Med Administration Exam Flashcards
therapeutic effects
intended or desired response to med
adverse drug reactions
unintended, undesirable and often unpredictable
effects of med
side effects
predictable and often unavoidable secondary effects of a med at usual therapeutic dose
toxic effects
med accumulates in blood because impaired metabolism or excretion, or when too high of dose is given
idiosyncratic effects
patients overact or underreact to a med or have
reactions different than normal
medication tolerance
more medication is required to achieve the same therapeutic effect
-tolerance is decreased physiological response that occurs after repeated administration of med.
medication dependence
Dependance can be physical or
psychological
-described in the past as addiction
medication misuse
overuse, underuse, nonadherence, polypharmacy
medication interactions
med modifies action of another med
-may result in an increase or decrease in therapeutic effect of each medication
absorption
passage of medication molecules into the blood from site of administration
what factors influence absorption
-first pass effect
-blood flow to site
-administration route
-patient size
-ability of med to dissolve
-lipid solubility of med
distribution
process of transporting a drug to the site of action
what factors influence the extent of distribution
-binding to albumin/protein binding (unbound goes to site)
-circulation
-cell membrane permeability
-perfusion
What do nurses need to be aware of with older adults and patients with liver disease?
-older patients and patients with liver disease have less albumin and decreased metabolism so there is more free and unbound drug causing toxicity
metabolism
medication is broken down to remove the active chemicals
where does metabolism occur?
mostly in liver but lungs, kidneys, blood and intestines play a role
excretion
process of medication exiting the body
peak plasma level
when a drug is at its highest concentration, not necessarily at its most therapeutic level
trough serum levels
lowest level of concentration of a medication that correlates to the rate of elimination
-happens 30 minutes before next dose
serious adverse drug event
life threatening reaction that requires medical intervention to prevent death or permanent disability
-must be reported to FDA to improve safety outcomes, revise drug labels and warnings and when to withdraw drugs from the market
black box warning
issues on medications that may produce lethal and iatrogenic results
medication reconciliation
performed anytime a patient is transferred from one health care professional to another
-reviews patients current medications with newly prescribed medications. getting rid of duplicates
verify all new orders
one time for every new order
-check order from provider and compare to the MAR to make sure it matches exactly
3 safety checks for medication administration accuracy.
- when retrieving medication from storage bin
- before placing in medication cup or before taking to the patients room (leave meds in wrappers to explain meds)
- at bedside before giving to the patient
What are the guidelines for administering opioids (narcotics)?
special handling:
-securely locked
-counted
-waster
-witness
-tamper evident syringes
Draw up all medicine in a bottle, discard extra in designated spot with another witness and both nurses fill out disposal form
What are the principles for safely handling chemotherapy medications?
-hand hygiene before and after gloving
-do not crush, cut or split medication
-use separate equipment
-know the agency spill policy
-dispose of single use clothing
-wash clothes or sheets contaminated by body fluids: wash twice in hot water, do not wash with other items
who can give chemotherapy?
any nurse can give PO chemo, certified nurse gives IV chemo
standing order
give until discontinued or prescribed number of days elapse
PRN order
as needed
single order
one time
STAT order
carried out immediately
NOW order
within 90 minutes
time critical medications
administer within 30 minutes before or after the scheduled time
-antibiotics, anticoagulants, insulin, immunosuppressives
non critical medications
administer 1-2 hours before or after scheduled time
unit dose
drug dosage system that provides prepackaged, prelabeled, individual medications that are ready for immediate use by the specific patient patient
-decreases med errors and saves steps in dispensing medications
standard measurement devices
-graduated cups
-syringes
-scaled droppers
can we split pills
only if medication is scored