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N143 Final exam > Med admin A > Flashcards

Med admin A Flashcards

1
Q

What isa medication

A

a substance used in the prevent, diagnosis, relief, treatment or cure of health alterations

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2
Q

what kind of treatment is medicine

A

primary (restoration of health)

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3
Q

what is a drug

A

any chemical that can effect a living process

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4
Q

a nurse is responsible for:

A
  • Evalutating the effect of the medications
  • teaching patients about their meds & possible adverse event
  • promoting adherence
  • evaluating the patients technique for medication delivery
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5
Q

What is pharmacology

A

The study of how medication: enters the body, absorbed & distributed in to organs tissues & cells and how it alters physiological functions & exits the body

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6
Q

What is pharmokinetics

A 
refers to the ACTION of the substance IN THE BODY (and how it gets to its sites of action) 
IMPACT OF THE BODY ON THE DRUGS 
-Absorption
-Distribution
-Metabolism
-Excretion
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7
Q

What is pharmacodynamics

A

IMPACT OF THE DRUGS ON THE BODY

  • once it reaches it’s site of action, it determines the nature & intensity of the response
  • binding to receptors
  • functional state can influence this
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8
Q

What is half life a part of

A

pharmacokinetics

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9
Q

What is half life

A

how long it takes for half of the dose to be metabolized and the be eliminated from the body

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10
Q

Medications can be excreted via:

A
  • kidneys
  • liver
  • bowels
  • lungs
  • exocrine glands
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11
Q

All prescriptions must include

A
  • Patients name & ID
  • time & date
  • Name of the medication
  • Dosage
  • Route
  • Frequency
  • purpose of drug when it’s PRN
  • Physicians signature MD
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12
Q

To safely & accurately administer medications nurses need knowledge related to:

A
  • Pharmacology
  • Pharmacokinetics
  • Growth & developement
  • Human anatomy
  • Pathophysiology
  • Psychology
  • Nutrition
  • Mathamatics
  • Safety
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13
Q

What is clinical pharmacology

A

the study of drugs in humans

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14
Q

what is therapeutics or pharmacotherapeutics

A

the use of drugs to diagnose, prevent or threat disease of to prevent pregnancy

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15
Q

What are the 3 properties of idea drugs

A

1) Effectiveness
2) safety
3) selectivity

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16
Q

What are the additional properties of an ideal drug

A
  • reversible action
  • predictability
  • ease of adminisration
  • free from drug interaction
  • low cost
  • chemical stability
  • possession of simple generic names
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17
Q

No drug is ideal because

A
  • They have the potential to produce side affections
  • responses are difficult to predict & may be altered by interactions
  • drugs may be expensive, unstable or hard to administer
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18
Q

All members of the health care team mist exercise car to promote therapeutic effects &

A

minimize drug induced harm

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19
Q

The of ejective of a drug therapy

A

Provide maximum benefit with minimal harm

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20
Q

Is giving medications routine task?

A

never

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21
Q

Is any med is potent enough to help it is..

A

potent enough to harm & kill

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22
Q

What are The factors that determine the intensity of drug responses

A

1) Administered dose
- Drug, Dose, Route, Timing
2) Pharmacokinetics (how much of the drug gets to the site of action)
- Drug absorption, Distribution, metabolism, excretion

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23
Q

What is absorption

A

the passage of the medication molecules into the blood from the site of administration

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24
Q

what factors influence absorption

A

1) route of admin
2) Ability for med to dissolve
3) Blood flow to site of administration
4) Body surface area
5) Lipid solubility of medication

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25
Q

What is distribution

A

after absorption when it goes into the tissues & organs to the specific sites of action

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26
Q

factors of distribution

A
  • Circulation
  • Membrane permeability
  • Protein binding (meds bound to albumin cannot exert pharmacological activity)
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27
Q

What is happening in metabolism

A

they are metabolized into a less potent of inactive from

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28
Q

When do bioltransformations occur

A

when enzymes detoxify. degrade & remove active chemicals (MOST IN THE LIVER)

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29
Q

Pharmacodynamics

A

The impact of the drug on the body

  • Binding to it’s receptor
  • patients functional state
  • placebo effects
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30
Q

Factors that determine the intensity of drug response

A

1) Pharmacodynamics
- Bind of the drug to it’s receptor
- pt. functional state
- placebo effects
2) Sources of individual variation
- Drug interactions
- Physiologic variables (AGE WEIGHT GENDER)
- Pathological varables (EFFECTIVNESS OF LIVER & KIDNEYS)
- genetic variables

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31
Q

wil patients response the same to identical drug regimens?

