Medication Administration Flashcards
Pharmakinetics
study of absorption, distribution, metabolism, and excretion (ADME)
ionization
pH of the medication and the site of absorption; ionized: weak bases more readily absorbable in the small intestine
dissolution
meds must be dissolved before absorption takes place
surface area of the absorption site
size of the surface area where the meds will be absorbed
what facts can influence absorption
route of administration
ionization
dissolution
blood flow
lipid solubility
surface area of the absorption site
client-specific factors
between high and low lipid soluble meds, which will get absorbed faster
high lipid soluble meds
enteral route
meds administered via the mouth, stomach, or intestines
distribution
med delivery to the target after it has been absorbed into the circulatory system
what factors contribute to distribution
blood flow
solubility
protein binding ability
toxicity
body can’t metabolize or excrete a meds, can cause irreversible damage to organs
prodrugs
inactive chemicals that are activated through metabolism
which organ is the primary one for excretion
kidneys
factors that influence excretion
kidney, heart, and liver function
pharmacodynamics
how a medication works, its relationship to medication concentrations, and therapeutic range
what is therapeutic drug monitoring (TDM) method used for
monitor med concentration in pt’s blood; meds with a narrow therapeutic window
adverse drug event (ADE)
requires intervention to prevent death, permanent disability, or congenital anomaly, causes hospitalization; need to report to FDA
black box warning
on meds that may produce lethal and iatrogenic results
iatrogenic
unforesseable or unintended injury or disorder caused by the treatment or procedure
signs of allergic reaction
rash, hives, swelling, circulatory collapse, laryngeal edema
anaphylaxis symptoms
dyspnea, hypotension, and tachycardia
Steven Johnson syndrome (SJS) symptoms
respiratory distress, fever, chills, fine rash followed by blisters
high fat meals will decrease or increase the rate of absorption
decrease intestinal absorption
teratogenic
cause fetal defects, pregnancy loss, developmental disabilities, or prematurity
examples of teratogenic meds
cocaine, alcohol
angiotensin converting enzyme (ACE) inhibitors
gentamycin
lithium
NSAIDs
tetracycline
which meds can be excreted into breast milk after metabolism
codeine, morphine, herbal supplements, alcohol
1kg = ? lbs
2.2lbs
pediatric clients vs. adult med administration
pediatric: higher rates of metabolism so requires larger dose
adults: lower dose
polypharmacy
use of 5 or more medications by a nonhospitalized client
rights of drug administration accronym
patients do drugs round the day (PDDRTD)
right patient, dose, drug, route, time, documentation
what are the 3 identifications you can use for drug administration
name, DOB, medical record number and then compared to the medication administration record (MAR)
STAT vs. urgent/ASAP orders
STAT: administer within 30mins
urgent: within an hour
time-critical medications
administered 30mins before or after the scheduled time or would cause harm
non time-critical medications
administered 1-2hrs early or late without causing harm
3 checks before giving the medication
from medication drawer
preparation
immediately prior
prescription should include what information
name, date/time when it was written, medication name (generic), dosage, route, frequency, indication for use, provider’s signature
reconciliation process
review current meds, compare to new meds, address issues; include OTC or herbal supplements
3 factors that contribute to errors
identification: right meds etc
interruption
correction: alerts and temptation to ignore
workaround
avoiding a policy or procedure in a system
which medications should never be crushed or opened
enteric-coated, capsules, sustained-release, and immediate-release meds
punctal occlusion/nasolacrimal occlusion
prevent the med from entering into the nasolacrimal duct and into the systemic circulation; gentle pressure on the inner corner for 30-60 secs
parenteral route
intradermal, intramuscular, subcutaneous, IV; aseptic technique
gauge for intradermal injections
27-25G
gauge for intramuscular injections
25-18G
gauge for subcutaneous injections
27-25G
length of needle for intradermal injections
1/4 - 3/4inches
length of needle for intramuscular injections
1 - 1 1/2 inches
length of needle for subcutaneous injections
3/8 5/8 inches
intramuscular injection angle
90degrees
subcutaneous injection angle
45-90 degrees
intradermal injection angle
5-10 degrees
lipohypertrophy
small lumps of irritated fat tissue; in clients that receive long term subcutaneous injections
ventrogluteal
between iliac crest and the anterior superior iliac spine; no major blood vessels or nerves
vastus lateralis
anterior lateral aspect of thigh
dorsogluteal
butt
intermittent piggyback intravenous infusion
medication via IV infusion set
phlebitis
inflammation of the vein
infiltration: what is it and symptoms
IV fluid inadvertently administered to surrounding tissue; cool skin temp around insertion site, taut skin, oozing fluid
preferred IM injection site for infants
vastus lateralis
deci
divide by 10
centi
divide by 100
milli
divide by 1000
micro
divide by million(1,000,000)
deka
times 10
hecto
times 100
kilo
times 1,000
1tsp to apothecary
60 drops
1tsp to metric
5mL
1tbsp to metric
15mL
2tbsp to apothecary
1oz
2tbsp to metric
30mL
1cup to apothecary
8oz
1cup to metric
240mL
1 pint to apothecary
16oz
1 pint to metric
480mL
1 quart to apothecary
32oz
1 quart to metric
960mL
1 m = ? cm
100cm
1 inch = ? cm
2.54cm
1 kg = ?lbs
2.2lbs
what grade level should client educational material be written in
6th grade or lower
