Med Admin chapter 2&3 Flashcards
An order for a drug to be given as needed based on a nurse’s judgement of safety and patient need
as needed or PRN drug order
A special designation from the FDA that the drug has a higher than normal risk for causing serious and even life threatening problems in addition to its positive benefits for some people
black box warning
Drugs that are highly regulated because they are commonly abused. Also known as “scheduled drugs”
controlled substances
A one time drug order to be given immediately
emergency or stat drug order
Drugs that have the potential to cause significant harm to patients
high alert drugs
The nurse’s authority as defined by the state NPA. It involves the nurse’s judgement and actions while performing professional duties. All nurses must know what is legal in regard to drugs in the state they practice in
legal responsibility
The state law that licenses LPN, RN, Nurse anesthetists, nurse practitioners, and nurse midwives. It describes the minimal educational preparation and professional requirements needed to perform specific functions, including drug administration, to protect the public safety
NPA, nurse practice act
Category of drugs identified by federal legislation as having low risk to patients and may be purchased without a prescription; have low risk for abuse; and are safe when directions are followed
Over the counter (OTC) drugs
The actual physical symptoms that occur with drug withdrawal
physical dependence
Category of drugs regulated by federal legislation because they are dangerous and their use must be controlled; may be purchased only when prescribed. Examples are antibiotics or oral birth control pills
prescription drugs
The authority designated by a individual state that determines who is legally permitted to write an order or prescription for drugs
prescriptive authority
The obligation of nurses to act appropriately, ethically, and to the best of their ability as a healthcare provider
professional responsibility
Feeling of anxiety, stress, or tension when a patient does not have a medication
psychologic dependence
A one-time order to be given at a specified time
single drug order
A drug order that indicates that the drug is to be given until discontinued or for a certain number of doses
standing drug order
What are two examples of medication you do not crush?
24hour tablets and ER or XR
What is the description for a Schedule 1 drug
High potential for abuse. No accepted medical use in treatment in the United States. Lack of accepted safety for use of the drug or other substance under medical supervision.
What are examples for a Schedule 1 drug
alpha-acetylmethadol, gamma-hydroxybutyric acid (GHB), heroin, lysergic acid diethylamide (LSD), marijuana, mescaline, peyote, Quaaludes
What is the description for a Schedule 2 drug
High potential for abuse. Currently accepted use for treatment in the United States. Abuse may lead to severe psychologic dependence or physical dependence.
What are examples for a schedule 2 drug
Amphetamines, cocaine, codeine, fentanyl, hydromorphone (dilaudid), meperidine (demerol), methadone, methylphenidate (ritalin), morphine, oxycodone (percodan), pentobarbital, secobarbital
What is the description for a Schedule 3 drug
Potential for abuse is less than the drugs or substances in Schedules 1 and 2. Currently accepted medical use for treatment in the united states. Abuse may lead to moderate or low physical dependence or high psychologic dependence
What are examples for a Schedule 3 drug
Most drugs are compounds containing some small amounts of drugs from Schedule 2 along with acetaminophen or aspirin such as Tylenol #3 or #4 and Fiorinal. Other drugs include anabolic steroids such as testosterone preparations and sodium oxybate (Xyrem), a drug that contains GHB for use with the sleep disorder narcolepsy. (#3 has codine in it)
What is the description for a Schedule 4 drug
Low potential for abuse relative to the drugs or substances in Schedule 2. Currently accepted medical use for treatment in the United States. Abuse may lead to limited physical dependence or psychologic dependence relative to the drugs or substances in Schedule 2
What are examples for a Schedule 4 drug
Include diet drugs with propionic acid. Other well-known drugs include benzodiazepines (lorazepam [ativan], flurazepam [dalmane], diazepam [valium], midazolam [versed}, alprazolam [xanax]), chloral hydrate, paraldehyde, pentazocine (talwin), phenobarbital (Versed has paralyzing effects)
What is the description for a Schedule 5 drug
Low potential for abuse relative to the drugs or substances in schedule 4. Currently accepted medical use in the United States. Abuse may lead to limited physical dependence or psychologic dependence relative to the drugs or substances in schedule 4
What are examples for a Schedule 5 drug
Include cough preparations with small amounts of codeine and drugs for diarrhea that also contain small amounts of opioids such as diphenoxylate with atopine (Lomotil)
What are two examples of medication that need a 2nd nurse witness
anti-seizure meds and opioids
What is the goal of all regulations and policies?
to verify and account for all controlled substances
What is the most common cause of common cold drug overdoses?
They occur in children because of confusion by parents over the correct dosage to give, so these drugs are no longer recommended for use in pediatric patients (such as Benadryl)
Older patients are at high risk for problems with prescription drugs because they may not take the drug properly because of poor eyesight, memory, or coordination; they may take many drugs that interact with each other; or they may have chronic diseaase that interfere with how the drug works. What is this known as?
poly pharmacy’s
Can you refill a controlled substance?
no, you must acquire a new prescription every time
What is an example for a standing drug order
Amoxicillin 500 mg orally every 8 hours for 10 days
What is an example of an emergency or stat drug order?
Diphenhydramine 50 mg IV stat
What is an example of a single drug order
Cefazolin 1 g IV at 10:00am before surgery
What is an example of a PRN drug order
docusate 100 mg orally at bedtime as needed for constipation
What does PDR stand for?
Physician’s drug reference
Where is the original drug order found?
in the chart
What are the 9 rights of drug administration in order
#1 right patient #2 Right drug #3 Right dose #4 right route #5 Right time #6 Right documentation #7 Right reason #8 Right response #9 Right to refuse
How do you check if it is the right patient
Check the patient’s name using two methods to identify the patient
How do you check if it is the right drug
Check drug order and check drug label
How do you check if it is the right dose
Check drug order and confirm drug dose is appropriate
