Medication Administration

Question 1

What is the chemical name?

Answer 1

first name given, describes the chemical components and molecular structure– rarely used in medical practice

Question 2

What is the generic name?

Answer 2

shortened chemical names given by first manufacturer, ex. Ibuprophen

Question 3

What is the trade/brand name?

Answer 3

name given by manufacturer for marketing, ex. tylenol

Question 4

What is the generic drug?

Answer 4

copies of brand name drugs and contain the same medicinal ingredients as brand name drugs

Question 5

What is a drug classification?

Answer 5

it indicates the effect of medication on the body, the symptoms it relieves, or it’s desired effect– some meds are in more than one classification

Question 6

Define pharmacokinetics

Answer 6

the study of how meds enter the body, reach their site of action, metabolize, and exit the body

Question 7

Define the first pass effect

Answer 7

a phenomenon for oral medications in which a med gets metabolized at a specific location in the body resulting in a reduced concentration of the active drug reaching its site of action

Question 8

Define bioavailability

Answer 8

the amount of med available to reach the target cells after metabolism to produce its intended effect– is affected by the first pass effect

Question 9

What are the four processes that encompass the pharmacokinetics of a medication?

Answer 9

absorption, distribution, metabolism, and excretion

Question 10

What has an effect on the production of albumin and why is that important?

Answer 10

Albumin is a serum protein produced by the liver. Most medications bind to protein when they enter the body but those that bind to albumin cannot produce their intended effects. Patients with liver failure don’t produce as much albumin so they are at a higher risk for drug toxicity.

Question 11

What is metabolism?

Answer 11

the breakdown of medication into an inactive/less active form– drug toxicity can result when the patient is unable to metabolize effectively

Question 12

What is the main route of med excretion?

Answer 12

through the kidneys, so if there is decreased renal function then there is a risk for med toxicity

Question 13

Define therapeutic effect

Answer 13

the intended or desired physiological response of a medication (the reason it is prescribed)

Question 14

Define side effect

Answer 14

the unintended secondary effect, usually predictable, and is either harmless or potentially harmful– it is a common reason for why patients will decide to stop taking a medication

Question 15

Define adverse effect

Answer 15

a severe negative response to a medication prompting immediate discontinuation of the medication

Question 16

Define toxic effect

Answer 16

the development of toxicity following prolonged intake of the medication or after a medication accumulated in the blood due to either impaired metabolism or impaired excretion

Question 17

Define idiosyncratic reaction

Answer 17

the unpredictable effects which occur when a patient over or under reacts to a medication or has a different reaction than what is expected– ex. giving benadryl to adults makes them sleepy but giving it to children can cause excitement

Question 18

Define medication interactions

Answer 18

when one med modifies the action of another medication– either increasing, decreasing, or effecting the pharmacokinetics

Question 19

Define polypharmacy

Answer 19

the use of multiple drugs or more than are medically necessary– occurs frequently in older adults

Question 20

Define synergistic effect

Answer 20

occurs when the combined effect of two medications or a med and a substance is greater than the effects of the medications given separately– ex. grapefruit and statins– can result in potentially dangerous levels of the drug in your body, but sometimes the interaction is desired

Question 21

What are the time intervals of medication action?

Answer 21

Onset– when med starts to produce therapeutic response
Peak– med reaches max therapeutic response, highest serum concentration, after peaking the serum med concentration fall progressively
Trough– point at which lowest amount of drug is detected in serum
Duration– length of time drug exhibits therapeutic response

Question 22

When does a patient receive a successive dose of medication?

Answer 22

when the medication reaches half-life

Question 23

What is an order?

