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Funds II Lab > Medication Administration > Flashcards

Medication Administration Flashcards

1
Q

What are the six rights of medication administration?

A

right patient
right medication
right dose
right route
right time
right documentation

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2
Q

Controlled Substances vs High Alert Medications

A

a drug or other substance that is tightly CONTROLLED by the government bc it may be abused or cause addiction

a drug that bears a heightened risk of causing significant pt harm when used in error (ex: wrong dose is given)

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3
Q

Shortly after administering four pills to your patient, she vomits. What are your next actions?

A

examine the vomit to see if any fragments of the pills were there
if any parts of the pill were in the vomit, I would notify the physician and have him tell me my next course of action, such as giving out more tablets (see if there was a different route they can be administered) or waiting until the next dose is due

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4
Q

How to dispose of a controlled substance pill?

A

flush in the presence of two licensed nurses or there may be a container specified to put them in

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5
Q

How to dispose of an injectible controlled substance?

A

dispose in sharps container

YOU MUST DISPOSE OF EXCESS BEFORE ENTERING PT’S ROOM

YOU NEED A 2ND NURSE WATCH YOU WASTE THE EXCESS

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6
Q

How to dispose of a nicotine patch?

A

fold so that sticky sides are together and flush in the presence of two licensed nurses or dispose in specific container

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7
Q

Is this med order complete?

Diphenhydramine 12.5 mg PO every 4 hours prn

A

No bc you need a reason for the PRN to indicate what the PRN is for (ex: headache, fever, pain, etc)

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8
Q

Is this med order complete?

Acetaminophen 2 tabs po every 4 hours prn pain/fever

A

No bc tabs is not an acceptable dose (need mg, mcg, etc)

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9
Q

Is this med order complete?

Enoxaparin 1 mg/kg subcutaneously bid

A

Yes

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10
Q

Is this med order complete?

Levofloxacin 750 mg

A

No needs a route and time

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11
Q

Is this med order complete?

Lortab 5mg/325mg 1-2 tabss po every 4-6 hours prn pain

A

Lortab is a combination drug

No it has two ranges which is incorrect (5mg/325mg and 1-2 tabs)

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12
Q

What is important to consider when thinking about the right medication?

A

is it appropriate for the pt?

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13
Q

What is important to consider when thinking about the right dose?

A

Is it an acceptable amount for this pt?

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14
Q

What is important to consider when thinking about the right dose?

A

Is it an acceptable amount for this pt?

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15
Q

What are appropriate dose measurements?

A

mg, mcg, mg/kg, %, etc

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16
Q

What measurements are not considered a dose?

A

number of tablets or mL

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17
Q

What are the other rights for medication administration?

A

right education
right to refuse
right assessment
right evaluation

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18
Q

What is important to educate your pt about when giving a medication?

A

what the med is
why they’re taking it
side effects
how long they have to take it

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19
Q

What is important to assess before giving a med?

A

check for what the med affects
Ex: cardiac med - check AP
Ex: blood pressure med - check BP
Ex: pain med - check pain rating (before and after)
Ex: narcotics (decrease RR) - check RR before giving

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20
Q

What is important to evaluate after giving a med?

A

evaluate effectiveness, side effects, allergic reactions

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21
Q

How do you identify a client?

A

two client identifiers: name and DOB
ask their name and DOB then check ID band

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22
Q

What do you do to inform your pt before administering a med?

A

educate them

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23
Q

When are the three checks done to administer a medication? And what do you checks confirm?

A
  1. when taking med out of drawer
  2. when prepping the med
  3. in room before administering

route, dose, med, time

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24
Q

How many pills should you give at a time?