A

no because all individuals differ

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32
Q

What are the three drug names

A

1) Chemical
2) Generic
3) Trade
4) Drug identification number

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33
Q

what are the ways drugs can be classified

A

1) Effects on body system
2) which symptoms relieved
3) Desired effects

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34
Q

What is the generic name

A
  • approved by health canada

- non proprietary / not protected by trademark

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35
Q

what is the trade name

A
  • prorietary name
  • indicates a drug registered to the owner of the patent
  • production is restricted until patent expires
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36
Q

what is the chemical name

A

-describes the molecular structure

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37
Q

What is a therapeutic classification

A

organizing drugs based on their therapeutic usefulness for treating particular diseases (eg. cardiac care drugs)

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38
Q

What is a parhmocological classification

A
  • Address a drugs MECHANISM OF ACTINON or HOW a drug produces an effect on the body
  • some are part of more than 1
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39
Q

Why must nurses understand all the effects that medications can have on patients

A
  • Don’t always response the same way to each dose

- Sometimes the game medication causes very different responses in different patients

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40
Q

What are therapeutic effects

A

-Expected or predictable

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41
Q

what are side effects

A
  • unintended secondary effect

- unavoidable but a medication will PREDICATBLE cause this

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42
Q

what are adverse effects

A

severe, negative response to medication

  • These are unintended, undesirable & often UNPREDICTABLE
  • can be intolerable
  • They justify immediate discontinuation of the medication
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43
Q

what are toxic effects

A

medication accumulation in the blood stream

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44
Q

What is an idiosyncratic reaction

A

-overreaction or underreaction to medication

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45
Q

what is an allergic reaction

A
  • unpredictable response to a medication
  • Could be a medication allergy or an anaphylactic reaction
  • immunologically sensitized
  • antibiotics have a high rate of allergic reactions
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46
Q

what are anaphylactic reactions

A

SEVER ALLERGIC REACTIONS THAT ARE LIFE THREATENING

  • characteized by sudden constriction of bronchial muscles, edema of the pharynx & larynx, severe wheezing, shortness of break & circulatory collapse
  • needs immediate treatment with epinephrine, bronchodilators & antihistamines
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47
Q

What are contraindications

A

many medications should not be taken by some patients due to unwanted, dangerous reactions

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48
Q

What is a medication interaction

A

where one medication modified the action of the other one

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49
Q

what is a synergistic effect

A

occurs when the combined effect of two medications is greater than the effect of the meds given separately

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50
Q

What is the goal of prescribing medications

A

to achieve a constant blood level of medication within a safe therapeutic range

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51
Q

what is onset

A

time it takes for a medication to produce a response

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52
Q

what is peak concentration

A

the highest effective concentration reached after medication is administered

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53
Q

What is through concentration

A

minimum blood serum concentration before next scheduled dose

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54
Q

what is duration

A

time medication takes to produce greatest results

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55
Q

what is plateau

A

blood serum concentration reached & maintained

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56
Q

Parenteral routes include

A

-Intradermal, Subcutaneous, intramuscular, intravenous, epidermal, trathecal, interosseous, intraperitoneal, intrapleural, intra-arterial

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57
Q

Topical routes on administration

A

-transdermal or mucous membranes

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58
Q

Household/apothecaries measurements

A

Drops, tablespoons, teaspoons, pints, quarter, ounces, pounds

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59
Q

What does the apothecaries system do

A

a system of measuring & weighing drugs & solutions in which fraction are used to identify part of the unit
1lb = 16oz

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60
Q

The household system

A

is considered inaccurate because varying sizes of cups, glasses & eating utensils & this system has been replaced with metrics. It’s important nurse understands the household measurement system to be able to use & teach it to client & families

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61
Q

1 cup = ? oz

A

8 ounces

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62
Q

2 tbsp = ? oz

A

1 oz

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63
Q

3 tsp = ? tbsp

A

1

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64
Q

1 tsp = ? gtt

A

60gtt

65
Q

Who can be a prescriber

A

physician, nurse practioner or pharmacist

66
Q

Prescriber must document the:

A

Diagnosis, condition or need for each medication

67
Q

orders can be:

