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NURS 200 > Medication Administration > Flashcards

Medication Administration Flashcards

1
Q

to administer medications safely; what must nurses have an UNDERSTANDING OF? (7)

A
  • HEALTH CARE
  • PHARMACOLOGY
  • PHARMACOKINETICS
  • LIFE SCIENCES
  • PATHOPHYSIOLOGY
  • HUMAN ANATOMY
  • MATHEMATICS
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2
Q

defintion of PURE FOOD & DRUG ACT

A
  • requires MEDS to be FREE of impure products
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3
Q

describe the FDA; FOOD & DRUG ADMINISTRATION

A

enforces MEDICATION LAWS that ensure that medications on the market go through VIGOROUS TESTING before being sold to the public

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4
Q

describe the MEDWATCH PROGRAM

A
  • type of VOLUNTARY PROGRAM
  • encouragement of REPORTING when meds, products or medical events cause SERIOUS HARM to a patient
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5
Q

what are other MEDICATION LEGISLATIONS to consider?

A
  • STATE & LOCAL REGULATION of medications;
    ex. CA Department of Health
  • HEALTH CARE INSTITUTIONS & MEDICATION LAWS
    ex. Kaiser, Scripps, Palomar
  • MEDICATION REGULATIONS & NURSING PRACTICE
    ex. SON
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6
Q

what are the types/classifications of MEDICATION NAMES?

A
  • CHEMICAL
  • GENERIC/OFFICIAL NAME
  • TRADE/BRAND/PROPRIETARY (TM)
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7
Q

definition of NPAS

A
  • known as the STATE NURSE PRACTICE ACTS
  • defines the SCOPE OF NURSE’S professional functions & responsibilities
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8
Q

definition of CHEMICAL MEDICATION NAME

A
  • this is RARELY USED in medication admin
  • gives the EXACT DESCRIPTION of medication COMP + MOLECULAR STRUC
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9
Q

definition of GENERIC MEDICATION NAME

A
  • known as the OFFICIAL NAME
  • from the MANUFACTURER when first developed
  • listed in U.S. PHARMACOPEIA
  • ex. acetaminophen
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10
Q

definition of TRADE/BRAND/PROPRIETARY NAME

A
  • name of the MARKET DRUG the manufacturer is selling
  • EASY TO SPELL & REMEMBER
  • ex. tylenol
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11
Q

how are MEDICATIONS CLASSIFIED?

A
  • on its EFFECT on the BODY SYSTEM
  • the type of SYMPTOMS the medication relieves
  • the medication’s DESIRED EFFECT
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12
Q

what does PO stand for?

A

by mouth

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13
Q

what are the types of ORAL (PO) MEDICATION FORMS?

A
  • SOLID; tablets, capsules, pills
  • LIQUID; syrup, suspension, elixir
  • OTHERS; lozenge / aerosol
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14
Q

definition of PHARMACOKINETICS

A

the study of how medications enter the body, reach the site of action, metabolize, and exit the body

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15
Q

definition of ABSORPTION

A
  • when medication molecules pass from blood to the SITE of needed administration
  • has factors considered from its specific ROUTE, END SITE, BSA, and LIQUID SOLUBILITY
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16
Q

what are some FACTORS that can influence ABSORPTION?

A
  • ROUTE OF ADMINISTRATION
  • the ABILITY of a MEDICATION to DISSOLVE
  • BLOOD FLOW TO SITE (greater the vascularity = the faster the flow!)
  • BSA
  • LIQUID SOLUBILITY
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17
Q

what are the FASTEST to SLOWEST ROUTES OF ADMIN?

A
  • INTRAVENOUS (IV)
  • INTRAMUSCULAR/SUBQ (IM/SQ)
  • SKIN & PO
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18
Q

what can medications bind to that can DECREASE its effect?

