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IM1 Exam 5 > Med Admin 2 > Flashcards

Med Admin 2 Flashcards

1
Q

pharm concepts

A

medication names:
- chemical names (nurses rarely use)
- generic (use this)
- trade (brand name, can use w/generic)
classification:
- group of meds that work similarly
- have similar chemical makeup
- treat similar conditions
(ex: anti-pyretic, anti-inflammatory)
medication forms:
- pills
- injection
- liquid
- suppository
- topical
- orifice drops/sprays
- troches (lozenges?)

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2
Q

non-parenteral meds

A

introducing proper administration of:
- oral meds
- topical meds
- suppositories
- eye meds
- ear meds
- inhalant meds

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3
Q

adverse drug reactions (ADR)

A

unintended and undesired side effects at normal drug doses
side effects:
- predictable
- intensity is dose dependent
- development varies
- ex: drowsiness with antihistamines, gastric irritation with aspirin
(side effects that we tell patients)

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4
Q

adverse reactions

A

toxicity is severe ADR
- excessive drug dosing or therapeutic drug dosage
- ex: respiratory depression from morphine, hypoglycemia from overdose of insulin, neutropenia from anticancer drugs

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5
Q

adverse reactions

A

allergic reactions
- immune response
- intensity of reaction varies
- not based on dosage
- sensitivity of drug can change overtime

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6
Q

adverse reactions

A
  • idiosyncratic effect: uncommon drug response bc of genetic disposition
  • paradoxical effect: opposite effect drug was intended for
  • iatrogenic effect: disease caused by drug (or treatment)
  • teratogenic effect: causing birth defects
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7
Q

adverse reactions

A

physical dependence effect
- body has adapted to drug exposure
- opioids, barbiturates, amphetamines, psych meds, etc.
- abstinence syndrome
– warn patients of abrupt discontinuation
– harmful effects if continued abruptly
(ex: alcohol, suddenly stopping will need drugs to prevent abstinence syndrome)

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8
Q

adverse reactions

A

identification

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9
Q

adverse reactions

A

identification
- did symptoms occur shortly after drug use?
- did symptoms leave after drug discontinued?
- did symptoms reappear when drug was reinstitued?

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10
Q

adverse reactions

A

ways to minimize them
- education
- early identification
- monitoring
– lab values
– s/s
– individualized therapy: risks vs benefits
- black box warning
– strongest safety warning
– serious or life-threatening risk
– heavy black border around the text

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11
Q

medication guides

A
  • description of drug and indications
  • who should not take the drug
  • how the drug should be taken (overdose? if dose is missed?)
  • what should be avoided while taking the drug
  • possible and reasonable side effects
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12
Q

oral meds

A
  • tablets/caplets (tablets that look like capsules) /capsules (filled like gel)
  • modified release
    – delayed release: enteric coated
    – extended release: controlled release, sustained release and long-acting
    – oral disintegrating: disintegrates in mouth
  • syrups
  • suspensions
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13
Q

administering oral meds

A
  • HOB at least 30 degrees (semi-Fowler)
  • assess for potential aspiration - can you take a sip of water
  • opening packaged meds
  • offer 1-3 pills at a time
  • administration of solids and liquids (liquids measured in cup or syringe, tablets or solids may need to be cut in half or crushed as long as not extra release, etc.)
  • always supervise swallowing (to make sure they swallow it and can swallow it)
  • gloves whole time
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14
Q

avoid po meds if

A
  • changes in LOC
  • NPO status (may be NPO with meds = nothing except meds)
  • altered GI function
    – NG tube with suction (po won’t be absorbed)
    – N/V
  • dysphagia
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15
Q

meds not to crush, split, or chew

A
  • enteric coated: EC
  • sustained release: SR
  • time released: TR
  • controlled delivery: CR
  • sublingual: SL
  • buccal
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16
Q

if need to crush

A
  • crush if having trouble swallowing
  • look for do not crush
  • may use pill crusher in original/alternative package
  • mix in applesauce or ice cream
  • call pharmacy
  • don’t rush to crush
17
Q

pill splitting

A
  • split pills bc ___
  • clean pill splitter with alcohol swab before and after use
  • use gloves
  • remove pill from package
  • position pill to be split where scored
18
Q

topical meds

A

medications applied to body surfaces or mucous membranes
- skin application
- eye instillation
- ear instillation
- vaginal instillation
- rectal instillation