A

written (paper or electronic)

verbal or telephone

68
Q

The orders are faxed or forwarded to the pharmacy & prescribed onto the mar. Who do they need to be signed by

A

1) two nurses

or 2) a nurse & pharmacist

69
Q

what do u need to do with telephone or verbal orders

A

repeat back to the prescriber

70
Q

What is a routine order

A

carried out until the prescriber cancels it by writing a new order or until a prescribed number of days have elapsed

71
Q

What are single dose

A

given one time only for a specific reason like surgery

72
Q

STAT vs NOW

A 
stat= given immediately in an emergency 
now= when a med is needed quickly but not immediately
73
Q

What is the pharmacists role

A

-distribution system

Stock supply system, unit dose system, automatic dispensing unit, computers on wheels

74
Q

Nurses role:

A
  • determine whether the correct medication was ordered
  • don’t assume all medications in the patients pill box are to be given
  • determine correct time, administration route, & evaluation of effects
  • assess patients ability to self administer
  • patient & fam education
75
Q

What provides the framework for medication administration

A

-The nursing process

76
Q

Pediatric doses may vary based on

A

age. weight, body surface area & med amount

77
Q

Formula

A

Dose ordered/ dose on hand times amount on hand

78
Q

Medication administration assessment

A

1) Medical history includes
- History of allergies, medication data, diet, perception or coordination problems
2) Patients current condition

79
Q

when do you apply pharmacology in patient care

A

1) Pre-administration assessment
2) Dosage & administration
3) evaluating & promoting therapeutic effects

80
Q

What is the goal or pre admin assessment

A

1) baseline data
2) ID high risk
3) Patients attitude toward medication use
4) Patients knowledge & understanding of medication therapy
5) patients nursing needs
* any meds they’ve every been on, route, eating patterns, religious beliefs about meds, how they pay for them, if they have an questions, how do you remember to take your meds, have you ever stoped taking them what are they for.

81
Q

What should you know about dosage & Administration n

A
  • Certain drugs have more than 1 indication with different doses for different uses
  • many drugs can be admired in more than one rout and dosage & differ depending
  • Certain intravenous drugs can cause sever local injury if the drug seeps not the tissues sip-rounding the injury so it must be monitored closely
82
Q

What are the parts of promoting therapeutic effects

A

1) Evaluating therapeutic response
2) Promoting adherence
3) Implementing non drug measures

83
Q

How to mimimize adverse effects

A
  • Identifying high risk patients thought history
  • ensure proper administration though education
  • teaching patients about actives that may precipitate an adverse event
  • thorough drug history
  • advising to avoid over the counter drugs that can interact
  • monitoring adverse interactions known to occur between the drugs & patient that is taken them
  • be alert to not yet know interactions & reactions
84
Q

To implement a PRN order rationally

A

a nurse must know the reason for drug use & be able to assess the patients needs for medications

85
Q

to manage toxicity & minimize harm

A

must know early signs of toxicity & the procedure for toxicity management

86
Q

patient must be educated about the following:

A
  • Name & therapeautic category
  • dosage & dosing schedule of admin
  • route & technique of admin
  • expected therapeutic response & onset
  • nondrug measures to enhance therapeutic responses
  • duration of drug dose
  • method of drug storage
  • symptoms of major adverse reactions & measures to minimize discomfort & harm
  • Method od drug storage
  • symptoms of adverse effects & measures to minimize discomfort & harm
  • major adverse drug-drug & drug-food interactions
  • whom to content in the event of therapeautic failure, severe adverse reaction & severe adverse interactions
87
Q

Concerns for older persons

A

poly pharmacy & non adherence

88
Q

10 Righits

A
  • Right medication
  • Right dose
  • right patient
  • right route
  • right time & frequency
  • Right documentation
  • Right reason
  • Right to refuse
  • Right patient education
  • Right to patient education
  • Right evaluation
89
Q

To refuse…

A

regardless or consequences

90
Q

to be informed about..