A

albumin

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19
Q

definition of DISTRIBUTION

A
  • follows after ABSORPTION
  • DISTRIBUTION towards other TISSUES, ORGANS, & SPECIFIC SITE
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20
Q

what FACTORS INFLUENCE DISTRIBUTION?

A
  • CIRCULATION; CHF patients
  • MEMBRANE PERMEABILITY; specific BBB - only passes FAT-SOLUBLE MEDS
  • PROTEIN BINDING (albumin)
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21
Q

definition of METABOLISM

A
  • process of BIOTRANSFORMATION; use and influence of enzymes that begin to DETOXIFY, BREAK DOWN, & REMOVE ACTIVE CHEMICALS
  • begins to METABOLIZE medication to more of an INACTIVE FORM/LESS POTENT
  • preparation for EXCRETION
  • typically occurs in the LIVER
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22
Q

definition of EXCRETION

A
  • the EXITING OF MEDICATIONS
  • typically occurs in the KIDNEYS
    (can be excreted through liver, bowels, lungs, exocrine glands) **depends of medication really
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23
Q

what happens if a patient has LIVER OR KIDNEY ISSUES?

A
  • have a greater risk of developing GREATER TOXICITY due to medications
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24
Q

therapeutic effect

A

the EXPECTED OR PREDICTED physiological response

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25
Q

adverse effect

A

the UNINTENDED, UNDESIRABLE, OR UNPREDICTABLE response

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26
Q

side effect

A

a PREDICTABLE, UNAVOIDABLE secondary effect

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27
Q

toxic effect

A

the ACCUMULATION OF MEDICATION within the bloodstream
- often due to result of IMPAIRED METABOLISM & EXCRETION

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28
Q

idiosyncratic reaction

A

an UNPREDICTABLE OVERREACTION, UNDERREACTION, or really just a DIFFERENT REACTION THAN NORMAL

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29
Q

urticaria

A
  • also known as HIVES
  • irregularly shaped eruptions; red margins / pale centers
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30
Q

pruritus

A

the ITCHING of the SKIN; comes with rashes

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31
Q

rhinitis

A

the INFLAMMATION of the MM lining
- swelling + watery discharge

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32
Q

allergic reaction

A
  • this is DIFFERENT FROM SIDE EFFECTS
  • type of UNPREDICTABLE REACTION
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33
Q

medication interactions

A

where ONE MEDICATION MODIFIES the ACTION OF ANOTHER
- type of SYNERGISTIC EFFECT – combined effect is greater than singular

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34
Q

medication tolerance

A
  • where MORE MEDICATION is required to achieve the same THERAPEUTIC EFFECT
  • more increased dosages of the med
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35
Q

medication dependence

A
  • known as ADDICTION
  • can be either PHYSICAL (showcase of withdrawal symptoms) or PSYCHOLOGICAL
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36
Q

what is the TIMING OF MEDICATION DOSE RESPONSES?

A

THERAPEUTIC RANGE:
consists of the lowest MEC to highest TOXICITY

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37
Q

definition of MEC

A

MINIMUM EFFECTIVE CONCENTRATION (MEC):
- the PLASMA LEVEL of a medication below which the effect of the MEDICATON DOES NOT OCCUR

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38
Q

definition of TOXIC CONCENTRATION

A
  • TOXIC CONCENTRATION:
    level at which TOXIC EFFECTS OCCUR
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39
Q

definition of PEAK & TROUGH

A

PEAK - highest level in our therapeutic range
TROUGH - lowest level in/entering MEC

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40
Q

definition of BIOLOGICAL HALF-LIFE

A

time it takes for excretion processes to LOWER the serum medication concentration by 1/2

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41
Q

when do we ADMINISTER TIME-CRUCIAL MEDICATIONS?

A
  • “You need to administer time-critical medications at a precise time, within 30 minutes before or after their scheduled time.”
  • “You administer non–time-critical medications within 1 to 2 hours of their scheduled time.”
42
Q

what are the ORAL ROUTES OF MED ADMIN?

