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Fundamentals of Nursing > Medication Administration > Flashcards

Medication Administration Flashcards

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1
Q

MAR

A

medication administration records

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2
Q

ADS

A

automatic dispensing system

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3
Q

where is medication by central pharm located

A

in patient drawer

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4
Q

where is medications metabolized

A

liver

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5
Q

where is medication excreted by

A

kidney

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6
Q

what should we do with a patient with liver or kidney failure

A

make sure the medication is being metabolized and excreted

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7
Q

do we leave meds at bedside

A

no

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8
Q

adverse effect is the

A

side effect

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9
Q

how do we measure the adverse effect

A

is the side effect so severe does it outweigh benefits

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10
Q

if the side effects out weigh the benefits what do we do

A

switch meds

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11
Q

opioids for pain, the pain med is working but pt is constipated, so we give a laxitive
does the benefit outweigh the effects

A

yes

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12
Q

anti seizure meds are given that cause Steven Johnsons where all the skin falls off
does the benefit outweigh the effects

A

no

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13
Q

what is an example of mild allergic reaction

A

itching

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14
Q

what is an example if anaphylactic reaction

A

stop breathing

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15
Q

what is tolerance

A

pt takes med over extended period of time so the patient will eventually need more drugs to reach therapeutic level

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16
Q

toxic

A

failure on the nurse
don’t know what they are doing
EX: push meds over 4 mins and they push over 40 seconds

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17
Q

idiosyncratic

A

opposite effect of anticipated affecr

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18
Q

therapeutic range

A

concentration of drug in the blood serum that produces the desired effect without causing toxicity

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19
Q

how do we know if we are in the therapeutic range

A

draw blood levels

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20
Q

how do we reach the therapeutic range

A

give enough medications to get there and then give enough meds to stay there

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21
Q

peak level

A

the point when the drug is at its highest

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22
Q

when do we draw for peaks

A

30-60 mins after infused

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23
Q

trough level

A

the point when the drug is at its lowest concentration, indicating the rate of elimination

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24
Q

when do we draw for trough

A

right before next dose
30-60 mins

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25
Q

what level indicates the rate of elimination

A

trough

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26
Q

half life

A

amount of time it takes for 50% of blood concentration of a drug to be eliminated from the body

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27
Q

what is a drug that has a fast half life

A

heparin

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28
Q

medication reconciliation

A

meds taken at home vs at the hospital

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29
Q

what is an example of accidental miss of a medication that is taken at home and not in the hospital

A

pt has blood systolic of 160-180, take BP med at home but not in hospital

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30
Q

what is an example of a purposeful miss of a medication that is taken at home and not in the hospital

A

patient came in with extremely low blood sugar and we chose to hold insulin

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31
Q

PTA medications

A

prior to admision

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32
Q

pregnancy and lactation

A

meds can transfer to baby

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33
Q

why is it important to ask about allergies

A

sometimes allergies are not imputed into epic

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34
Q

why is it important to ask “what do you take at home including over the counter”

A

dietary supplements and herbal and natural remedies
homeopathic can interfere with pharmaceutical meds

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35
Q

if someones puts in Q day on epic what time does it put it

A

9am

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36
Q

with the older adult do they have decreased or increased gastric motility

A

decreased

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37
Q

what does it tell you that older adults have decreased gastric motility

A

medications stay in gastric region longer and if we are giving many medications that could lead to nausea and vomiting which could lead to aspiration

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38
Q

do older adults have decreased or increased total body water

A

decreased

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39
Q

do older adults have decreased or increased lipid content in skin

A

decreased

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40
Q

what does it tell you that older adults have decreased titan body water and lipid content in skin

A

this affects absorption,
lipid soluble vs water soluble
exaggerated reaction/experience

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41
Q

do older adults have decreased or increased liver function

A

decreased

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42
Q

do older adults have decreased or increased kidney function

A

decreased

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43
Q

what does this tell you that older adults have decreased kidney and liver function

A

this will affect metabolism and/or excretion
meds will be in body longer

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44
Q

do older adults have increased or decreased CNS efficiency

A

decreased

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45
Q

what does it tell you that older adults have decreased CNS efficiency

A

this affects pain medication

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46
Q

older adults have altered peripheral vascular tone which means they are extremely reactive to

A

antihypertensive meds

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47
Q

what does this mean the older adult pt is at risk for if they take antihypertensive meds

A

could experience orthostatic hypotension
could lead to falls
we need to educate patient

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48
Q

what is the proper order for medications

A

right patient (name & DOB), drug, dose, time, route

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49
Q

if any of the proper order in medication administration is missing what do we do

A

call physican

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50
Q

why is it important to know what medications do

A

could change vital signs

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51
Q

why is it important to check vital signs on patient when we know they are going to receive a vital sign changing medictions

A

see if they are within an abnormal value, if they are in a normal value we do not want to give medication cause we could drop them down to abnormal medication

