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NUR120 > Med Administration > Flashcards

Med Administration Flashcards

1
Q

***What are the five routes of med administration?

A
  • PO (oral)
  • enteral (NG tube, G tube, J tube)
  • parenteral (IV, injections)
  • sublingual (under tongue)
  • buccal (cheek) *used to absorb into mucous membranes rather than GI tract
  • topical (lotion, cream, ointment, transdermal patch, inhalations, eye, ear, nasal, rectum, vagina)
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2
Q

What are the different names for medications?

A

**Chemical- chemical comp and molecular structure

**Generic- nonproprietary name to market it, more simple than chemical name but similar

**Official- US pharmacopeia or National Formulary name

**Brand Name- Tylenol, more expensive, usual capitalized and registration mark

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3
Q

What resources can we reference for drug safety?

A
  • USP or NF
  • nursing drug handbook
  • physicians desk reference
  • internet-based formularies
  • med package inserts
  • institutional policy and procedures
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4
Q

What drugs would you need a paper prescription for?

A

narcotics and controlled substances

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5
Q

What do the nurse practice acts identify as nursing responsibilities for medication administration?

A

administration and monitoring

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6
Q

***What is a stock supply?

A

most frequent meds kept in bulk quantity (multi-dose bottles)
*cost effective

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7
Q

***What is a unit dose?

A
  • locked, mobile cart

- individually packaged for each patient and refilled q 24 hours

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8
Q

***What is an automated dispenser?

A
  • similar to unit dose but its password protected and dispenses according to documented need
  • example: pixis, omnicell
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9
Q

***What is self-administered medication? (SAM)

A
  • individual container at bedside
  • encourages independence
  • good for patients transitioning to home
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10
Q

***What is pharmocokinetics?

A

absorption, distribution, metabolism, and excretion of the drug once it enters the body

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11
Q

***What is pharmacodynamics?

A
  • how the drug effects the body

- primary AND secondary effects of drugs

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12
Q

***What is time of onset vs peak?

A

onset- how long it takes for effects to appear (this is also the minimum effective concentration)
peak- when concentration is highest in the blood

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13
Q

***What is therapeutic level?

A

concentration of a drug in the blood serum that produces the desired effect without toxicity

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14
Q

***How to determine trough level?

A

-take blood at the point when the drug is at its lowest concentration, right before next dose

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15
Q

***What is half-life?

A

amount of time it takes for half of the drug to be eliminated

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16
Q

What factors affect pharmacokinetics?

A

age- young (less is more), old (higher risk of toxicity)

body mass- bigger the pt the more drug they need

gender- different body composition between men and women

pregnancy- some meds are toxic to the fetus

environment- heat and cold affect circulation

timing of administration- ibuprofen or nsaids should be with meals

fluids- some meds are absorbed better with more water

pathological state- hepatic, renal, or circulatory problems

genetic factors- some meds affect certain pts different

psychological factors- placebo, cognitive state

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17
Q

**What are primary effects?

A

the effects that are predicted, intended, and desired

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18
Q

***What is palliative effects?

A

relieves signs and symptoms of disease

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19
Q

***What is substitutive effects? Example!

A

replace body fluids or a chemical required by the body

example:

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20
Q

***What are supportive effects?

A

support integrity of body functions until other meds or treatments can become effective

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21
Q

***What are chemotherapeutic effects? Example!!

A
  • destroy disease-producing microorganisms or body cells

- antibiotics and antineoplastic drugs

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22
Q

**What are restorative effects?

A
  • return the body to or maintain the body at optimal levels of health
  • example: vitamins/minerals
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23
Q

***What are secondary effects?

A

unintended, can be harmful

24
Q

What is drug tolerance?

A

decreasing response to repeated doses of a medication

25
Q

What is drug dependence?

A

reliance on, need for a drug

compulsive

26
Q

What is drug misuse?

A

improper use of drugs

27
Q

What is drug abuse?

A

inappropriate intake of a substance by amount, type, or situation

28
Q

What are illicit drugs?

A

drugs sold illegally

29
Q

What are the components of a med prescription?

A
  • full name
  • date and time
  • name of med
  • dosage size, freq, number of doses
  • route of admin
  • signature of provider
30
Q

What is a written order?

A

apply without a renewal date until prescriber decides to write another or discontinue

31
Q

What is automatic stop date?

A

protocol to discontinue med after a certain amount of time, especially narcotics

32
Q

What is a stat order?