A
  • SUBLINGUAL
  • BUCCAL
43
Q

what SYSTEM of MEDICATION MEASUREMENT do we use?

A
  • METRIC SYSTEM
  • use for METER (LENGTH), LITER (VOLUME) & GRAM (WEIGHT)
44
Q

rules to follow when calculating med admin

A
  • ALWAYS USE LEADING ZERO (ex. 0.5)
  • NEVER USE TRAILING ZERO (5.0 XX)
45
Q

how do we express SOLUTIONS in medication measurement?

A
  • expressed THREE WAYS;
    g/L or mg/mL
    percentages
    proportions
46
Q

what are the types of methods you can use for CLINICAL CALCULATIONS

A
  • the RATIO & PROPORTION METHOD
  • FORMULA METHOD
  • DIMENSIONAL ANALYSIS
47
Q

what medications or doses should have HIGHER CAUTION?

A
  • HIGH RISK MEDS; insulin, heparin, narcotics
  • PEDIATRIC DOSEs
48
Q

who can PRESCRIBE MEDICATIONS?

A
  • physicians
  • nurse practitioners
  • physician’s assistants
49
Q

how can ORDERS be given?

A
  • WRITTEN (hand or electronic)
  • VERBAL
  • TELEPHONE
50
Q

can abbreviations cause errors?

A

YES; use CAUTION, there are PROHIBITED ONES

51
Q

definition of STANDING or ROUTINE MED ORDERS

A

have their own SET DOSE, FREQUENCY & DURATION

52
Q

prn orders

A

as needed

53
Q

STAT orders

A

given med IMMEDIATELY

54
Q

NOW orders

A
  • needed quickly
  • around 90 MIN from receiving order
55
Q

what is the PHARMACIST’s ROLE in med admin?

A

preparation & distribution of meds

56
Q

what is the NURSE’s ROLE in med admin?

A
  • determining and checking MEDS are CORRECT
  • monitoring effects
  • determining timing
  • correct administration
  • assessment of self-admin
  • provides patient teaching
57
Q

what are the type of DISTRIBUTION SYSTEMS we have?

A
  • UNIT DOSE SYSTEMS
  • AUTOMATIC MEDICATION DISPENSING SYSTEM (AMDS)
58
Q

definition of MEDICATION ERROR

A
  • preventable event that can cause INAPPROPRIATE MEDICATION USE & possible harm to patient safety
  • failing to administer medication
59
Q

what do you do if a MEDICATION ERROR OCCURS?

A
  • ASSESS PATIENT CONDITION FIRST !! PATIENT SAFETY ALWAYS FIRST
  • NOTIFY HCP
  • stable patient; report incident
  • prep for file/incident report
  • reporting also any near misses/incidents
60
Q

what are the RIGHTS OF MED ADMIN?

A
  • RIGHT MEDICATION
  • RIGHT DOSE
  • RIGHT PATIENT
  • RIGHT ROUTE
  • RIGHT TIME
  • RIGHT DOCUMENTATION
  • RIGHT INDICATION/REASON

+RIGHT RESPONSE
+RIGHT ASSESSMENT
+RIGHT EDUCATION
+RIGHT TO REFUSE

61
Q

definition of POLYPHARMACY

A

the use of MULTIPLE MEDS
- potential use of MEDS THAT ARE UNNECESSARY/do not match diagnosis

62
Q

definition of ORTHOSTATIC HYPOTENSION

A

sudden BP changes with movement changes
- drastic drop of 20+ mm Hg (positive sign)

63
Q

how to continue prevention of medicine errors?

A
  • AVOID DISTRATIONS
  • CORRECT ADMIN
  • RECORD MED ADMIN
64
Q

what happens to METABOLIC PROCESSES as we grow older?

A
  • liver begins to SHRINK
  • declining rate of HEPATIC BLOOD FLOW & ENZYME ACTIVITY
  • medication stays for a longer duration; may need smaller doses
65
Q

what happens to EXCRETION PROCESSES as we grow older?

