Lesson 3 Flashcards
1
Q
Oral Forms
A
- powder
- tablet
- capsule
- lozenge or troche
- liquid
- suspension
- emulsion
- elixir
- syrup
2
Q
tablet
A
- some are scored
- enteric coated dissolves in small intestine (do not crush)
3
Q
capsule
A
- gelatin shell
- some contain powder or liquid
- time release
- do not crush
4
Q
suspension
A
liquid form of drug particles suspended, not dissolved
5
Q
emulsion
A
liquid form in oils and fats in water
6
Q
elixir
A
liquid formulation with alcohol base
7
Q
syrup
A
sweet liquid formulation
8
Q
Routes
A
- oral
- sublingual
- buccal
- NG
- instillation
- topical
- inhalation
- parenteral
- rectal
- vaginal
9
Q
Do not crush
A
- enteric coated tablets
- Time release capsules
10
Q
Process for administering medication via the oral route
A
- wash hands, clean gloves
- assess for contraindications to oral route
- pt sitting upright with chin flexed
- open packaged meds at bedside
- perform needed assessment (s)
- administer critical meds first
- if help needed, place cup to lips, giving one med at a time
11
Q
Measuring liquid medication
A
- cup on flat surface
- move down to eye level
12
Q
Advantages to NG/Enteric Tube Route
A
- if pt cannot swallow
- unconscious
- avoids use of injection
13
Q
Disadvantages to NG/Enteric Tube Route
A
- discomfort of tube
- risk of aspiration
- can get occluded
14
Q
Drug forms with NG Tube
A
can be crushed: liquids and orals
15
Q
What forms can you NOT use in a NG tube
A
- enteric coated
- time release
16
Q
How to read the meniscus
A
locate the lowest fluid mark
17
Q
Meds given through NG tube should…
A
be administered separately
18
Q
Dilute NG crushed pills in…
A
30 ML of sterile water before administering
19
Q
How to verify placement of NG tube
A
air, aspirate, pH testing
20
Q
HOB after meds/feeding…
A
remain in fowlers position preferably 45 degrees or higher
-never less than 30 degrees
21
Q
Apply topical meds using…
A
gloves to clean skin
22
Q
liniments
A
liquid or lotion, made with oil for rubbing on body to relieve pain
23
Q
with topical meds no…
A
double dipping or sharing
24
Q
hydration equals..
A
increased absorption
25
thin skin equals..
increased absorption
26
larger area of application equals..
increased absorption
27
Advantages of dermal patches
- systemic effect
- constant, even release of med over long period
- absorption slow
- consistent blood levels
- easy application
28
Disadvantages of dermal patches
- skin sensitivity
| - difficulty with adherence of adhesives
29
Topical Drug Forms
- cream
- ointments
- paste
- lotions
- liniments
- powder
- dermal patches
30
creams
- semisolid
| - nongreasy emulsion
31
ointments
-oil base semisolid
32
paste
stiffer than ointment
33
lotions
- aqueous preparations
| - suspended particles
34
liniments
liquid containing alcohol, oil, or soapy emollient
35
Instillation Drug Forms
- eyes
- ears
- nose
36
Eye drug forms
- drops
| - ointments
37
Ear drug forms
-drops
38
Nose drug forms
- drops
| - sprays
39
Vagina drug forms
- cream
- suppositories
- douche
40
Rectum drug forms
- suppositories
| - enema
41
Spacers
enhance the delivery of medications from the MDI
42
Metered-dose inhaler
handheld devices that deliver medication to the lower respiratory tract
43
Some MDIs have...
a counter to indicate the number of inhalations used
44
For MDIs that do not have a counter..
the most accurate way to determine the number is for the patient to count and record the number of inhalations used
-often not practical
45
Inhalation route
- spray or mist
- gas
- powder
46
spray or mist
- nebulizer
| - inhaler (w or w/out spacer)
47
gas
general anesthesia
48
powder
powder placed in spinhaler
49
Advantages of parenteral route
- more rapid absorption and effect compared to other routes
- bypasses GI tract
- bypasses first pass (liver)
50
Disadvantages of parenteral route
- risk of local tissues, nerves, bone damage
| - risk for administering drug into vascular system
51
When parenteral route is selected...
