MA test 3 Flashcards
Pharmacology
The study of medication
Pharmacokinetics
the study of how the medications move within the body
What does pharmacokinetics involve?
absorption, distribution, metabolism, and excretion
What are the 6 Rights of Medication Administration
Right Patient
Right Medication
Right Dose
Right Route
Right time
Right Documentation
Contraindications
cautions used when taking certain drugs
How often is a new PDR available?
each year
What does the Physicians Desk Reference include?
- current detailed information about 1,000s medications
- lists contraindications
- product identification guide
Schedule I Medications
- def
- example
substances that have the highest abuse rate
- heroin, LSD
Schedule II Medications
- def
- example
can lead to psychological and physical dependence
- morphine, oxycodone, hydrocodone
Schedule III Medications
- def
- example
- # refills in # months
have a moderate to low dependency
- steroids, testosterone
- 5 refills in 6 months
Schedule IV medications
- def
- example
- # refills in # months
low potential for abuse and dependence
- diazepam, clonazepam
- 5 refills in 6 months
Schedule V medications
- def
- example
contains limited quantities of some narcotics.
- antitussives, analgesics, and antidiarrheals
Analgesics
- def
- example
relieve pain
- acetaminophen, hydrocodone
Antacids
- def
- example
neutralize stomach acids
- Pepcid, Maalox
Anticoagulants
- def
- example
delay blood clotting
- Heparin, coumadin
Antiemetics
reduce nausea and vomiting
Emetics
induce vomiting
Antipyretics
- def
- example
reduce fever
- Acetaminophen (APAP)
- aspirin (ASA)
Diuretics
- def
- example
eliminate fluid
- Lasix
Antihistamines
- def
- example
relieves allergies
- Zyrtec
- Loratadine
Antibiotics
- def
- example
kill bacteria
- Penicillin (PCN)
- amoxicillin
Decongestant
- def
- example
relieve nasal congestion
- Sudafed and Mucinex
Antihypertensive
- def
- example
reduces blood pressure
- lisinopril
Adverse Reaction
an undesired reaction caused by medication
Anaphylaxis
severe allergic reaction could lead to death
Hypersensitivity
when the use of a medication is not recommended due to a prior condition
What is the most common contraindication?
hypersensitivity
ID
intradermal
IM
intramuscular
Inj
injection
IV
intravenously
PO
stands for and definition
per os
by mouth
PR
per rectum
Parenteral
a medication digested outside the digestive tract
oral
mouth
buccal
between the cheek and gums
inhalation
albuterol, asthmatic memdications
Topical
local absorption into the skin
Mucosal
- definition
- example
absorbs into the mucous membranes
- eye medication
Transdermal
absorbed through the skin using a patch
before meals
AC
3 times a day
TID
every morning
Q. am
after meals
PC
twice a day
BID
Adlib
as desired
4 times a day
QID
night
Noct
as needed
PRN
every # hours
q#h
1 mL to __ drops
1 mL to 15 drops
1 teaspoon to __ mL
1 teaspoon to 5 mL
1 tablespoon to __ mL
1 tablespoon to 15 mL
1 cup to __ mL
1 cup to 240 mL
1 tablespoon to __ teaspoon
1 tablespoon to 3 teaspoons.
gt/gtt
drop/drops
What are intradermal injections used for?
used for TB and allergy testing
Location of TB testing
left lower forearm
location of allergy testing.
upper back
What angle is TB needle inserted at? how much medication is given
10-15 degree angle
0.1 mL
TB testing is also known as
PPD- purified Protein Derivative
What syringe does TB use?
Tuberculin
What is the time range the TB test is read within?
48-72 hours.
What is the universal TB testing arm.
Left Armm
What is not allowed after TB test?
no band-aid, no scratching, no rubbing, and no massaging
Where is the TB medication placed where in the skin
under the epidermis and into the dermis
what happens after TB medication is injected?
a wheel is formed
What determines if the TB test is positive or negative
duration of the wheel.
What duration of a wheel needs to be investigated? how is it measured?
3-5 mm
measured with a disposable ruler
What test confirms TB after positive wheel?
a chest x-ray
What does it mean if a wheel is present 48-72 hours after injection?
possibly positive TB test.