A

one at a time so they don’t choke and they are easier to keep track of

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25
What does MAR stand for?
medication administration record
26
What are some examples of high alert medications? What do you need the second nurse for?
insulin, heparin, dopamine to sign off on you giving the med
27
What are some examples of controlled substances?
narco, morphine, diluadid, diazepam
28
What are score marks on tablets for?
has mark so you can cut it in half with a pill slicer
29
How do you pour a liquid medication?
label to palm to protect the label from getting medicine on it
30
What do liquid syrups consist of?
sugar DO NOT GIVE TO DIABETIC PT
31
What do liquid elixirs consist of?
alcohol (ex: Nyquil) DO NOT GIVE TO CHILDREN, LIVER DISEASE PTS, ALCOHOLICS, PREGNANT WOMEN
32
What are the two routes for oral/topical meds?
sublingual (under tongue) buccal (in cheek)
33
Where does absorption occur for oral/topical meds?
in mucous membranes in mouth very quick absorption
34
Can you give oral/topic meds to NPO pts?
Yes
35
What medications do you NOT crush whatsoever?
extended release meds enteric coated meds sublingual meds buccal meds
36
What do you assess before giving oral medications?
ability to swallow and allergies if choking is likely notify HCP / know allergies of pt before giving meds
37
What are contraindications for giving oral meds?
vomiting suction (Ex: NG tube connected to suction) unconscious (can't swallow) NPO
38
What position should the pt be in to receive oral med?
Fowler's Position
39
What is important for the pt to have while taking oral meds?
water
40
What are the types of enteral tubes?
nasogastric orogastric gastrostomy
41
How should you prepare medications for administration via enteral tubes?
use liquid form of med if possible may dilute liquid med with water if needed crush tablets into fine powder and dissolve in tap water (crushing one tablet at a time)
42
How to prep pt for administering medications via enteral tubes?
apply gloves place tube feeding on hold, if applicable turn suction off, if applicable verify tube placement check gastric pH (1-5) place stethoscope over client's epigastrium and inject air (at least 30 mL) while listening for a "bloop" bubbling sound
43
How to prevent backflow of gastric contents before administering meds via enteral tubes?
using Lopez valve, turn valve off toward the pt to prevent backflow of gastric contents (keep valve turned off to the pt anytime you're disconnecting/connecting syringe) if no Lopez valve, pinch or fold the tubing to clamp it
44
How to administer meds via enteral tubes?
administer each med separately usually administer liquid meds first flush the tube with 30 mL of tap water before and after administering any medication to verify patency (1st is to clear everything out, 2nd is to flush any residue) flushes occur for each med (goes toward I&O so keep track of how much water was flushed)
45
What to do after administering meds via enteral tube?
turn tube feeding back on, if applicable if the pt was connected to suction, keep tube clamped/suction off for at least 30 min (so you don't suck up meds) document administration of meds (meds on eMAR; fluid for flushes as intake)
46
Uses for Dermatologic Medications
reduce itching moisturization vasoconstriction/vasodilation (can be local or systemic) skin protectant antibiotic or antiseptic reduce local inflammation absorption of systemic meds
47
What should you ensure before applying topical meds?
skin is clean
48
How to apply powder topical med?
skin must be dry, spread skin folds, fine thin layer, clean off old powder before applying new
49
How to apply lotion topical med?
shake; apply with gauze dressing/pad; apply in direction of hair growth
50
How to apply creams/ointments/pastes/oil-based solutions?
warm in gloved hands; apply in direction of hair growth
51
How to apply an aerosol spray?
shake; apply at recommended distance (about 6-12 in)
52
How to apply a transdermal patch?
remove old patch and clean area change locations apply to clean, dry, hair free area; check for manufacturer placement recommendations apply firmly to skin; hold for 10 sec if adhesive patch if paper patch, tape in place no heating pads over patches MRIs you need to take off patch
53
What do you need to put on a paper patch?
apply med to paper put initials, time, and date on back of patch
54
How do you dispose of an old patch?
fold so sticky sides are together if controlled substance, flush in presence of two licensed nurses (dispose correctly bc there is still medicine on the patch) if not controlled, place in black container
55
Why would you need to irrigate the eye?
for if something's in there (chemicals, metal, etc)
56
How to install eye drops?
tilt head back, pull down conjunctiva until you see the conjunctival sac, put drops on conjunctival sac, have pt close eye, hold pressure on lacrimal gland for 30 sec
57
How to install ointments into eye?
squeeze a little and wipe it off (bc it's contaminated), tilt head back, pull down conjunctiva until conjunctival sac is seen, squeeze ointment on conjunctival sac, close eye
58
Why would you need to irrigate the ear and what do you need?
for foreign substances warm water, towels
59
How to administer ear drops?
clean pinna straighten ear canal (pinna up and back for over 3, down and back for under 3) gently massage tragus (helps w/ absorption) have pt remain in side-lying position for 5 min insert small piece of cotton loosely into ear prn for 15-20 min
60
What should the pt do before receiving nasal meds?
blow nose
61
Administration of nose drops/sprays
blow nose prior to administering med head upright to prevent swallowing inhale gently as med is administered (plug opposite side)
62
What are nebulizers typically?
bronchodilators
63
Nebulizer Info
uses aerosolization delivers fine mist of med can be inhaled through nose or mouth
64
Inhaler MDI Info
meter dosed inhaler pressurized container of med premeasured dose of med shake before use inhaled through mouthpiece may use spacer; helps prevent swallowing of med and get all the med hold breath after for 10 sec rinse mouth after and spit
65
Dry Powder Inhaler Info
DPI capsule - no shaking needed steroid type med rinse mouth after and spit to prevent thrush
66
Should you take two puffs of inhaler right after each other?
No, wait 1-2 min between puffs
67
Do you do the bronchodilator or steroid first?
bronchodilator
68
What are the types of vaginal meds?
creams, suppositories, irrigation (douche)
69
How to apply vaginal meds?
applicator for creams privacy supine w/ HOB elevated a bit lubrication, if needed (water-based) remain lying for 5-10 min after
70
Advantages to rectal administration
bypass upper GI; pts who have N/V med has bad taste or odor drug can be released at a slow, steady rate may provide higher bloodstream levels (titers) of med
71
Administration technique for rectal meds
left sims position (laying on left, right leg bent) water soluble lube round end of suppository goes first
72
What can enemas be used for?
treatment for constipation or pre-op
73
Cleansing enema
removes feces
74
What do you cleanse with for an enema?
tap water and some kind of soap
75
Carminative Enema
relieves abdominal distention by expelling flatus
76
Retention enema
introduces oil (mineral oil) or med into rectum and is held for 1-3 hours
77
Return-flow enema
alternate flow of 100-200 mL of fluid in and out of rectum, expel flatus
78
How long does the pt need to hold it after enema?
as long as they can
79
Do you need any lubrication for an enema?
yes, lubricate the end

Funds II Lab (5 decks)

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