A
  • declining of KIDNEY FILTRATION & RENAL BLOOD FLOW
  • same aging effects of the liver
66
Q

what happens to DISTRIBUTION PROCESSES as we grow older?

A
  • changing of FLUIDS & BODY PROPORTIONS decrease
  • concentration of WATER-SOLUBLE MEDICATIONS rises
  • decrease of PROTEINS; less binding of drugs
67
Q

what is the easiest route for medication?

A

ORAL ADMINISTRATION; the most preferred route

*consider food & its effects
*prevent aspiration (upright position, chin-down)

68
Q

what are our PARENTERAL ROUTES?

A

types of INJECTION;

  1. INTRADERMAL (ex. TB test)
  2. SUBCUTANEOUS (ex. insulin)
  3. INTRAMUSCULAR (ex. flu shots)
  4. INTRAVENOUS (ex. antibiotics, pain meds)

*there are other routes; EPIDURAL, INTRAPLEURAL, INTRAARTERIAL etc…INTRACARDIAC, etc…

69
Q

what is important to note when administering via PARENTERAL ROUTE?

A
  • much more INVASIVE + necessary for ASEPTIC TECHNIQUE; can be a risk for infection & needle sticks
  • must consider 7 rights always
70
Q

describe TOPICAL ADMINISTRATION

A
  • considers use of ABSORPTION of medication through the SKIN or MUCOUS MEMBRANES
71
Q

describe SKIN APPLICATION (topical)

A
  • application of TRANSDERMAL PATCH; ask if patient has an existing one
  • be careful; can be prone to OVERDOSE
  • documentation of LOCATION & REMOVAL on MAR
72
Q

what are the methods of NASAL INSTILLATION?

A
  • sprays
  • drops
  • tampons

**most commonly uses SPRAY or DROPS

73
Q

describe EYE INSTILLATION

A
  • avoid the CORNEA
  • avoid DIRECT TOUCH of eye/lid
  • NEVER SHARE EYE MEDS
74
Q

definition of INTRAOCULAR INSTILLATION

A
  • disk used for medication; often resembles a contact lens
  • teach patients how insert/remove
75
Q

describe EAR INSTILLATION & IRRIGATION

A
  • allow eardrops to be in ROOM TEMP
  • never OCCLUDE EAR CANAL
  • children <3; ear down & back
  • children >3/adults; ear up & back
  • irrigation used to REMOVE CERUMEN if wax softeners don’t work
76
Q

describe types of VAGINAL MEDS

A
  • foam
  • jellies
  • creams
    (use of applicator inserter)
  • suppositories
    (gloved hand)
77
Q

describe RECTAL INSTILLATION

A

RECTAL SUPPOSITORIES:
- exerts LOCAL EFFECTS
- often seen for NPO patients & stroke patients
- often comes with a small cleansing enema

78
Q

pressurized metered-dose inhalers (pMDIs)

A
  • needs hand strength/hand-breath coordination
  • can be used with spacer
79
Q

breath-actuated metered-dose inhalers

A
  • depends on strength of patient’s breath on INSPIRATION
80
Q

Dry powder inhalers (DPIs)

A
  • activated by PATIENT’s BREATH
  • delivers more med to lungs
81
Q

how do we administer medications by IRRIGATION?

A
  • use of clean technique
  • use aseptic technique if there is break
  • use of often saline, sterile water, or other antiseptic solutions
82
Q

describe the type of SYRINGES

A
  • LUER-OK (has ability to SCREW ON or OFF–can be threaded to an IV)
  • NON-LUER OK
83
Q

describe NEEDLE ANATOMY

A
  • HUB (the connection piece)
  • SHAFT
  • BEVEL (has lumen, always looking up)
  • PLUNGER (what moves up & down)
  • BARREL (contains medication)
84
Q

how to prepare med from ampule?