A

a medications name, purpose, action & undesired affection

91
Q

to have a qualified nurse or physician

A

assess a medication history including allergies & herbal therapies

92
Q

to be properly advised on:

A

The experimental nature of medication therapy & give consent to use it

93
Q

to receive:

A
  • labeled medications safely without discomfort in accordance to 10 rights
  • supportive therapy in relation to medication therapy
94
Q

To not receive:

A

unnecessary medications

95
Q

A change in a patients condition can be physiologically related to

A

health status
medications
or both

96
Q

What is a medication error

A

Any event that could cause, INDIRECTLY OR DIRECTION, either administration inappropriate medication therapy or FAILURE TO ADMINISTER APPRORIATE MEDICATIONS
-Can cause or lead to INAPPRORIATE MEDICATION use or patient harm

97
Q

what are common med errors

A

Omission, improper dose, wrong time, wrong patient

98
Q

what do medication errors highly

A

the importance of determining accountability

99
Q

What are possible contributing factors to medication errors

A

-procedures & systems such as product labeling & distribution

100
Q

What are incident or occurrence reports used to track

A

incidence patterns & quality improvement

101
Q

what is an example of culture of safety

A

“near miss” reporting

102
Q

when do medication errors often occur

A

when a patient is being transferred to a different unit

103
Q

What should you know about an incident report

A
  • Written amount of incident (usually within 24 hours)
  • Not a permanent part of medical record & not referred to in the record
  • used to track incident patterns & address quality improvement and risk management issues when necessary
  • disclosure to family & patients : IMPORTANT
104
Q

what is included in incident report

A
  • IDentification info
  • Location & time of incident
  • Accurete, factual description of what occurred & what way done
  • The nurses signature
105
Q

What are the steps to take to prevent medication errors

A

1) Follow the rights of medication administration
2) Read labels at least 3 times (compare with MAR) -Before, during & after administering med
3) Use at least 2 patient identifiers
4) Do not allow any other activity to interrupt medication administration
5) Double check all calculations & verify with another nurse
6) Do not interpret illegible handwriting, clarify with the prescriber
7) Question unusually small or large doses
8) Document all medications as soon as they are given
9) When you have made an error, reflect on what went wrong & how you could have prevent the error
10) evaluate the context or situation in which a medication error occurred. Helps to determine whether you have the necessary resources for safe med admin
11) When repeated errors occur, identify & analyze the factors that may have caused the error & take corrective action
12) Attend in service programs that focus on the medications commonly administered

106
Q

What is included in the process for medication reconciliation

A

1) verify (current list of pt. meds)
2) Clarify ( Ensure accuracy of medication dosages, and frequencies, clarify the content of the list with as many people as necessary: Caregivers, patient, health care providers, pharmacists)
3) Reconcile (Compare new medication orders against the current list … Investigate any discrepancies by contacting the patients health care provider)
4) Transmit (communicate the updated & verified list to caregivers & patients as appropriate)

107
Q

What is meant by effectiveness

A

-Elicits the response of which it is given. THIS IS THE MOST IMPORTANT QUALITY. If its not effective there’s no point in giving it & it will not be marketed.

108
Q

What is meant by safety

A

will not produce harmful effects even if administered at very high doses for a long time. THIS CAN NEVER BE ELIMINATED

109
Q

what is selectivity

A

a drug that elicits only the response for which it is given . No such thing because all drugs have side affects

110
Q

Reversible action

A

we want all drugs to subside eventually. excited antibiotics

111
Q

what is predictability

A

it would be helpful to know how a patient would respond, but predictions aren’t very accurate. It must be tailored

112
Q

What is ease of administration

A

should be simple route, low # of doses. Can enhance adherence & decrease infection

113
Q

knowing the drug name will..

A

reduce patient overdose risk

114
Q

What is a tincture

A

medicinal alcoholic extract from plant or veg

115
Q

what is a liniment

A

applied to skin

116
Q

Food and drugs act

A

gave federal government control over the manufacture of all drugs except narcotics

117
Q

Who sets the standards to strength, quality, purity, packaging, labelling & dosage

A

-British Pharmacopoeid & canadian formulary

118
Q

What is bioabavilability

A

the ability of the drug to breleased from its dosage form and transport ed to drugs site of action

119
Q

Provinces

A

indirectly effect sales. They determine how they are ordered, dispensed & administered & what drugs need a perscription

120
Q

the health institutes

A

develop polices that conform & are more restrictive than the province. Can be influenced by institution, services, personnel & policy

121
Q

Except when administer IV … meds take

A

time to enter the blood stream

122
Q

when is peak concentration

A

just before the body absorbs the last of the medication. IT quickly drops after this

123
Q

When is troufff level

A

30 mins before a drug is administered

124
Q

When does the therapeutic range occur

A

between minimum effective concentration & toxic concentration

125
Q

Meds are most effective

A

around the clock & not PRN

126
Q

When does the pt. receive their next dose

A

when the first dose reaches its half life

127
Q

Oral route

A

easiest & most common
patient prefers
slower onset & more prolonged effect than parenteral