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52
Q

what is one equipment decision we can make

A

syringe size

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53
Q

what is the protocol for receiving a verbal order

A

write it down and mandatory read back

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54
Q

standing orders

A

written
in chart
stand until discontinued

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55
Q

PRN orders

A

as needed

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56
Q

what is normally a PRN medication

A

pain meds

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57
Q

stat order

A

immediately

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58
Q

one time order

A

one dose only

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59
Q

5 rights of medication administration

A

medication, patient, route, time, dose

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60
Q

how many rights has it expanded to

A

11

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61
Q

what are the three checks
first one

A

removing medication from Med Cart

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62
Q

what are the three checks
second one

A

comparing medication to MAR

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63
Q

what are the three checks
third one

A

rechecking to EMR/MAR/ at beside prior to admission

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64
Q

do students have 3 or more checks

A

4.
the clinical instructor will check all meds

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65
Q

when do we ask questions regarding medications

A

before handing meds to clinical instructor

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66
Q

BID

A

x2

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67
Q

TID

A

x3

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68
Q

QID

A

x4

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69
Q

ac

A

before means

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70
Q

pc

A

after meals

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71
Q

HS

A

hour of sleep

72
Q

what are the 2 identifiers

A

name
DOB
or Medical record number

73
Q

what if the patient cannot talk how do we collect the two identifiers

A

need 2 nurses, one reading the wrist band and the other checking the chart

74
Q

we compare the two identifiers with

A

the EMR

75
Q

EMR

A

electronic medical records

76
Q

if we have a medication that is administrated more frequently than Q6 (Q1, Q2, Q3, Q4, Q5) we have how long to give medication prior and after scheduled time

A

30 mins

77
Q

what is a rapid short acting insulin name

A

Aspart/Novolog

78
Q

if we have a medication that is Q2 and it is due at 0700. What time prior and after do we have to administer it

A

30 mins
0630-0730

79
Q

if we have a medication that is given Q6 or less frequently (Q7,Q8,Q9,Q10) we have how long before and after the scheduled time do we have to administer

A

60 mins

80
Q

if we have a medication that is due Q12 at 0400. what time before and after do we have to administer

A

60 mins
0300-0500

81
Q

if we have a medication that is due daily, weekly, monthly how long before or after do we have to administer

A

2 hours

82
Q

if we have a medication that is due at 0900 weekly, what time before and after do we have to administer

A

2 hours
0700-1100

83
Q

if you are unable to give medication on time the next dose is given using the

A

half time rule

84
Q

what does the half time rule mean

A

if the late dose can be given up to half way to the next scheduled dose and you can give it and then the next dose as scheduled
if the patient or med are available later than halfway between doses, give the missed dose, skip the next dose and resume scheduled

85
Q

what are the 2 exceptions to half time rule

A

ahminoglycosides and chemotherapy

86
Q

if you have a patient that has a medication due at 0600 and 1200 and the patient is off the floor what time do they have to take the medication by to not miss the next dose

A

0900

87
Q

if you have a patient that has a medication due at 0600 and 1200 and the patient is off the floor and they come back at 1030 what do you do

A

give the medication but skip the next 1200 dose and then continue the scheduled medication after the purposely skipped dose

88
Q

what type of medication is oral

A

enteral

89
Q

enteral means

A

gi tract

90
Q

are injections entral

A

no they are parental

91
Q

PO

A

by mouth

92
Q

why might we give a sublingual medication

A

under the tongue is a rich capillary bed and it disolves

93
Q

if we give a pt a sublingual medication what do we want to not do

A

let them swallow the medication
or give water

94
Q

are liquid medications entral

A

yes

95
Q

scored

A

tablets are able to cut

96
Q

SR

A

sustained release

97
Q

XL

A

extended release

98
Q

CR

A

controlled release

99
Q

enteric coated

A

special coating to reduce irritation and absorption to gastric lining so its released in small intestine
cannot crush

100
Q

do we crush SR, XL, CR, Enteric coated

A

NO NEVER

101
Q

why do we not crush SR, XL, CR

A

because they have a special coating and we could kill someone if we crush them

102
Q

why do we not crush enteric coated

A

cause gastric irriation

103
Q

what if we have orders for a SR, XL, CR, or extended release pill for a patient who cannot swallow whole pills

A

call pharmacy

104
Q

brown syringes are only meant for

A

oral

105
Q

do we need instructor to give topical medications

A

yes

106
Q

what are some examples of topical medications

A

lotions, creams, ointments, medicated powders, transdermal patches, eye drops, nose drops/mists, ear drops, suppositories

