Med Admin Ch 4 Flashcards
Small, breakable glass containers that contain one dose of drug for intramuscular or intravenous injection
amuples
Manipulation that does not contaminate the sterility of the drug and drug delivery system
aseptic technique
The total tissue area (including height and weight) of a patient’s body
body surface area (BSA)
A drug that is given by being applied to or held in the cheek. The drug diffuses through the oral mucosa directly into the bloodstream.
buccal route
Gelatin container that holds powder or liquid drug
capsule
A method for determining pediatric drug dosage calculated by ratio and proportion, based on the child’s body weight
Clark’s rule
The number of drops per milliliter of fluid
drop factor
The rate at which intravenous fluids are given
flow rate
Injections that are given into the dermis, just below the epidermis, most often used for allergy testing and tuberculosis testing
intradermal injections
Injections that deposit drugs past the dermis and subcutaneous tissue, deep into the muscle mass
intramuscular (IM) route
The administration of drugs directly into the bloodstream
intravenous (IV) route
A two compartment vial that contains a sterile solution in one compartment and the powdered drug in the second compartment, separated by a rubber stopper. The solution and drug powder are mixed together immediately before use
mix-o-vial
An enteral route of drug administration and oral feeding that bypasses the mouth by use of a tube going through the nose and esophagus into the stomach
nasogastric (NG) tube
A chart that displays the relationships between two different types of data so that complex calculations are not necessary
nomagram
Administration of a drug by injection directly into the dermal, subcutaneous, or intramuscular tissue; epidurally into cerebral spinal fluid; or through intravenous injection into the bloodstream
parenteral route
Administration of a drug through topical (skin), sublingual (under the tongue), buccal (against the cheek), or inhalation (breathing) methods
percutaneous route
A second or secondary intravenous fluid bag or bottle containing drugs or solution that is connected to the main IV line rather than directly to the patient
piggyback infusion
injections that place no more than 2 mL of drug solution into the loose connective tissue between the dermis of the skin and muscle layer
subcutaneous injections
Application of a drug to the mucous membranes under the tounge
sublingual route
Dried, powdered drugs compressed into small shapes
tablet
drugs applied directly to the area of the skin requiring treatment; most common forms are creams, lotions, and ointments
topical route
Drugs applied to the skin for absorption into the bloodstream
transdermal
Small, single or multiple dose glass drug container
vial
A type of IM injection technique used to prevent tracking (leakage) of the medication into the subcutaneous tissue (underneath the skin)
Z-track technique
___ are given directly into the gastrointestinal (GI tract) extending from the mouth through the anus. They can be given by the oral (PO), nasogastric (NG), or rectal route
enteral drugs
(know) Do not leave drugs at the bedside for patients to take later
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(know) Never give a drug poured or prepared by another nurse or healthcare provider to a patient. You may only give drugs that you have prepared
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(know) before you give oral drugs, you must make sure the patient can safely swallow any drug given
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(know) all oral drugs are brought to the patient’s bedside unwrapped, or in the original container, and can be placed in a paper soufflé cup using aseptic technique before giving the drug
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What are 3 things you do when preparing to give a liquid form oral drug
#1 liquid must be shaken to ensure the drug is evenly distributed throughout the liquid #2 take the lid off the bottle and place the lid upside down (outer surface down) on a flat surface #3 hold the bottle so the label is against the hand
(know) the syringe or medicine dropper is placed halfway back in the baby’s mouth, between the cheek and gums, and slowly emptied, giving the baby time to swallow it
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(know) do not dilute a liquid drug unless ordered to do so by the prescriber
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What is the pH rage when the PEG tube is most likely in the stomach?