Answer 23

a written direction given by a nurse practitioner, physician, or regulated prescriber regarding treatment or medication– nurses can transcribe medication when given orally but NURSING STUDENTS CAN NOT

Question 24

Define routine orders

Answer 24

orders that are carried out until the prescriber discontinues/cancels it, writes a new order, or the order has elapsed due to time or doses in order– this is the most common form of order

Question 25

Define stat orders

Answer 25

an order that is to be given immediately and only one dose– usually in emergencies

Question 26

Define single orders

Answer 26

also referred to as “one-time orders”, it is an order for just one dose to be given one time– usually in relation to surgeries, such as a preop med
The difference between single order and stat order is that the single order is written beforehand/predicted, and the stat order is emergency

Question 27

Define standing orders

Answer 27

an order conditioned upon the occurrence of certain events; it allows other medical professions (like nurses) to use if the patient hits all of the necessary criteria

Question 28

Define PRN orders

Answer 28

these are “as needed” orders, they are prescribed but the nurse uses their judgement on if/when/how much of the medication should be given

Question 29

Define med reconciliation

Answer 29

the process of creating the most accurate list possible of all medications, including OTC by comparing the patient list with the health care providers orders– used to prevent any adverse drug events

Question 30

What are the 3 rights that are not listed during med administration but still apply everytime?

Answer 30

the right to refuse, right of client education, and right to evaluation (evaluating the effects after the med has been administered)

Question 31

What are the 3 A’s?

Answer 31

Arm band, Allergies, and Assessment

Question 32

In what order should you administer meds?

Answer 32

from top to bottom on the MAR unless the client is likely to refuse meds half-way through then start with the highest priority meds and work your way down

Question 33

When should you NOT crush a med?

Answer 33

if they are enteric/gel coated, long/sustained acting, SL or buccal, contents of caps

Question 34

What is the Health Products and Food Branch (HPFB)?

Answer 34

a branch of the federal government that regualtes the manufacture and sale of all health products and drugs within Canada– they assess the safety, efficacy and quality of a drug and authorizes it

Question 35

What is the Food and Drug act?

Answer 35

an act that regulates prescribing standards of composition, strength, potency, purity, quality or other property of any article of food, drug, cosmetic or device

Question 36

What is the College of Registered Nurses of Manitoba (CRNM)?

Answer 36

a governing body that establishes regulations that guide nursing practice related to safe medication administration
– they developed the standards of practices that serve as a legal reference to describe reasonable and prudent nursing practice

Question 37

What is negligence?

Answer 37

nursing conduct that does not meet a standard of care established by law– courts define nursing negligence as failure to use degree of skill or learning ordinarily used under the same of similar circumstances by other nurses

Question 38

What is a med error?

Answer 38

any preventable event that oculd cause or lead to a client either receiving inappropriate med therapy or failing to receive an appropriate med therapy
-most common med errors by nursing students are omission, improper dose, wrong time, extra dose, and wrong patient

Question 39

Med safety can be compromised by..?

Answer 39

interruptions, miscalculations, fatige, increased workload and lack of knowledge

Question 40

What does safe PRN medication include?

Answer 40

-assessment of client to determine what drug, dose, route, is appropriate
-check when the last dose was given
-timely documentation on MAR and progress notes of assessment finding and rationale for giving drug
-follow up documentation of effectiveness of drug

Question 41

What are the special requirements for narcotics and controlled substances?

Answer 41

-only be dispensed with prescription
-be stored in locked cabinets
-documented
-wastage witnessed

Question 42

What are the forms of dermatologic medication?

Answer 42

ointments, pastes, creams, lotions, powders, sprays, and patches

Question 43

What are transdermal medications?

Answer 43

a form of dermatologic medication that administers sustained action meds via a multi layered film containing the drug and an adhesive later– can be worn for 12 hours to a week depending on the medication

Question 44

Where can a transdermal patch be applied?

Answer 44

only on clean, intact, hairless skin on the chest, back, abdomen, anterior thigh, buttocks, side, or upper arms– do NOT apply on distal extremities, breast tissue, areas with rash or scar tissue or to areas that have excessive movement, wrinkling, or friction
MUST be removed before a new one is put on!!

Question 45

What is an ophthalmic medication?

Answer 45

medication for the eyes in liquid, ointment, or gel and administered via installation or irrigation

Question 46

What is an otic medication?

Answer 46

medication for the external auditory canal via instillation or irrigation

Question 47

What are the factors influencing drug action in older adults?

Answer 47

-absorption
-protein binding sites
-metabolism
-nephrons, GFR