Medication Administration 1 Flashcards
What is medication?
A substance used in prevention of disease, diagnosis, relief of a symptom, treatment or cure of health alterations
What are 7 responsibilities a nurse has related to medication?
- Interpret
- Transcribe
- Prepare
- Administer
- Teach
- Document
- Evaluate patients response to meds
What would a nurse TEACH a patient about medication?
- Side effects
- Purpose
- Directions
- Frequency
Can student nurses transcribe medication?
NO
What does the chemical name of a medication mean?
It is the first name given and describes chemical components/molecular structure
What does the generic medication name mean?
It is a shortened chemical name given by the first manufacturer
What does the trade/brand name mean?
Name given by manufacturer for marketing
What generally is the reason for drug classification?
Indicates the effects of medication on the body, the symptoms it relieves or the desired effects
What are some examples of drug classifications?
- Beta blockers
- ACE inhibitors
- Anticoagulants
Is it possible for a drug to have more than one classification
Yes
What two classifications does Tylenol have?
- Analgesic
- Antipyretic
The drug form determines ______
it’s route of administration
What influences a medications absorption and metabolism?
it’s composition
What is pharmacokinetics?
The study of how medications enter the body, reach their site of action and exit the body
What are the 4 steps of pharmacokinetics?
- Absorption
- Distribution
- Metabolism
- Excretion
Each step in pharmacokinetics is influenced by what two things?
- Route of administration
- Functioning of body organs
What does absorption mean in pharmacokinetics?
- Movement of medication from where it entered body to bloodstream
What are 5 factors that influence absorption of a medication?
- Route of administration
- Ability of medication to dissolve
- Blood flow to site of administration
- Body Surface area
- Lipid solubility
Why would lipid solubility affect absorption of medication?
High lipid solubility absorbs quicker because a cell membrane has a lipid layer
Which absorbs faster: acidic or alkaline?
Acidic
What does distribution mean in pharmacokinetics?
Transport of medication via bloodstream to site of drug action
What are two factors that influence drug distribution?
- Properties of medication
- Physiology
What are some reasons physiology could play a role in drug distribution throughout the body
- Circulation
- Membrane permeability (ex. blood brain barrier, only lipids can pass through)
- Protein binding
- Amount of medication
What can lower albumin in blood mean for medication distribution?
Less= more free medication, which can lead to toxicity
What is the first pass effect?
The concentration of a drug is greatly reduced before it reaches the systemic circulation
( the first pass through the liver greatly affects bioavailability of the drug)
What is bioavailability
the proportion of a drug or other substance that enters the circulation when introduced into the body and so is able to have an active effect.
What is metabolism in regards to pharmacokinetics
The breakdown of medication into an inactive/less active form
How does metabolism occur?
As enzymes detoxify, degrade and remove biologically active chemicals
Where can biotransformation occur?
Mostly in liver
Can occur in lungs, kidneys, blood and intestines
If kidneys aren’t functioning, what can there be a risk of when taking medication?
Toxicity
What is excretion in regards to pharmacokinetics?
Process of medication exiting the body through the lungs, exocrine glands, bowel, kidneys and lungs
What determines which organs excretes a medication?
Chemical makeup
What is the ‘half life’ of a medication
The amount of time it takes for 50% of the medication to be eliminated from the blood stream
What is the therapeutic effect of a medication?
The intended/desired physiological response of a med
It is possible for a medication to have more than one therapeutic effect?
Yes, e.g. aspirin
What is an adverse effect of a drug
The unintended effect of a medication, either harmless or detrimental
What are 4 adverse effects of a medication?
- Side effect
- Toxic effect
- Idiosyncratic effect (unpredictable effect)
- Allergic reaction
What does a medication interaction mean?
- Occurs when one med modifies the action of another med
Can medication interactions include over the counter drugs
Yes
What can occur if there is a medical interaction
Can increase or diminish actions of other meds and alter absorption, metabolism or elimination from body
What is a synergistic effect mean?
When the combined effect of 2 meds is greater than the meds given separately
What is the goal when giving a medication?