19
Q

types of topical meds

A
  • powders
  • creams/pastes/gels/ointments
  • drops
  • ointments
  • aerosols or sprays
  • medicated patches
  • suppositories
20
Q

administering topical meds

A
  • assess area prior to application: for cuts, rashes bc med won’t go on there (unless specifically to treat the rash)
  • clean previous and present area well
  • avoid shaving: bc you could cut the skin and then can’t put med there
  • measure if needed
  • apply as directed: wear gloves
  • cover (?)
21
Q

transdermal medicated patches

A

remove and clean previous area before replacing the patch
- proper removal and replacement: new one not in same spot bc could cause irritation
- date, time and initial: before patch put on
- wear gloves whole time
- most are do not cut - know med
- remove for MRI, AED
- avoid heating pads

22
Q

suppositories

A
  • explain procedure
  • left lateral side-lying (SIMS)
  • don gloves - remove packaging
  • prep the med: lubricant
  • relaxation techniques: deep breath
  • proper insertion: 1-1.5 inches for adults
  • patient teaching: don’t go to bathroom, don’t push even though feel like it, prob around 15 minutes to absorb
23
Q

vaginal medications

A
  • explain procedure
  • position: lithotomy (if incontinent, may have to clean them up before giving)
  • don gloves - remove packaging
  • proper insertion/application: 2-3 inches in, done gently, may be done digitally sometimes, may not have applicator
  • patient teaching
    – patient may administer own
    – may need perineal pad
    (ex: yeast infections, hormone creams)
24
Q

administering eye meds

A
  • know the med and why
  • explain procedure and instructions
  • don gloves
  • position of pt and eyelid: laying down, supine
  • instill as prescribed: lower bottom of eyelid, drop in conjunctive or squeeze into bottom lid,
  • tip of bottle or tube must not touch eye or lashes (contamination)
  • tissue to inner part of eye, apply pressure for 1 minute so doesn’t go systemic into nose
    (no tissue for cream,
    common use for eye infections like pink eye (conjunctivitis), glaucoma)
25
Q

administering ear meds

A
  • explain procedure and instructions
  • don gloves
  • turn head or lie on unaffected side
  • position auricle
  • instill prescribed amount
  • don’t medicate opposite ear immediately
    (warm them with hands, if cold it will hurt eardrums)
26
Q

inhalants

A
  • common use: infection, asthma
  • purpose/mechanism of action
  • MDI vs DPI: MDI requires manual dexterity and coordination, can put spacer on it for children and older adults so they can get more medication
  • care of inhalers
  • spacers
  • nebulizers
27
Q

administering inhalers

A
  • pre-post assessment (lung sounds so can tell difference if worked)
  • explain procedure
  • position patient and inhaler/spacer (sitting up?)
  • shake the MDI 5-6x
  • instructions: deep breath then exhale, tilt head back slightly, depress canister x1 and then inhale slowly
  • hold breath approx 5-10 secs or more
  • wait 1 min then repeat if rx’d
  • rinse mouth (for all but most important for steroids)
28
Q

MDI spacers

A
  • attach mouthpiece of inhaler to spacer
  • shake inhaler
  • patient seals mouth on space
  • press inhaler then inhale, breathe in
  • remove inhaler from spacer and recap both
    (allows them to still get dose even when don’t inhale at right time,
    w/o spacer, have to inhale at right time or don’t get med)
29
Q

DPI

A
  • usually has dose counter
  • pull the lever back to load inhaler
  • hold it flat like a hamburger, do not tilt
  • put mouth around mouthpiece after exhaling
  • quickly inhale, hold breathe
  • take empty capsule and throw away, clean mouthpiece
  • strong medication taste in mouth = didn’t do it correctly
30
Q

multiple inhalers

A
  • wait at least 2-5 minutes between medication
  • bronchodilators - first (to open airway so steroid can be absorbed more)
  • steroids - second
    – rinse (or steroids can cause thrush)
31
Q

safe med admin

A

verification steps:
1. acknowledge prescriber’s order (yes this is appropriate for my patient)
2. check EMR vs meds at pyxis, etc. (med matches order)
3. check EMR vs meds and pt at bedside
goal = safety

32
Q

components of drug label

A
  • expiration date
  • lot number
  • drug form
  • manufacturer
  • generic name
  • brand name (trade)
  • dosage
33
Q

student performance expectations

A

same chart as for sim lab

34
Q

what to teach for meds

A
  • name of med: trade and generic names
  • dosage
  • route
  • frequency
  • reason
  • possible side effects

IM1 Exam 5 (7 decks)

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