0 to 5
Needle gauge for Intradermal
25-27
Needle gauge for Subcutaneous
25-27
(SG) Needle gauge for Intramuscular
20-22
Needle gauge for Intravenous
15-22
Needle length for Intradermal
3/8 - 1/2
Needle length for Subcutaneous
1/2 - 1
Needle length for Intramuscular
1 - 2
Needle length for Intravenous
1/2 - 2
Volume to be injected for Intradermal
0.01 - 0.1
Volume to be injected for Subcutaneous
0.5 - 2
Volume to be injected for Intramuscular
0.5 - 2
Volume to be injected for Intravenous
Unlimited
(know) If more then 3 mL of drug is to be given IM, the drug must be divided and given in two injections so that a large pool of drug does not form in the tissue, which would irritate the tissue
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Steps when using a vial (5)
#1 remove the metal lid and cleanse the diaphragm with an alcohol wipe #2 pull into the syringe an amount of air equal to the amount of solution to be withdrawn #3 insert the needle with the bevel up and inject the air into the space about the solution #4 withdraw the drug #5 move the needle downward to allow the needle to continue to fill
Steps when using an ampule (3)
#1 shift drug from the top to the bottom portion of the ampule by flicking the top lightly with a finger #2 wrap a gauze pad around the neck of the ampule and use a snapping motion to break off the top of the ampule along prescored line at the neck. Always break away from the body by bending the top toward you. #3 insert the filter needle into the ampule and draw up the drug
Steps to a mix-o-vial (3)
#1 remove the protective sterile cap from the mix-o-vial #2 push the rubber plunger on the top compartment; this will force the rubber stopper into the bottom compartment and let the solution dissolve the powder
Know Clark’s rule for calculating pediatric doses
Pediatric child dose = (weight of child/150lbs) x adult dose
(know) If an elderly patient has a bunch of drugs scheduled to be administered first thing in the morning, allow them a little extra time
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You’ve just given your patient their medication that has an NG tube, what do you do next?
clamp it for 30 minutes and then reconnect it to suction
Someone who is in your care is suddenly experiencing a life threatening emergency. Which route do you give life sustaining measures through?
IV
Know how to teach a patient about giving his own subcutaneous injections
Teach the patient about the drug, expected effects and adverse effects to report, and proper techniques for drug administration. Teach the patient and family to develop a plan for rotating injection sites
An IV becomes infiltrated (busts), the IV is still running and the vein has busted open. What’s a sign of that?
pain at sight, red, swelling
Know how to do a z track injection
Draw up the drug as usual, plus 0.1 to 0.2 mL of air. The injection of the air seals the injection site, preventing leakage of the drug. Drugs of the type that require the Z-track technique are injected into the ventrogluteal site. Once the injection site is prepared, pull the tissue downward and away from the injection site. Inject the drug and allow the skin to move back into place before you remove the needle. This action allows the tissue to make a seal over the injection site, sealing the drug in place. Do not massage the injection site.
Know the steps to take to apply topical nitroglycerin ointment
Wash hands and Don gloves. The correct amount of ointment is squeezed onto the paper. The paper is applied to the patient’s skin. Clear plastic wrap may be applied over the paper to increase absorption and protect clothing from staining.
Know about transdermal injections and safety precautions. Transdermal is on top of the skin, you need to wear gloves.
Choose the skin site carefully> avoid skin that has been tattooed, skin that has lesions, or broken skin, all of which can affect absorption. Clean the skin before applying topical drugs to reduce the risk for infection, and remove remaining drug from the previous application to prevent drug buildup. Wear gloves for protection, because the drug you are giving can also be abored through your skin. Carefully pick up the patch and remove the clear plastic backing. Firmly press the patch drug side down onto the skin. The adhesive on the edges will hold the patch to the skin. Transdermal patches are changed on a regular schedule, as indicated by the order. Transderm-nitro, fentanyl patches, nitro-dur, and birth control patches may be worn while showering; all other drug patches are to be applied after bathing.
You need to know how to do a metered dose inhaler and appropriate teaching
have them exhale and activate inhaler as the next inhale begins, sit up right
Know about Use of an inhaler during an asthma attack
make sure the drug reaches the lungs
You have an order for IV antibiotics, you need to know the steps you have to take to get that accomplished
check drug order, make sure patient doesn’t have an allergy, once you’ve gathered your supplies, go to the room and identify the patient with two identifiers, explain what drug is going to be given
You need to know how to give an oral capsule
you want to make sure they swallow it whole, stay until they have swallowed it
(know) Capsules are not usually meant to be opened
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