medication administration

Question 1

what nursing actions support safe medication administration

Answer 1

• Review patient allergies.
• Review and reconcile prescribed medications.
• Identify possible adverse effects of medications.
• Identify potential interactions with other medications.
• Determine route of administration.
• Determine time of administration.
• Develop patient education regarding medication administration.

Question 2

what actions can help reduce the risk of medication errors

Answer 2

making sure to check all of the 10 rights of medication administration

Question 3

compare and contrast the various routes by which medication can be administered

Answer 3

oral (PO)
Sublingual (SL)
rectal (PR)
Intravenous (IV)
Buccal
Inhalation
Intramuscular (IM)
subcutaneous (Subcut)
transdermal
otic
opthalmic
nasal

Question 4

what role does the nurse play in relation to educating the clients about their medications

Answer 4

A nurse plays a critical role in educating clients about their medications by providing clear, understandable information about the purpose, dosage, administration method, potential side effects, and interactions of each prescription

Question 5

The six rights of medication administration

Answer 5

• Right client: Verify the client’s identity using two client identifiers. (DOB and name)
• Right medication: Confirm the name and form of the medication is correct. (transcribing and read back, MRS)
• Right dose: Check the medication you have against the order in the medical record.
• Right route of administration: Confirm the route (IV, IM, SC, etc.).
• Right time of delivery: Confirm the time the drug is to be given and the last time the drug was administered.
• Right documentation: Document the time the drug was given and any pertinent remarks.

Question 6

Right to refuse

Answer 6

Client has the right to refuse the medication

Question 7

Right assessment

Answer 7

Confirm that the medication is appropriate for the clients condition
- make sure to check the medication and double check for allergies

Question 8

Right education

Answer 8

Provide adequate education addressing
what medication the client is taking, expected benefits, and side effects.
- make sure they know what to expect when taking it

Question 9

Right response/evaluation

Answer 9

Observe the client’s response to the rug
- check for adverse reactions and if it is working

Question 10

Additional safety strategies for medication administration

Answer 10

• checking the medication against the Medication administration Record or medication information device upon removal of the drug from the dispensing device
• checking the drug upon preparation
• checking the drug just prior to administration

Question 11

Medication reconciliation

Answer 11

• performed anytime the care of the client is transferred from one health care professional to another, such as when a client returns or from one physical location to another
• involves reviewing the client’s current medications, then addressing omissions and duplications
  
  • ensure continuity of care (make sure all medications are correct)

Question 12

Pharmacodynamics

Answer 12

The study of how a drug works, its relationship to drug concentrations, and how the body responds to

Question 13

Examples of pharmacodynamics

Answer 13

Therapeutic range
Peek blood level (highest)
Trough blood level (lowest)
Half-life (half of duration)
Onset of action (when it starts working)
Peek effect
Duration of action (how long it stays in the body)

Question 14

Drug-drug interactions

Answer 14

The effect that two or more drugs that the client is administered have on each other
- enhance actions or block actions, increase or decrease ADR, etc).

Question 15

Drug-food interactions

Answer 15

Effects of nutrients on the absorption, distribution, metabolism, or excretion of medications
- iron and orange juice
- warfarin and diflucin

Question 16

Serious adverse drug event (ADE)

Answer 16

• a life-threatening reaction that requires medical intervention to prevent death or permanent disability, or congenital anomaly.
• must be reported to the FDA to improve safety outcomes, revising drug labels and warnings, and, when needed, to withdraw drugs from the market

Question 17

What is a black box warning

Answer 17

A warning issues on medications that may produce lethal and iatrogenic results

Question 18

Allergic reactions

Answer 18

• allergic or hypersensitivity reaction develops when the body perceived a foreign substance (medication) as an allergen, producing antibodies to counteract the allergen
  
  • the adverse reaction produces histamines in response to tissues injury

Question 19

Anaphylaxis

Answer 19

A severe, life-threatening reaction resulting from histamine release producing dyspnea, hypotension, and tachycardia