What is the measurement form for tuberculin needle?
mL
What is the measurement form for insulin needle?
units
Which two injections have their own needle?
insulin and TB
Where in the skin are subcutaneous injections placed?
into the fatty tissue under the dermis
What angle is used for subcutaneous injections?
45 degree angle
Which muscle is most often used for subcutaneous injections?
deltoid muscle
How to locate deltoid muscle for subcutaneous injections?
Make a “V” with a hand over the deltoid muscle and finger tips should touch the acromion process
What are the locations used for subcutaneous injections?
deltoid muscle, abdomen, and vastus lateralis.
What subcutaneous injection is give in the abdomen?
anticoagulants
Safe space for abdomen subcutaneous injections?
3-4 inches away from umbilicus area
Safe space for vastus lateralis subcutaneous injections.
the middle 3rd thigh
What should you avoid doing when administering insulin or anticoagulants?
do not massage or aspirate
what should you do after injecting medications other than insulin or anticoagulant.
massage area with a cotton ball to distribute
How should insulin be stored and what should be done before it is given
refrigerated but brought down to room temperature before administering.
How do you bring a medication down to room temperature? What should you not do?
roll vial in hands
DONT SHAKE
How long should patient remain in office after injection?
10-15 minutes
convert pounds to kg.
divide pounds by 2.2
convert kg to pounds
multiply kg by 2.2
What is Depoprovera?
What angle is it given at?
What should always done before giving the injection?
- a birth control injection
- placed at a 90 degree angle
- do urine pregnancy and confirm LMP before injection
Where are IM injections placed? what angle are they placed at?
placed in muscle
- at a 90 degree angle
What is the Z-track method?
prevents leakage of medication into the cutaneous tissue
How to locate ventrogluteal muscle injection site?
- locate the greater trochanter of the femur with the heel of your hand
- spread your index and middle fingers from the anterior superior iliac spine to as far along the iliac crest
How to locate the dorsogluteal muscle injection site?
- ask pt to stand up and lean over exam table
- take weight off the leg of the side of the injection
- have pt lift the heel and rest on the ball of the foot
Which locations may be used for IM injections?
ventrogluteal muscle
dorsogluteal muscle
deltoid muscle.
Gauge
- definition
- range
the diameter of the lumen of the needle
- 14-31
the lower the gauge the ___ the lumen
the lower gauge = wider lumen
Length
- range
3/8-4 inches
What is the gauge used determined by?
consistency of medication
What is the length used determined by?
site of patient’s arm.
ID injection
- gauge
- length
- 27-28 gauge
- 3/8 inch
Subcutaneous injection
- gauge
- length
- 25-26 gauge
- 1/2-5/8 inch
IM injection
- gauge
- length
- 20-23 gauge
- 1-3 inches
What length are IM injections normally?
1-1 1/2 inches
Pros for Electronic Prescription
- human error is reduced
- medications can be sent rapidly
- reduces chance of prescription pads being stolen
Con for Electronic Prescriptions
potential for network problems
When can prescriptions be faxed or phoned in and what must it be followed by?
- can be faxed/phoned in if there are no refills
- must be followed by a hard copy to pharmacist
4 Parts of a Prescription
- Superscription
- Inscription
- Subscription
- Sig
Superscription includes
the date, pt’s full name, and address, and the Rx symbol.
Inscription includes
name of the drug, and amount of drug per dose.
Subscription includes
- considered directions from ***
the amount of each dose and total amount to be dispensed
- directions from MD to pharmacist
Sig
- directions from ***
directions from pharmacist to patient.
Rx stands for
take thou
D.A.W
dispense as written
generic vs brand name difference
the coating
enteric coating
placed on the outside of the pill and causes slower release
Scored pill
only pill that should be broken in half
- assures equal distribution of medication throughout the pill
Order to write medications
- name
- strength
- route
- frequency
Antibiotics contraindications
- what is recommended to be used
reduce the effect of birth control
- use a 2nd form of birth control.
What juice interacts with many medicatiions?
grapefruit juice
What 4 medications in large quantities can be toxic to life?
