Medication Administration Flashcards
In the last 10 years, errors have ____________ .
Doubled
How many people die each year from human error?
98,000
How much percentage is due to physician orders?
38% (the nurse catches half of these)
How many die from drug error?
7,000
What is the time frame a med must be given?
Within a 2 hour window. 1 hour before to 1 hour after.
Who determines the safety and efficacy of drugs?
FDA
Who provides an official list of drugs including source and properties?
USP
How often see controlled substances counted?
Daily
If the count of a controlled substance is off what is the next thing?
Investigation
If a portion of a controlled substance is not used of wasted, what must be done?
It must be witnessed and documented
What does the Drug Abuse Prevention and Control Act of 1970 state?
How often rxs can be filled to prevent drug abuse
High abuse potential; no medical acceptance in the US; not prescribed
I.e. cocaine, LSD, heroin
Schedule I
High abuse potential; accepted medical use in US; abuse may lead to severe dependence
I.e. morphine, oxycodone
Schedule II
Abuse potential less than I and II; accepted medical use in US; moderate or low dependence
I.e. Xanax, Tylenol 3, Ativan
Schedule III
Low abuse potential, accepted medical use; limited dependence
Schedule IV
Lowest abuse potential; limited dependence
I.e. cough meds
Schedule V
Is a substance administered for the diagnosis, cure, treatment or relief of a symptom or prevention of disease also called drug (sometimes a negative meaning)
Medication
Name assigned by a manufacturer before drug becomes official
I.e. ibuprofen
Generic name
Constituents that makes drug molecular
2-(4 isobutylpphenyl) propinoic acid
Chemical name
Registered name assigned by the manufacturer (trademark name)
I.e. Advil, Motrin, Nuprin
Brand name
Name listed in the FDA publications
NSAID
Official name
The process where the drug enters the bloodstream
Absorption
Where are most PO meds absorbed?
GI tract
Intravenous vs. subQ absorption?
Intravenous = fast; subQ = slow
Even slower when ice is applied
The delivery of a drug to the tissue by the circulatory system
Distribution
When a drug is distributed, where is it carried?
The most vascular organs (liver, kidneys, brain)
The process by which a drug is transformed to a less active form
Metabolism
Metabolism is also called:
Biotransformation or detoxification
Where does metabolism take place mainly?
The liver
What is metabolism a product of?
Active and Inactive metabolites (active metabolites have a pharmacological action; inactive metabolites have none)
Action of an active drug and bi products removed from the body
Excretion
Where are most metabolites excreted?
In urine (other areas are in feces, breath, perspiration, saliva, and breast milk)
How is anesthesia excreted?
Via respiratory tract
The desired effect of a drug and the reason it is prescribed is called?
Therapeutic effect
What is a secondary or unintended effect of a medication that is predictable and can or cannot be harmful?
Side effect
What are severe side effects called?
Adverse effects
What is a level of a drug too high for the body causing adverse effects?
Drug toxicity
What is an immunological reaction to a drug where the body is exposed to a foreign substance?
Drug allergy
What are some examples of a mild or severe allergic reaction to a med?
Rash, pruritis, angioedema, rhinitis, lacrominal tearing, nausea, vomiting, wheezing, diarrhea
What is are some examples of a severe or anaphylactic reaction?
Acute SOB, tachycardia, hypotension, shallow airway
Drug allergies can take how long to react?
Immediate or within days
The body requires more of a drug for therapeutic effect
Drug tolerance
Alters effect of one or both drugs potentiating or inhibiting effect
Drug interaction
When 2 drugs are given together to produce a greater effect than given alone
I.e. Asa and codeine
Synergistic response
Time after administration to produce a response is called:
Onset of action
The highest serum concentration of drug maximum therapeutic effect
Peak level
Length of time drug present in concentration to produce therapeutic effect
Duration of action
Enough drug present in plasma to produce desired effect or response but not enough to cause toxicity
Therapeutic range
Least amount of drug in serum to produce a therapeutic response
Minimum dose
Greatest amount of drug in serum without causing adverse effects
Maximum dose
Maintains desirable drug level - administer time is important
Maintenance dose
What are some factors that influence drug action?
Developmental, pregnancy, infants, gender, diet, environment, psych, illness, and before and after meals
What are the physiological changes in the elderly for meds?
Loss of vision, accumulation of drug into the body, compatibilities, decreased kidney and liver functions
The primary reasons that patients don’t take meds correctly is?
The lack of understanding
What are the systems of drug measurement?
Metric, apothecary, and household
What is the most common, safest, and least expensive route of medication?
Oral
Under tongue
Sublingual
Parenteral
By needle
Local and on skin
Topical
Through the respiratory tract
Inhalation
To cheek
Buccal
What is the most widely used drug book?
Physicians desk reference
Compliance of drugs for use in the hospital
Hospital formulary
Indicates medication to be given immediately and only one time within 20 minutes
STAT
Only when physician can’t write order
Verbal order
A verbal order must be signed by the MD within ________ hours
24
Order given only once at a specific time
Single/one time order
Order that may or may not have a termination date, some terminates on set time during a policy
Standing order
As needed
PRN
Is located on the unit in large amounts, now only wound cleaners
Stock supply
Individual supply for each patient (most common) and prepared by the robot at BMC
Unit dose
Specific dose for each patient in an individual container
Individual supply
Must keep locked; each patient has their own drawer
Medication cart
Rare; located at SDS
Medication cupboard
Most common nursing diagnosis related to drug therapy
Deficient knowledge
“Real time” documentation is located where?
At the bedside
If a patient vomits after a med is given . . .
Notify the physician and document
If a med error occurs what needs to be done?
Assess patient first then fill out a STT (safety tracking tool)
How often is medication checked before given to the patient?
3 times: when removing from the drawer, before opening, and at bedside before administering
