Med administration Flashcards
What is the nurse’s role in med delivery?
Safe medication prep, administration, and evaluation effects on patient’s health status
Teaching patients about meds
Assess ability to self-administer
Follow legal provisions when administering controlled substances
What are the 6 rights of med administration?
Right medication Right dose Right patient Right route Right time Right documentation
What are the legal responsibilities of the nurse?
Inform pt of the name, purpose, action, and potential effects
Assess the med history
Make sure the patient does not receive unnecessary meds
What is the generic name?
Name assigned by manufactured
USP name
What is the trade name?
Mame under which a manufacturer markets a medication
TM symbol in upper R corner
What do medication orders include?
Pts name, order date, medication name, dosage, route, time of administration, drug indication, and prescriber’s signature.
What are the types of orders in acute care settings?
Routine/standing orders PRN Standing protocols One-time orders Stat orders Prescriptions
What info is collected during initial assessment?
Medication history
Allergies and intolerances
Medical history
Pregnancy and lactation status
How do you give meds via enteral tube?
Turn feeding off for 30 min prior if empty stomach is needed
Flush with 30 mL water
Give meds
Flush with 30 mL
What are the 4 parenteral med routes?
Intradermal
Subq
Intramuscular
IVP
What is intradermal used for?
Allergy/TB
What is subq used for?
Insulin, heparin, enoxaprin
What intramuscular sites are used?
Deltoid (vaccines)
Vastus lateralis
Ventral gluteal
How do you choose a needle size?
Pt’s size and weight
Injection site
Type of tissue into which you are injecting
Viscosity of fluid
How do you choose a syringe size?
Fluid amount
What angle is IM administered at?
90 degrees
What angle is subq administered at?
90 or 45 degrees
What angle is intradermal administered at?
15 degrees
What are characteristics of intradermal administration?
Slow absorption from dermis
Need to clearly see the injection site for changes
Do not touch or rub
What syringe should be used for intradermal administration?
26-28 gauge
1/2 inch
Tuberculin syringe
What are characteristics of subq injection?
Medication is placed in subq
Slower absorption than IM
A patient’s body weight indicates the depth of the subcutaneous layer.
Choose the needle length and angle of insertion (45- 90 degrees) based on the patient’s weight and estimated amount of subcutaneous tissue.
What syringe should be used for subq injections?
Small volumes (0.5-1 ml) 1-3 ml syringe 27-25 gauge ½ to 1 inch Most common: 25 gauge, 5/8 inch
Where is the recommended site for heparin?
Abd
Where is the recommended site for enoxaparin?
Abd 2 inches from umbilicus
Where is the recommended site for Lovenox?
Love handles
What size are insulin needles?
28-31g
5/16-1/2 inch
What are characteristics of IM injections?
Faster absorption than subq route
Used less commonly
Aspiration not longer recommended.
Z-track method for delivering irritating medication
What size syringe should be used for IM injections?
1 to 3 in
Very obese: 3 inches
Thin: ½ to 1 inch
20-25 gauge
What amounts can be absorbed by IM for infants?
up to 0.5 mL
What amounts can be absorbed by IM for small children and older infants?
up to 1 mL
What amounts can be absorbed by IM for children, older adults, and thin pts?
up to 2 mL
What amounts can be absorbed by IM for adults?
2-5 mL
What is pharmacokinetics?
How meds are metabolized and excreted
How does albumin affect pharmacokinetics?
Lower albumin -> more unbound drug in the body
How does creatinine affect pharmacokinetics?
Increased creatinine -> decreased renal function -> more drug in body -> drug exerts its effect for longer
How does lipid solubility affect absorption?
The more lipid soluble, the faster it’ll be absorbed
What are 5 guidelines when administering meds?
Antacids are not usually administered with meds
Grapefruit juice inhibits the activity of cytochrome P450 - affects metabolism
Withhold a medication if pt is experiencing side effect
Inquire about herbal/OTC meds
The patient should wear a Medic-Alert bracelet if taking anticoagulants, oral hypoglycemic agents or insulin, anticonvulsants
