication regardless of the consequences
- have qualified nurses or physicians assess a medication history
- be properly advised of the experimental nature of medication therapy and give written consent
- receive labeled medications safely without discomfort
- receive appropriate supportive therapy
- not receive unnecessary medications
- be informed if medications are a prat of a research study
Define the advanced techniques of medication administration: epidural
*administered in the epidural space via a catheter, usually used for postoperative analgesia
Define the advanced techniques of medication administration: intrathecal
*via a catheter that is in the subarachnoid space or one of the ventricles of the brain
Define the advanced techniques of medication administration: intraosseous
- administered directly into the bone marrow
* it is commonly used in infants and toddlers
Define the advanced techniques of medication administration: intraperitoneal
- administered into the peritoneal cavity
* such as chemotherapeutic agents, insulin, and antibiotics
Define the advanced techniques of medication administration: intrapleural
- administered directly into the pleural space
* chemotherapeutics
Define the advanced techniques of medication administration: intraarterial
*administered directly into the arteries
Define the advanced techniques of medication administration: intracardiac
*injected directly into the cardiac tissue
Define the advanced techniques of medication administration: intraarticular
*injected into a joint
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
- pt’s perceptual coordination problems
- pt’s current condition
- pt’s attitude about medication use
- pt’s knowledge and understanding of medication therapy
- pt’s learning needs
Identify 7 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 pt with a 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 medications with meal times
Identify factors that can influence the pt’s compliance with the medication regimen:
- health beliefs
- personal motivation
- socioeconomic factors
- habits
Identify the components of medication orders:
- pt’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:
- name of the medication
- dose
- route
- exact time of administration
- site
Explain the reasons why polypharmacy happens to a pt:
*when pts need to take several medications to treat their illnesses, take 2 or more medications from the same chemical class, use 2 or more medications with the same or similar actions or mix nutritional supplements or herbal products with medications, polypharmacy happens
Identify 2 goals for safe and effective mediation administration:
- pt responds to therapy
* pt has the ability to assume responsibility for self-care
Identify the precautions to take when administering any oral preparation to prevent aspiration:
- determine the pt’s ability to swallow and cough and check for gag reflex
- prepare oral medications in the form that is easiest to swallow
- allow the pt to self administer medications if possible
- if the pt 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 pt cannot tolerate thin liquids
- avoid straws because they decrease the control the pt has over volume intake, which increases the risk of aspiration
- have the pt hold the cup and drink it if possible
- time medication to coincide with meal times or when the pt 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 pt has an existing patch before application
- medication history and reconciling medications
- apply a noticeable label to the patch
- document removal of medication on the MAR
The most common form of nasal instillation is:
*decongestant spray or drops
List 4 principles for administering eye instillations:
- avoid instilling any eye medication directly onto the cornea
- avoid touching the eyelids or other eye
- use medication only for the pt’s affected eye
- never allow a pt to use another pt’s eye medication
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 effect (reducing nausea)
Pressurized metered-dose inhalers (pMDIs):
*delivers a measured dose of medication with each push of a canister often used with a spacer
Breath-actuated metered-dose inhalers (BAIs):
*releases medication when a pt raises a level and then inhales
Dry powder inhalers (DPIs)
*hold dry, powdered medications and create an aerosol when the pt inhales through a reservoir that contains the medication
