General

Question 0

Medication errors:

Answer 0

39% do to MD order ( half are caught by nurses), cause death, many look alike packages, bad handwriting, given on time, and have appropriate decimal places

Question 1

Nurses must have complete….

Answer 1

Knowledge of med., patients age, weight, allergies, diagnosis, preg. Status, lab values, vs, and other important parameters.

Question 2

7,000 people die from drug errors:

Answer 2

Wrong med., dose, patient, route, time, and documentation.

Question 3

Legal aspects of medication:

Answer 3

Understand limits of their knowledge and skill (NPA), practice within scope of practice, responsible for our own actions ( always check MD order), when in doubt question orders

Question 4

Drug standards:

Answer 4

Drugs are natural/synthesized that vary in strength and action, standards to ensure quality, FDA ( deter safety and efficacy of drugs),

Question 5

Generic name:

Answer 5

Name assigned by manufacture before drug becomes official

Question 6

Chemical name:

Answer 6

Constituents that make the drugs molecular structure

Question 7

Brand name:

Answer 7

(Trademark), registered name assigned by manufacture.

Question 8

Official name:

Answer 8

Name listed in FDA publication

Question 9

Effects of drugs:

Answer 9

Therapeutic, side effect, drug toxicity, drug allergies, tolerance, interaction, goal of drug therapy/dosing

Question 10

Therapeutic effect

Answer 10

Desired effect, reason drug prescribed, example: morphine

Question 11

Side effect

Answer 11

Secondary or unintended effect, predictable, can or can not be harmful, some effects=good effects, severe effects>adverse effects ( may need to stop rx) ex: digoxin helps heart contraction but causes nausea

Question 12

Drug toxicity

Answer 12

Level of drug too high for body (causing adverse effects), may be taken in wrong route or body has impaired metabolized, may be immediate or slow, monitor for toxicity, can have with OTC meds. And vitamins

Question 13

Drug allergy

Answer 13

Immunologic reaction to drug, mild to severe, can react immediately or in days

Question 14

Drug tolerance:

Answer 14

Body requires more of drug for therapeutic effect

Question 15

Drug interaction:

Answer 15

Alters effect of one or both drugs potentiating or inhibiting effect

Question 16

Synergistic response:

Answer 16

When 2 or more drugs given together to produce greater effect than if given alone, ex: ASA and codeine

Question 17

Goal of drug therapy:

Answer 17

To maintain constant level done with repeated doses (onset of action, peak level, duration of action, therapeutic effect)

Question 18

Therapeutic range:

Answer 18

Enough drug present in plasma to produce desired effect

Question 19

Drug half life

Answer 19

time required to reduce to 1/2 the concentration

Question 20

Goal of drug dosing

Answer 20

keep plasma level w/in therapeutic range (minimum, maximum, and maintenance)

Question 21

Minimum dose

Answer 21

least amount of drug in serum to produce therapeutic effect

Question 22

maximum dose

Answer 22

greatest amount of drug in serum w/o causing adverse effects

Question 23

Maintenance dose

Answer 23

maintains desirable drug level over period of time adm. time important

Question 24

Pharmacokinetics

Answer 24

Absorption, distribution, metabolism, and excretion

Question 25

absorption

Answer 25

process drug enters bloodstream (movement through body, most PO meds. absorb in the GI tract)

Question 26

Distribution

Answer 26

delivery of drug to tissue by circulatory system (liver, kidneys, brain) chemical and physical properties of drugs deter. action (fat soluble to fat)

Question 27

Metabolism

Answer 27

process by which drug transformed to less active form, aka biotransformation or detoxification. Primarily in liver, products are active (pharmacological action) or inactive (has none) metabolites,

Question 28

Excretion

Answer 28

active drug and by products removed from body. most excreted in urine, some in feces, breath, perspiration, saliva, resp. tract, or breast milk. *kidney function decreases with age, drug dose may need to be smaller

Question 29

Essential components of MD order (inpatient)

Answer 29

patient name, date, time, medicine, dosage, route, time to be given/frequency, signature of person writing order

Question 30

Components of a prescription (outpatient)

Answer 30

patient name, address, age, drug information, date written, dose, route, frequency, signature of prescriber, quanity, directions for the patient, refill number if any

Question 31

Types of orders

Answer 31

verbal, STAT, single/one time dose, standing, PRN,

Question 32

Routes of administration

Answer 32

Oral, sublingual, parenteral, topical, inhalation, buccal, others (rectal/vaginal/otic/ocular/nasal/irrigation)

Question 33

Correct adm. of meds

Answer 33

all meds must be checked with MD order first, before adm., Ten rights: RIGHT med, dose, time, route, client, education, documentation, assessment, evaluation, to refuse

Question 34

Check medicine three times before giving:

Answer 34

1. when pulling, 2. before opening, 3. at the bedside-before adm

Question 35

When at bedside:

Answer 35

check EMR, patient ID band, and have patient state name and DOB, right documentation

Question 36

Patient education

Answer 36

include in teaching: frequency, how med works, name of med, dose, SE, allergies, what to report to MD

Question 37

Nurses role:

Answer 37

Knowledge of drugs administering, responsible for actions! Assessment (psychological assessment, medication hx, and clinical assessment)

Question 38

Assessment includes:

Answer 38

Medication hx- current drugs, rx <6 months, reactions/allergies, compliance, caffeine/tobacco/alcohol use, eating habits

Question 39

psychological assessment -

Answer 39

prescription of drugs, frequency of self med., can they afford it, dependency issues,

Question 40

Clinical assessment -

Answer 40

Patient condition, purpose of drug, any factors that may limit effect of drug

Question 41

Nursing diagnosis:

Answer 41

Deter actual or potential nursing problems r/t drug therapy ( deficient knowledge), planning goals, implementation, charting, process

Question 42

Planning goals:

Answer 42

Compliance, therapeutic effect, monitor patient response, promote safety and comfort, educate

Question 43

Implementation:

Answer 43

Correct transcription of EMR order, compare to written MD order, clearly labeled, calculate and have checked, only adm. Meds you prepare, never leave meds unattended, vomiting notify MD, all orders must be rewritten post op, if med error occurs, STT/variance, report to charge nurse/MD

Question 44

Charting rules:

Answer 44

Real time document, follow prompts, two hour window to give a med. ( hr before and hr after), if given late document why, document assessment (vs), declined or held, NEVER chart before anything is done

Question 45

Process of giving meds:

Answer 45

Id patient, inform patient, adm med, implications (position pt correctly), document at bedside, evaluate response

Question 46

Five rights of med administration:

Answer 46

Medicine, dose, time, route, patient