- APAP
- lisinopril
- erythromycin
- PCN
How often should a patient be seen to get a new prescription of Schedule II medications.
every 30 days
Rules about Schedule II prescription
- must have a handwritten prescription
- No refills
- prescription should be locked up
if Schedule 2 prescription is lost, wha is needed before a new prescription?
a police report
Open Wound:
involves a break i the skin or mucous membrane.
Closed wound
involves injury to underlying tissues without a break
Puncture wound
pierced hole in the skin
Jagged wound
caused by a knife or stabbing
Straight-Edge Wound
caused purposely by an incision
What are the stages of wound healing?
- inflammatory stage
- Granulation phase
- Maturation phases
Inflammatory stage of healing
- lasts up to?
a clot or plug occurs over the opening of the wound to stop the blood flow.
lasts 3-4 days.
Granulation phase of healing
growth of new capillaries occur and begin wound healing
Maturation phase of healing
- can last up to?
scar tissue forms until the skin is totally healed
- can last up to 2 years.
What is the wound assessed for?
warmth, color, size, odor, and discharge
What color should a wound be?
what does a bluish or white wound indicate?
slightly red in color
- may indicate a sign of poor circulation
How to assess warmth and tenderness of a wound
with gloves, use the back of your hand to go over the edge of the wound and ask patient to tell you if the wound is tender AND assess for warmth
What does it mean if a wound is warm and tender?
sign of infection
How do you measure the size/width of a wound?
when is it necessary to do so?
use a disposable ruler to measure the width and length of wound
- done for ulcers to measure growth.
What is foul odor of a wound a sign of?
infection
When should you assess a wound?
prior to taking out stitches or reapplying dressing
Type of sutures
absorbable sutures
nonabsorbable sutures
Absorbable sutures
dissolve over time and don’t have to be removed
Nonabsorbable sutures
(5 types)
require removal
1. silk
2. nylon
3. polyester
4. steel
5. plastic
2 reasons that staples are used
- to close an area where the body bends
- to close an area that is larger
Adhesive skin closures
- use
- lower what?
eliminate the need for sutures and local anesthetics
- lower the risk of wound infection.
Fenestrated Drape
has an opening in the middle
What does every sterile drape have that is considered non-sterile
a 1-3 inch border used for picking it up.
What temperature should the autoclave be set to?
250-270 F
Plane that divides the body into front and back halves?
frontal
Which needle is fine enough to pierce the skin?
hypodermic needle
Normal BG for NF patient
74-120
Transmission Based Precautions?
contact, droplet, airborne
Most common cleaner in a medical setting
bleach 1:10 ratio to water
Main part of the body that metabolizes a drug
liver
Prescribing vs Dispensing Medicatiion
prescribing: requires a handwritten or computer generated that is filled at pharmacy
dispensing: given to pt at office to take home.
If 1st TB test is negative but 2nd is positive what could this indicate?
pt was previously infected with TB
TYpes of prescription
written, verbal, standing order, stock order.
Example of a 3rd party payer?
Medicare
Abbreviation for Alzheimer’s
AD
A rectal temperature is not taking from which type of patient
pt with heart disease.
How much medication can be given vis IM
4 ml
What are the 3 different types of appointment reminders?
- appointment card
- call pt 1-2 hrs before
- send email or computer generated letter.
intradermal: needle gauge and length
gauge: 27-28
length: 3/8 inch
subcutaneous: gauge and length
gauge: 25-26
length: 1/2-5/6
intramuscular: gauge and length
gauge: 20-23
length: 1-3 inches
what are signs of infection?
- redness or swelling at site
- warmth
- drainage (not clear)
- foul odor
- fever
- malaise
- red streaks
CPR: how many chest compressions per minute?
100-120 bpm
cryosurgery supplies
canister with liquid nitrogen
toenail removal supplies
sterile scissors, forceps, hemostat, anesthetic, bandage materialsm
mole/cyst removal
local anesthetic, scalpel, suture supplies.
What are the functions of EMR?
- appointments
- prescription services
- billing procedures
- insurance services
-labs - patient portal
what temperature water should be used for ear irrigation
room temp
what can happen if cold water is used for ear irrigation
dizziness.
onych
nail, claw