A

single dose to be given immediately

33
Q

***What are nursing responsibilities (legally) regarding med administration, narcotics, and controlled substances?

A
  • we have full legal responsibility
  • 3 checks and 10 rights
  • abide by institutional practices and state/fed laws
  • narcotics must be double locked
  • need witness for “waste”
34
Q

***What are the three checks?

A
  • before you pour
  • after you prepare med
  • at the bedside
  • *checking against MAR
35
Q

***What are the 12 rights?

A
  • right patient
  • right drug
  • right dose
  • right route
  • right time
  • right documentation
  • right reason
  • right to know
  • right to refuse
36
Q

***What is the difference between nebulization, aerosols, and metered dose inhalers?

A

nebulization- production of a spray of a liquid drug

aerosol sprayers- suspend droplets of medication in O2

MDI- prefilled with several doses, allows for high doses of med to be delivered

37
Q

***Where are intradermal injections given? What are they most commonly used for? Angle of injection?

A
  • nondominant forearm (or chest/upper back)
  • TB or allergy test
  • 5-15 degrees
38
Q

***Where are subcutaneous injections given? What are they commonly used for? Angle of injection?

A
  • abdomen and triceps (fast absorption) anterior thigh and upper buttocks
  • insulin, immunization
  • not closer than 5cm to belly button, 45-90 degrees
39
Q

***Where are intramuscular injections given? What are they commonly used for? Angle of injection?

A
  • deltoid, vastus lateralis, ventrogluteal (site of choice) **AVOID DORSOGLUTEAL
  • iron, anything really
  • 90 degrees
40
Q

**What does IV push mean?

A
  • a bolus of medication is given at once
  • can be irritating to the vessel walls
  • have antidote ready
41
Q

**What does IV piggy back mean?

A

drug is given as an infusion over 30-60 minutes with a 50-25ml bag containing dextrose or saline
-saline is in primary bag and diluted medication is in the secondary piggyback bag

42
Q

**When can you mix two meds in a syringe?

A
  • if they are compatible
  • if the total dose is within acceptable limits
  • if they are both prescribed by the same route
  • *if there is a change in color or consistency do not give it!!
43
Q

***How can med orders be communicated?

A
  • handwritten
  • provider order entry
  • verbal order (TORB/VORB)
44
Q

***What is absorption?

A

movement of drug from site of admin into the bloodstream

45
Q

***What is distribution?

A

transportation of a drug in the body fluids to tissues and organs of the body

46
Q

***What is metabolism?

A

biotransformation- chemical inactivation of a drug into a water-soluble compound or into metabolites

47
Q

***What is excretion?

A

drug molecules must be removed from their sites of action and eliminated by kidneys, liver, GI tract, lungs, and exocrine glands

48
Q

***What is the first-pass effect?

A

when oral meds are absorbed in the GI tract they go through the liver before circulation which means half of it becomes inactivated

49
Q

***What factors affect absorption?

A
  • route of admin
  • drug solubility
  • PH ionization
  • blood flow
50
Q

***What are factors affecting distribution?

A
  • membrane permeability
  • protein binding capacity
  • local blood flow
51
Q

***What factors affect metabolism?

A

liver function
first pass effect
health/disease status

52
Q

***What do you know about tylenol?

A
  • tx of mild to moderate pain
  • StevensJS, Toxic Epidermal Necrosis, hepatotoxicity, renal failure, anxiety, fatigue, insomnia, hyper or hypo tension, nausea, vomiting
  • taking with NSAIDS is bad for renal, taking with warfarin may increase bleeding
  • avoid alcohol
  • take no longer than 10 days
53
Q

***What do you know about ibuprofen?

A
  • tx of mild to moderate pain, fever, inflammation
  • heart complications (MI, failure, stroke), StevensJS, toxic epidermal necrosis, GI bleeding, hypertension, renal failure
  • taking with tylenol is bad for renal, taking with ACE inhibitors reduces their effect, dont take with aspirin
  • avoid alcohol, no driving
  • take no longer than 10 days
  • make sure well hydrated and take with food to minimize GI upset (less absorption though)
54
Q

***What do you know about Oxycodone?

A
  • moderate to sever pain
  • confusion, sedation, resp depression, constipation, dizzy, hallucination, hypotension
  • taking with MAO inhibitors increases toxicity, alcohol antihistamines and sedative will add to resp depression
  • consider repeat dose at peak if not effective enough
  • dont drive
55
Q

***What do you know about celebrex?

A
  • decreases pain and inflammation
  • headache, dizzy, nausea, hypertension, rhinitis, sinusitis, abdominal pain, stevensJS, toxic epidermal necrosis
  • dont take with NSAIDS or tylenol, dont take after CABG, could reduce effects of ACE inhibitors, thizaide diuretics, may increase risk of bleeding with other anticoags
  • asses ROM and swelling
56
Q

***What do we know about warfarin?

A
  • management of MI, prevention of blood clot, afib
  • causes bleeding, calciphylaxis, cramps, nausea, fever, dermal necrosis
  • do not use for uncontrolled bleeding, severe liver or kidney disease, uncontrolled hypertension
  • do not use with alcohol (doesnt work as good), many meds make bleeding worse including abx
  • *PT INR should be between 2-4.5
  • **antidote to warfarin is vit K (limit cranberry juice)
57
Q

***What do we know about macrodantin?

A
  • used for UTIs a lot
  • can cause pneumonitis, pulmonary fibrosis, c-dif, liver problems
  • dont use for oliguria/anuria, renal or hpatic impairment
  • antacids reduce absorption
  • take with food to decrease GI upset

NUR120 (17 decks)

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