Question 20

Steven’s-Johnson syndrome

Answer 20

A potentially fatal drug reaction
- develops 1-14 days following drug administration. SJS is manifested by respiratory distress, fever, chills, a diffuse fine rash, and then blisters

Question 21

What is a pharmacokinetic

Answer 21

The study of the absorption, metabolism, distribution, and excretion of drugs in the human body

Question 22

The parts to pharmacokinetics

Answer 22

• the dissolution of a medication is dependent upon its initial state and route of administration
• most medications are administered by the oral or enteral route, which provides for a much slower rate of absorption
• distribution is the process of drug delivery to the target organ or tissues that occurs before metabolism and excretion

Question 23

Metabolism defined

Answer 23

Metabolism or bio transformation is the process of converting a medication to a form that is easily excreted from the body

Question 24

Examples of how metabolism works

Answer 24

Most drugs are metabolized by the liver.
• Kidneys and sections of the small intestines may also be responsible for drug
metabolism.
• Prodrugs are inactive chemicals that are transformed through metabolism to become
active before they have therapeutic effect.
• Oral medications pass from the small intestine to the hepatic circulation via the
mesenteric vein and portal vein flowing into the liver. This is the first-pass effect,
resulting in a lower concentration of the medication in the systemic circulation.

Question 25

Define excretion

Answer 25

Is the process of removing drugs from the body

Question 26

The primary parts of excretion

Answer 26

The kidneys are the primary organ responsible for drug excretion.
• The skin, lungs, exocrine glands, mammary glands, and intestines excrete
medications to a lesser extent.
• Drug toxicity develops when the body is unable to metabolize and excrete
a drug.

Question 27

Teratogenic medications

Answer 27

Known to cause fetal defects, pregnancy loss, developmental disabilities, or prematurity

Question 28

Examples of teratogenic medications

Answer 28

o Cocaine
o Alcohol
o Angiotensin-converting enzyme inhibitors (ACE)
o Gentamycin
o Lithium
o NSAIDs
o Tetracycline

Question 29

Medication order

Answer 29

The order must have the client’s name, DOB, date and time the order was written, and the providers name and title

Question 30

A medication order written by the provides must include

Answer 30

o The name of the drug,
o The amount to be given
o The route of administration
o The frequency of administration

Question 31

What are high alert medications

Answer 31

Drugs that are associated with an increased risk of causing considerable client harm when they are administered in error

Question 32

Parts and types of high-alert medications

Answer 32

Insulin, opiates, narcotics, intravenous
heparin, and injectable potassium
chloride are high-alert medications.
• One strategy to reduce the risk of
harm is manual independent double
checks with two nurses verifying
identical information before these
drugs are administered.

Question 33

Oral or enteral route

Answer 33

via mouth, stomach or
intestine – absorbed in GI tract first, then to
the circulatory system

Question 34

Subcutaneous

Answer 34

Delivered into the fat layer under the dermis - usually slower absorption than IM due to small blood vessel size

Question 35

Intramuscular

Answer 35

Faster absorption due to
larger blood vessels in muscle tissue

Question 36

Intravenous

Answer 36

Most rapid absorption –
directly administered into the circulatory
system

Question 37

Topical and transdermal

Answer 37

Applied directly to the area being treated – absorbed through mucus membranes or skin into capillaries and then to the bloodstream

Question 38

Time

Answer 38

• Time-critical medications are those
  that when administered either 30 minutes before or after the scheduled administration time can cause harm to client or substandard pharmacological effect.
• Non-time critical medications are defined as medications that can be administered between one and two hours early or late without causing harm or substandard pharmacological effects to the client.

Question 39

The formula method

Answer 39

Dose ordered or desired X quantity (tablet or ml) / available dose or what is available

Question 40

examples of medications with black bow warnings

Answer 40

loop diuretics
estrogen
iron supplements
naproxen
birth control
aspirin