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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
Q

What does MAR stand for?

A

medication administration record

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26
Q

What are some examples of high alert medications? What do you need the second nurse for?

A

insulin, heparin, dopamine

to sign off on you giving the med

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27
Q

What are some examples of controlled substances?

A

narco, morphine, diluadid, diazepam

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28
Q

What are score marks on tablets for?

A

has mark so you can cut it in half with a pill slicer

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29
Q

How do you pour a liquid medication?

A

label to palm to protect the label from getting medicine on it

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30
Q

What do liquid syrups consist of?

A

sugar

DO NOT GIVE TO DIABETIC PT

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31
Q

What do liquid elixirs consist of?

A

alcohol (ex: Nyquil)

DO NOT GIVE TO CHILDREN, LIVER DISEASE PTS, ALCOHOLICS, PREGNANT WOMEN

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32
Q

What are the two routes for oral/topical meds?

A

sublingual (under tongue)
buccal (in cheek)

33
Q

Where does absorption occur for oral/topical meds?

A

in mucous membranes in mouth

very quick absorption

34
Q

Can you give oral/topic meds to NPO pts?

A

Yes

35
Q

What medications do you NOT crush whatsoever?

A

extended release meds
enteric coated meds
sublingual meds
buccal meds

36
Q

What do you assess before giving oral medications?

A

ability to swallow and allergies

if choking is likely notify HCP / know allergies of pt before giving meds

37
Q

What are contraindications for giving oral meds?

A

vomiting
suction (Ex: NG tube connected to suction)
unconscious (can’t swallow)
NPO

38
Q

What position should the pt be in to receive oral med?

A

Fowler’s Position

39
Q

What is important for the pt to have while taking oral meds?

A

water

40
Q

What are the types of enteral tubes?

A

nasogastric
orogastric
gastrostomy

41
Q

How should you prepare medications for administration via enteral tubes?

A

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
Q

How to prep pt for administering medications via enteral tubes?

A

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
Q

How to prevent backflow of gastric contents before administering meds via enteral tubes?

A

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
Q

How to administer meds via enteral tubes?

A

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
Q

What to do after administering meds via enteral tube?

A

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
Q

Uses for Dermatologic Medications

A

reduce itching
moisturization
vasoconstriction/vasodilation (can be local or systemic)
skin protectant
antibiotic or antiseptic
reduce local inflammation
absorption of systemic meds

47
Q

What should you ensure before applying topical meds?

A

skin is clean

48
Q

How to apply powder topical med?

A

skin must be dry, spread skin folds, fine thin layer, clean off old powder before applying new

49
Q

How to apply lotion topical med?

A

shake; apply with gauze dressing/pad; apply in direction of hair growth

50
Q

How to apply creams/ointments/pastes/oil-based solutions?

A

warm in gloved hands; apply in direction of hair growth

51
Q

How to apply an aerosol spray?

A

shake; apply at recommended distance (about 6-12 in)

52
Q

How to apply a transdermal patch?

A

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
Q

What do you need to put on a paper patch?

A

apply med to paper
put initials, time, and date on back of patch

54
Q

How do you dispose of an old patch?

A

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
Q

Why would you need to irrigate the eye?

A

for if something’s in there (chemicals, metal, etc)

56
Q

How to install eye drops?

A

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
Q

How to install ointments into eye?

A

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
Q

Why would you need to irrigate the ear and what do you need?

A

for foreign substances

warm water, towels

59
Q

How to administer ear drops?

A

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
Q

What should the pt do before receiving nasal meds?

A

blow nose

61
Q

Administration of nose drops/sprays

A

blow nose prior to administering med
head upright to prevent swallowing
inhale gently as med is administered (plug opposite side)

62
Q

What are nebulizers typically?

A

bronchodilators

63
Q

Nebulizer Info

A

uses aerosolization
delivers fine mist of med
can be inhaled through nose or mouth

64
Q

Inhaler MDI Info

A

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
Q

Dry Powder Inhaler Info

A

DPI
capsule - no shaking needed
steroid type med
rinse mouth after and spit to prevent thrush

66
Q

Should you take two puffs of inhaler right after each other?

A

No, wait 1-2 min between puffs

67
Q

Do you do the bronchodilator or steroid first?

A

bronchodilator

68
Q

What are the types of vaginal meds?

A

creams, suppositories, irrigation (douche)

69
Q

How to apply vaginal meds?

A

applicator for creams
privacy
supine w/ HOB elevated a bit
lubrication, if needed (water-based)
remain lying for 5-10 min after

70
Q

Advantages to rectal administration

A

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
Q

Administration technique for rectal meds

A

left sims position (laying on left, right leg bent)
water soluble lube
round end of suppository goes first

72
Q

What can enemas be used for?

A

treatment for constipation or pre-op

73
Q

Cleansing enema

A

removes feces

74
Q

What do you cleanse with for an enema?

A

tap water and some kind of soap

75
Q

Carminative Enema

A

relieves abdominal distention by expelling flatus

76
Q

Retention enema

A

introduces oil (mineral oil) or med into rectum and is held for 1-3 hours

77
Q

Return-flow enema

A

alternate flow of 100-200 mL of fluid in and out of rectum, expel flatus

78
Q

How long does the pt need to hold it after enema?

A

as long as they can

79
Q

Do you need any lubrication for an enema?

A

yes, lubricate the end

Funds II Lab (5 decks)

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