128
Q

What is sublingual admin

A

Designed to be absorbed just after being placed on tongue, shouldn’t be swallowed or given liquids

129
Q

what is buccal admin

A

solid med against cheek until it dissolves . Alternate cheats so not irritation. Don’t chew or swallow. Acts locally or systemically

130
Q

Advantages to oral

A
  • Economical
  • comfrotable
  • easy
  • local or systemic efcts
  • rarely causes anxiety 1
131
Q

disadvantages to oral

A
  • aovid with GI tract malfunction (surgery, nausea, reduced motility)
  • Gastric secretions destroy some
  • some can’t swallow
  • may discolour teeth or vitiate or taste bad
  • may hold under tongue
  • cant be given with gastric suction & some surgeries ect.
132
Q

Pareneral means

A

injecting into tissue

133
Q

What is the intrathecal route

A

catheter in the subarachnoid space or into ventricles of the brain
long term meds through surgically implanted catheters

134
Q

what is the intraosseous route

A

into bone, common in infants & toddlers bc intravascular is hard to get to

  • in an emergency
  • dont by a physician
  • tibia
135
Q

What is intraperitoneal route

A

peritoneal cavity where absorbed by circulatory. Chemotherapeautic agents, insulin & antibiotics

136
Q

What about intra-arterial route

A
  • directly into arteries to deliver plasminogen activators
  • often through cathetar
  • nurses need to monitor & evaluate
137
Q

intra-articular

A

into a joint

138
Q

Advantages to parenteonal

A
  • Alternative to oral
  • more rapid
  • good for long term or critical
  • can maintain levels over tiem
  • if peripheral perfusion is poor IV is better
139
Q

disadvantages or parentoenal

A 
Risk for infection
expensive
painful 
avoided when bleeding tendencies 
-risk of damage 
-higher risk for reactions
-anciety
140
Q

When can systemic effects happen bc of topical

A

when the skin is thin or broken, concentration high or contact to skin is prolonged

141
Q

what are the advantages to topical

A
  • temporary local effected
  • painless
  • limited side effects
142
Q

what are the disadvantages to topical

A

skin abrasions = systemic

slow absorb

143
Q

Transdermal patch

A

12hr to 7 days

  • systemic effect
  • prolonged with limited adverse effects
  • leaves oily or pasty substance on clothes & skin
144
Q

How long can intraocular stay in

A

up to a week

145
Q

Reducing errors for verbal perceptions

A
  • limited to urgent situations
  • no verbal or antineoplastic
  • needs to be inept
146
Q

Which has higher errors & lower errors

A

Stock supply system has high errors & Unit dose & automated are better

147
Q

Most common errors made by students

A
  • omission
  • improrper dose or quantity
  • wrong time
  • extra dose
  • wrong patient
148
Q

Weh nan error occurs

A
  • assess condition & notify physician ASAP

- after pt. is stable, should be reported within 24hr

149
Q

History

A 
Allergies
medication data 
diet history 
perceptual & coordination problems
-current condition
attitude toward use
understand ing & learning needs
150
Q

Rule of calculations

A 
no period don't add s
place space for more than 4 digits 
use decimals for fractions 
use leading zero 
omit unnessesary zeros 
don't use CC for ML 
L in let's is capped
151
Q

what system is most common for medicine

A

metric (SI IS THE ONLY UNITS USED)

152
Q

units & milliequivalent are

A

measures of strength or potency

153
Q

What is a unit

A

biological effect that cannot yet to known or defined precisely by SI units
(insulin, hormones, vitamin, penicillin) it is a measure of standardized potency

154
Q

what is millequivalanrts

A

measure of combing/ reaction value & power vs mass per volume
strength of ion cocnetretion used for electrolyte replacements

155
Q

0001 =

A

zero zero zero one hour (always say hour at the end

156
Q

A patients trough level

A

drawn as a sample 30 mins before drug is administered .. tests reveal if the drug is reaching therapeutic level

157
Q

The greater the half life

A

the longer it takes to be excreted

short half life = more frequently taken

158
Q

Plasma half life will increase in clients with

A

reduced liver or kidney function who are at most risk for toxic levels. So med s are given less frequently at reduced doses

N143 Final exam (11 decks)

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