107
Q

what and when do we write on the transdermal patches

A

date time and initials and we write this before applying

108
Q

we want to put patches were

A

hair free area

109
Q

why do we wear gloves when giving a transdermal patches

A

so our skin doesn’t absorb the medication

110
Q

when giving eye drops where do we tell the patient to look

A

up

111
Q

where do we aim the eye drop

A

in the conjuctival sac

112
Q

do we wear gloves when giving eye drops

A

yes

113
Q

after we give eye drops where do we put the tissue and for how long and why

A

in the inner corner of the eye for 30 seconds so the medication does not drain down the duct

114
Q

what is important to have when giving an inhaler

A

spacer

115
Q

one and only campaign

A

one needle
one syringe
only one time

116
Q

direct syringe reuse

A

using the same syringe for more than one patient

117
Q

is contamination limited to the needle

A

no

118
Q

if you can’t see blood in the syringe it can’t contain a blood borne pathogen

A

no

119
Q

indirect syringe reuse

A

accessing a parental medications with a use syringe followed by reuse of the vital container for additional patients

120
Q

needles and syringes are

A

single use devices

121
Q

do we or do not administer medications from a single dose vial or bag to multiple patients

A

no

122
Q

saline bags can be used for more than one pateint

A

no

123
Q

ex of intradermal test

A

tb

124
Q

subq administration of what drugs

A

insulin
heparin

125
Q

IM administration sites

A

deltoid
ventral gluteal
vastus lateralis site

126
Q

what is the right equipment

A

length
gauge
needless system
safety guard
sharps container

127
Q

what is the only part of the syringe and needle that is not sterile

A

barrel

128
Q

intramuscular degree of insertion

A

90 degrees

129
Q

subcutaneous degree of insertion

A

90- 45 degrees

130
Q

intradermal degree of insertion

A

5- 15 degrees

131
Q

intradermal inch

A

1/4-1/2 inch

132
Q

intradermal gauge

A

25, 27

133
Q

how much medication can we administer to the intradermal route

A

less than 0.5mL

134
Q

do we aspirate the site of intradermal

A

no

135
Q

do we massage the site of intradermal

A

no

136
Q

subcutaneous has what type of syringes

A

drug specific

137
Q

subq needle inch

A

3/8-5/8

138
Q

subq needle gauge

A

25-30

139
Q

subq max volume

A

1mL

140
Q

subq aspiration

A

no

141
Q

subq massage

A

no

142
Q

what do we want to remember when giving a subq

A

rotate sites

143
Q

why do we want to rotate sites when giving subq

A

if we don’t we create knotty type of skin that is not suitable to use because that type of area has decrease absorption

144
Q

subq injection site

A

backs of arm
abdomen 2cm around belly button
fronts of thighs
above butt
scapular region

145
Q

why do we want to go 2cm around belly button

A

because the rectus abdomens muscle is there

146
Q

if someone is skinny and we want to give a subq what do we do

A

pinch skin

147
Q

do we leave the skin pinched or release once the needle is in

A

release

148
Q

why do we pinch skin

A

to get subq off of the muscle

149
Q

IM inch

A

5/8-1.5

150
Q

IM gauge

A

20-25

151
Q

how much volume can we give IM (in large muscles)

A

3mL

152
Q

what do we do after we give IM

A

gentle pressure

153
Q

what is the Z track method

A

pull skin to side after we remove needle to avoid med uptake

154
Q

do we recap dirty needles

A

no

155
Q

do we aspirate or massage after IM

A

no

156
Q

aspiration evidence

A

no reported evidence that aspiration with or without blood return confirms needle placement

157
Q

where might aspiration may be indicated for IM injection

A

injections of large molecule medications such as penicillin

158
Q

IM sites

A

vastus lateralis
deltoid
ventral glueteal

159
Q

the deltoid muscle is small so how much do we administer

A

1 mL

160
Q

why do we not use dorsal gluteal

A

sciatic nerve and sciatic artery

161
Q

reconstituting medication

A

comes in a powder and we add liquid

162
Q

what is a never thing we do with dirty needles

A

recap, bend, break a used needle straight to the sharps containter

163
Q

controlled substances are

A

locked

164
Q

narcotics must be

A

counted

165
Q

make sure to report any _______ doses of narcotics

A

partial

166
Q

when do we need a witness

A

for destroying a narcotic

167
Q

cactus smart sink is to prevent

A

diversion

168
Q

what do we need to document when drugs are given

A

sites and parameters

169
Q

what do we need to document when doses are missed

A

explanation of why

170
Q

what do we need to document

A

patient refused

171
Q

where do we not put the incident report for medication errors

A

in medical record

172
Q

if we do give a med error what do we do

A

check patient condition immediately
observe for adverse effects
notify nurse manager/physican
complete form

173
Q

we want to make sure when doing a SHARE that

A

not indicate that this form was completed in the patient chart

174
Q

what is one thing we always do before giving meds

A

ID patient and check allergies

175
Q

do we chart the SHARE report

A

NO

176
Q

is rectal entral or parentral

A

entral

Fundamentals of Nursing (23 decks)

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