To achieve a constant blood level of a medication within safe therapeutic range
How would we be able to maintain constant therapeutic concentration of a drug in bloodstream?
Regularly scheduled doses because a portion of drug is always being excreted
When should a medication be given to maintain constant therapeutic levels?
When previous dose reaches half life
What are the 3 time intervals of medication action? Explain each
Onset
Peak: max effect
Trough: the lowest amount of drug detected in system
What is a medication order?
A written direction given regarding treatment or medication
What are the 7 essential parts of a drug order?
- Patient name
- Date/time order written
- Drug name
- Drug dose
- Administration frequency
- Route of Administration
- Signature of prescriber
As a student nurse, can you take verbal orders?
No
What is medication reconciliation?
The process of creating the most accurate list possible of all the med’s a patient is taking
How does one do medication reconciliation?
By comparing patients list against health care providers order
What is the goal of medication reconciliation?
To increase patient safety by providing the correct medications to the patient at all transition points thus preventing adverse reactions
Where should medication reconciliation be implemented?
In all healthcare facilities
What are forms of medication supply?
Individual dose packets, stock supply, etc
What is a unit dose system?
Portable medication carts, each patient gets a drawer with a 24 hour supply of medication for each patient
What are 4 things a nurse is accountable for when administering medication?
Knowing: which meds are ordered
- Reason for the med
- Effect of the medication
- Nursing implications associated with med
When administering medication, the nurse is responsible for performing a physical assessment to determine…?
- If the medication is safe to administer
- If patient education is required
What 4 things are nurses responsible when administering the drug (and afterward)
- Correctly administering
- Monitoring effect of the drug
- Documenting
- Responding to and reporting any reactions
What are the 10 rights of Medication Administration?
- Patient
- Medication
- Dose
- Route
- Time/frequency
- Documentation
- Reason
- Right to refusal
- Right patient education
- Right Evaluation
Would the dose change if we use a different route to administer?
YES
Is TID and every 8 hrs the same?
NO
What is required when giving PRN meds?
Nursing assessment to determine safe and appropriate time for administration
What 4 things can a nurse do to increase patent safety in regards to documentation
- Accurate documentation
- Ensure med isn’t already given
- Only sign MAR once administered, documenting assessment data
- Document if med not given and why
What are some things nurses need to pay attention to when researching a medication?
- Nursing implications
- Pre-admin assessments
- Contraindications
What would we do if we find orders that are contraindicated or exceed recommended limits?
Verify order with prescriber
What do we do, if a patient refuses medication
- Ask for reason
- Ensure patient is fully informed about reason for med and potential consequences if not taken
- Notify prescriber, document refusal and reason
When educating a patient about medication, what must we include?
- Reason for medication
- Its action
- Possible side effects
- Any special precautions
What must we evaluate once we administer medication
- Monitor effectiveness by conducting appropriate assessments
- Side effects
- Adverse reactions
- Drug interactions
What are the 7 rights that should be done in your 3 checks before administering medication
- Patient
- Medication
- Dose
- Route
- Time
- Reason
- Documentation
What are some contraindications that can accompany oral medications
- Nausea/Vomiting
- GI alterations: ileus (lack of bowel movement), obstruction
- Gastric suction
- Unconscious
- Increased RR
What is one thing to remember when giving sublingual and buccal meds
Should not have anything to eat/drink immediately after administration
When dealing with a difficult patient, what should we do when administering oral medication?
Give the most important ones first incase patient will not take all
Who regulates practice standards for medication administration?
College of Registered Nurses
What are high alert medications?
Medications more prone to be given incorrectly
What department regulations medication on a federal level? What do they do that
Health Canada, approves and regulates food/drug quality and safety
What does the province do to regulate medication?
Manage health care services, regulate health care personnel/scope of practice and financial details of distribution
What are the different schedule of drugs?
Schedule 1: prescription
Schedule 2: Behind counter, no prescription
Schedule 3: Area in pharmacy with self selection
Unscheduled: sold from any retail outlets
What are DIN numbers found on?
Prescription and over-the-counter drugs