A
  • snap OFF AMPULE NECK
  • use of FILTER NEEDLE; aspirating medication
  • must REPLACE FILTER NEEDLE to proper needle; just used to filter out any broken glass
85
Q

describe mixing meds from VIAL & AMPULE

A
  • get medication from VIAL FIRST
  • use the SAME SYRINGE /FILTER NEEDLE from AMPULE
86
Q

describe how to mix insulin

A

:)

87
Q

define INSULIN & its CLASSIFICATIONS

A

INSULIN; hormone used to treat diabetes; oral insulin is destroyed; must be INJECTED
- use of 100-UNIT INSULIN SYRINGE

CLASSIFICATIONS:
(by rate of action)
- RAPID
- SHORT
- INTERMEDIATE
- LONG-ACTING
**CANNOT MIX LONG-ACTING with regular

88
Q

what type of INSULIN can we never mix?

A

LONG-ACTING INSULIN
- GLARGINE
- DETERMIR

89
Q

what should we know before injecting the patient?

A
  • VOLUME OF MEDICATION
  • CHARACTERISTICS & VISCOSITY of MEDICATION
  • LOCATION OF ANATOMICAL STRUCTURES at injection site
  • PATIENT LEVEL OF DISCOMFORT
90
Q

describe ANGLES OF TYPES OF INJECTIONS

A

IM: 90
SUBQ: 45-90 *90 *depends on weight
ID: 5 - 15

91
Q

what types of NEW TECHNOLOGIES are being used for SUBQ injections?

A
  • INJECTION PENS
  • NEEDLELESS JET INJECTION SYSTEMS
  • SUBQ INJECTION DEVICES
92
Q

describe AMOUNTS of med admin in IM injections

A

*has FASTER RATE OF ABSORPTION vs. SUBQ

ADULTS; 2 - 5 mL
CHILDREN, OLDER ADULTS, THIN PATIENTS; -2 mL
SMALLER CHILDREN/INFANTS; 1 mL
SMALLER INFANTS; 0.5 mL (vasta lateralis)

93
Q

what LOCATIONS can we inject?

A

VENTROGLUETEAL SITE;
in the GLUETEUS MEDIUS–preferred site

VASTUS LATERALIS;
used for adults & children; using MIDDLE THIRD OF MUSCLE

DELTOID;
risk for injury; close to nerves & artery

94
Q

Needlestick Safety & Prevention Act

A
  • proper use of prevention of needlestick incidents
  • use of safety syringes & proper disposal
95
Q

describe IV ADMINISTRATION

A
  1. use to INFUSE LARGE AMOUNTS OF IV FLUID - with medications
  2. use to INJECT BOLUS/SMALL AMT OF MED through an EXISTING IV INFUSION LINE *ex. heparin & saline lock
  3. use of PIGGYBACK INFUSION
96
Q

describe LARGE-VOLUME INFUSIONS

A
  • the MOST SAFE & EASIEST
  • large volumes; 500 -1000 mL
  • IF TOO RAPID; can be at risk for OVERDOSE
97
Q

describe IV BOLUS

A
  • introduction of a CONCENTRATED DOSE OF MED into the circulation
  • is the MOST DANGEROUS; no time to correct
98
Q

describe VOLUME-CONTROLLED INFUSIONS

A
  • use of SMALLER AMTS 50 - 100 mL
  • has THREE TYPES; V-C ADMIN SETS, PIGGYBACK SET, & SYRINGE PUMPS
  • advantages; stability / controls fluid intake
99
Q

piggyback

A

small IV BAG (25 - 250 mL); connects to primary infusion line or intermittent venous access

100
Q

syringe pump

A
  • BATTERY OPERATED
  • gives medication in SMALL AMTS, controlled infusion times
101
Q

saline lock/ intermittent venous access

A
  • saves money
  • effective in saving time; no more constant monitoring

NURS 200 (16 decks)

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