Medication Administration

Question 1

The nurse recently administered oral medications to a client who notified the assistive personnel (AP) that they just vomited. Which of the following actions should the nurse take first?

Answer 1

You answered correctly. It is most important for the nurse to inspect the vomitus for any evidence of the medication. This assessment is the first step in the nursing process. This assessment information may then assist the provider in deciding whether the dose should be repeated or held until the next scheduled dose, or if the medication or route of administration should be changed. It is important to document the episode but assessing the vomitus would be the first action. Having the AP provide mouth care to the client is also appropriate, but is not the priority action the nurse should take.

Question 2

A client who is pregnant at 8 weeks gestation reports they are having cold symptoms and trouble sleeping to the nurse. The client asks the nurse if they can take over-the-counter cold medicine. What is the most appropriate response the nurse should make?

Answer 2

The nurse should explain to the client that although some medications are safe during pregnancy, others can harm the fetus. It is best that the client discusses the situation with the health care provider, who can explain the risks and benefits of the particular medication.

Question 3

The nurse is preparing to administer medications to a client. The pharmacy has delivered the correctly prescribed medications, but they are labeled with another client’s name and medical record number. What action should the nurse take?

Answer 3

Notify the pharmacy immediately to fix.

Question 4

A nurse is educating a client on the reasons for different routes of medication administration. Explain why a health care provider might prescribe a medication to be administered via the IV route rather than orally in an emergency situation.

Answer 4

In an emergency situation, a health care provider may prescribe a medication to be administered via the IV route rather than orally due to the need for a rapid response. The IV route allows the medication to be delivered directly into the bloodstream, providing immediate therapeutic effects. This is essential in critical conditions where time is a factor and the client requires quick relief or stabilization. Additionally, the IV route bypasses the digestive system, avoiding issues with absorption that can occur with oral medications, and ensures dosage accuracy as the medication can be titrated based on the client’s response. This route is preferred in emergencies to ensure the medication acts quickly and effectively to treat the client’s condition.

Question 5

Explain why it is important for a nurse to use the appropriate syringe type when administering medications, specifically distinguishing between insulin and TB syringes.

Answer 5

It is crucial for a nurse to use the appropriate syringe type to ensure accurate dosing and proper administration of medications. Insulin syringes are calibrated in units specific to insulin dosages and have a slightly longer needle designed to deliver medication subcutaneously. TB syringes, on the other hand, have a shorter needle for intradermal injections and are calibrated differently. Using an insulin syringe as a substitute for a TB syringe could result in incorrect medication dosing and depth of administration, potentially leading to medication errors and adverse client outcomes. Therefore, selecting the correct syringe based on the medication prescribed and the route of administration is a key action in reducing the risk of medication errors.

Question 6

Injection Site

Between the iliac crest and the anterior superior iliac spine

Answer 6

Ventrogluteal

Question 7

Injection site: Anterior lateral aspect of the thigh

Answer 7

Vastus lateralis

Question 8

Injection site: 1 to 2 inches below the acromion process

Answer 8

Deltoid

Question 9

Injection Site - Dorsogluteal

Answer 9

Located on the Buttocks

Question 10

At which of the following grade levels should client educational materials be written?

Answer 10

Sixth

Question 11

Four components of pharmacokinetics

Answer 11

Absorption - Movement of the drug from where it enters the body to the circulatory system
Distribution - Drug delivery to target organs or tissues.
Metabolism - Breakdown of the drug into metabolites for excretion.
Excretion - Elimination of the drug metabolites from the body.

Question 12

Highest concentration of the drug in the bloodstream, which occurs when the absorption is complete

Answer 12

Peak Blood level

Question 13

Lowest concentration of the drug in the bloodstream

Answer 13

Trough blood level

Question 14

The length of time it takes for a drug’s concentration in the bloodstream to decrease by 50%. Half-lives vary between drugs.

Answer 14

Half-life

Question 15

A warning placed on drug packaging that indicates risk and potentially lethal adverse effects associated with the medication’s use

Answer 15

Black box warning

Question 16

The concurrent use of more than one drug, which can either potentiate or decrease the therapeutic or adverse effects of the individual drugs.

Answer 16

Drug-Drug

Question 17

The interaction between a drug and a food item, which can either potentiate or decrease the therapeutic effect of the medication.

Answer 17

Drug-Food

Question 18

The use of a herbal supplement while taking a drug, which can either potentiate or decrease the therapeutic or adverse effects of the drug.

Answer 18

Drug-herbal supplement.

Question 19

Factors influencing the effects of medication

Answer 19

Client’s Weight, Organ function, Amount of adipose tissue, cultural aspects, rate of metabolism, comorbidities

Question 20

What is the information required on a medication prescription?

Answer 20

Client’s name, Date/time that the prescription was written, Medication name and dosage, Route and frequency of administration, Indications for use, Provider’s signature.

Question 21

When do you complete medication reconciliation?

Answer 21

Upon client admission, Anytime the client transitions from one level of care to another, Anytime the client transitions from one health care facility to another, Upon client discharge

Question 22

What are the factors contributing to medication errors?

Answer 22

Nurse’s lack of medication knowledge, Failure to follow the rights of medication administration, Interruption during the medication preparation and delivery processes, Ignoring warnings or alerts.

Question 23

Steps to take in the event that a medication error occurs

Answer 23

Assess the client’s condition
Notify the client’s health care provider
Follow facility protocols
Complete an incident/occurrence report

Question 24

Medications that can result in considerable harm to a client if administered in incorrect doses or through incorrect routes. Safety protocols are put in place for such medications, including the verification of information by two nurses. High-alert medications include insulins, opiates, intravenous heparin, and potassium chloride.

Answer 24

High-alert medications.

Question 25

Medications that are administered via the gastrointestinal tract, including the oral (PO), sublingual (SL), buccal, and enteral feeding tube routes.

Answer 25

Enteral administration of medications.

Question 26

Medications that are administered into the intradermal (ID), subcutaneous (subcut), or muscular (IM) tissues, or directly into the vascular system (IV)

Answer 26

Parenteral administration of medications.

Question 27

When selecting a syringe to administer insulin, the nurse should be aware of?

Answer 27

The amount of insulin to be administered: Insulin syringes vary in their dosage capacities, Ensure the syringe is calibrated according to units.

Question 28

What to keep in mind using Intradermal injections?

Answer 28

The use of intradermal injections is diagnostic testing such as allergies or tuberculosis. The insertion of intradermal injections is at a 5 to 15 degree angle with no more than an amount of 0.1 ML. The site is typically the ventral aspect of the arm or the client’s back (for allergy testing). Caution: Avoid injections into areas that appear inflamed or have lesions or scars.

Question 29

What to keep in mind using Subcutaneous injections?

Answer 29

Administration of medication that requires a prolonged absorption time, such as insulin or heparin.

Inserted at a 45 to 90 degree angle, depending on the amount of adipose tissue. Multiple sites available.

Avoid injections into areas that appear inflamed, have lesions or scars, or have lipodystrophy.

Question 30

What to keep in mind using Intramuscular injections?

Answer 30

Use: Administration of medications that are viscous or irritating, that are larger in volume than can be administered subcutaneously, or that require a more rapid absorption rate.

Insertion: 90 degree angle.

Site: Multiple sites, including vastus lateral, ventrogluteal, and deltoid muscles. The site selected depends on the client’s age and size and the amount of medication to be administered.

Cautions: Avoid injections into areas that are edematous or inflamed, have impaired mobility, contain bruises or lacerations, or are painful.