- pt cannot take oral meds
- drug is not suitable for GI tract
- faster effect is desired
52
Parenteral Drug Routes
- intravenous
- intramuscular
- subQ
- intradermal
- intraspinal
- epidural
- intracardiac
- intraosseous
- intraarterial
- intracapsular
- intraperitoneal
- intrapleural
53
Parenteral drug forms
- solutions
| - powders
54
Solutions
drugs suspected in sterile medium such as sterile water or in an oil medium
55
Powders
must be reconstituted with suitable sterile solvent such as sterile water
56
Intradermal needle length and gauge
25-27 gauge
| 3/8 to 5/8 inch
57
subcutaneous needle length and gauge
25-27 gauge
| 1/2 to 5/8 inch
58
intramuscular needle length and gauge
18-23 gauge
1 to 1 1/2 inche
18 for blood products
59
intradermal injection sites
1. ventral mid-forearm
2. clavicular area on chest
3. scapular area on back
60
what to know about subcutaneous injection sites
- chosen for adequate fat-pad size
- sites should be rotated to avoid overuse
- larger amount of medication may have to be divided and administered at two sites or else the medication route may change
61
what to know about intradermal injection sites
chosen so that inflammatory reaction can be observed
62
subcutaneous injection sites
- upper arm
- thigh
- stomach
- mid back
- above buttocks, love handles
63
what to know about intramuscular injection sites
chosen for adequate muscle size and minimal major nerves and blood vessels in the area
64
IM injection sites
1. ventrogluteal (preferred for adults and toddlers - walking)
2. dorsogluteal (not preferred due to sciatic nerve)
3. deltoid
4. vastus lateralis
65
Intravenous
-peripheral veins
66
adult IV
20-21g 1 to 1 1/2 inch
67
infant IV
24g 1 inch
68
children IV
22g 1 inch
69
Insulin action
lowers blood sugar by stimulating glucose uptake in the skeletal muscle and fat
-inhibits hepatic glucose production
70
insulin types
- clear (regular or crystalline)
| - cloudy (NPH)
71
protamine
what makes the insulin cloudy
| -used to prolong the action of insulin in the body
72
which insulin can be given both IV and SubQ
only clear (reg)
73
types of insulin
- rapid
- fast
- intermediate
- long
- commercial premixed
74
Intradermal injection
bleb
| -inject medication slowly to form a wheal (blister or bleb)
75
rapid-acting insulin
- humalog
- Aspart
- Apidra
76
fast-acting insulin
Humulin R
Regular
Novolin R
77
intermediate-acting insulin
- NPH
- Humulin N
- Novolin N
78
long-acting insulin
- Levemir
| - Lantus
79
commercial premixed insulin
mix of fast and intermediate-acting insulins
80
Do not mix which insulin
Lantus or Levemir with any other insulin
81
Preparing for injection
- check order
- check pertinent patient info
- expiration date
- contaminants
- label checks
- dosage strength/concentration
- total amount in vial or ampule
- DO THE MATH, check calculations with another nurse
82
Reducing risk of infection
- prevent contamination of solution
- prevent syringe and needle contamination
- site selection
- skin prep
83
Skin prep
- wash with soap and water if soiled
- clean 2 in diameter X 15 seconds using alcohol swab using inner to outer circular motion
- allow to dry
84
Minimizing injection discomfort
- sharp needle
- how much volume is being admin?
- select appropriate site
- apply vapocoolant or topical anesthetic if indicated
- position to relax muscles
- hold syringe already
- inject medication slowly (1 ML per 10 seconds)
- wait 10 second, withdraw quickly and smoothly
85
angle for IM injection
90
86
angle for subQ
45 or 90
87
angle for intradermal
15
