Medication Administration Flashcards
What are the 3 names for drugs
generic
official - name by which drug is identified in the official publications US Pharmacopeia
trade name
What are ways drugs can be classified
effect on body systems
chemical composition
clinical indication/therapeutic action
What is pharmacokinetics
the effect of the body on the drug - mvmt of drug molecules in the body in relation to the drugs absorption, distribution, metabolism, and excretion
Are acidic drugs well absorbed?
Yes; basic drugs remain ionized/insoluble in acid environments
Elixir
medication in a clear liquid containing water, alcohol, sweeteners, and flavor
Enteric coated
a tablet or pill coated to prevent stomach irritiation
Extended release, and what are other names for it
preparation of a med that allows for slow and continuous release over a predetermined period; aka CR/CRT (controlled release) SR (slow/sustained release) SA (sustained action) LA (long acting) TR (time release)
What is a loading dose
dose that is larger than normal - usually given when a pt is in acute distress and maximum therapeutic effect is desired as quickly as possible
What is a maintenance dose
lower dosage that becomes the usual or daily dosage
Therapeutic Range
the concentration of the drug in the blood serum that produces the desired effect with out causing toxicity
Peak Level
highest plasma concentration - should be measured when absorption is complete
Half-life
amount of time it takes for 50% of the blood concentration of a drug to be eliminated from the body…monitoring this ensures that therapeutic ranges are obtained without reaching toxic levels
Distribution
after drug is absorbed: depends on blood flow to the tissues, the drugs ability to leave the bloodstream and the drug’s ability to enter cells.
**Binding to plasma proteins = unequal distribution/prevents drug from reaching intended site of action
What are 3 factors that affect distribution
binding of drug to plasma proteins = unequal distribution
blood brain barrier= prevents toxins and poisons from reaching the brain
placenta = NOT A BLOOD BARRIER - blood freely flows across it and can drugs can affect the fetus
Metabolism of a drug
aka biotransformation is the change of a drug from its original to its new for
What is the primary site for drug metabolism
liver
Excretion
the process of removing a drug or its metabolites from the body
**kidneys excrete most drugs; lungs = primary route of excretion for gaseous substances; bile in GI tract
Where should adverse reactions to medications be reported
MEDWATCH or a national database
MedWatch
safety information and voluntary adverse events reporting program, sponsored by the U.S. Food and Drug Administration, which also provides up-to-date information about medication errors and potential or actually medical product problems and errors
For a drug to be an adverse effect it must
life threatening action
requires intervention to prevent death/impairment
leads to death/hospitalization/disability/congenital deformity
What are the 3 red drugs
Insulin (need 2 licensed prof to dbl check)
Any anticoagulants
IV narcotics
What are CPOEs and what do they allow
Computer-generated pharmacy order system
allows prescriber to enter medication sorters in a standard format + guide the prescriber in complete, accurate, and appropriate ordering
**prevents guess handwritten orders
stat order
single order, but carried out immediately
What is needed on the medication order
Patient name
Date and time order is written
Name of drug
Dosage of the drug
Route by which the drug is to administered
Frequency of administration of the drug
Signature of the person writing the order
What are the terms used to describe route administration
Oral
Parenteral (SubQ,Intramuscular, Intradermal)
Topical
Pulmonary
What is the nurse responsible for when checking the medication order
checking that the medication order was transcribed correctly from the original to the MAR; if it was not you must rewrite the order correctly
Nurse must also check the dosage 2X and 1 x more right before injection
A drug is ordered that would potentially interact with another medication the patient is taking…what should you do?
All medications the patient is taking should be verified before administration
NEVER guess an order
How are children’s medications typically calculated
by weight
What is the most common FORM of medication error
omitted dose
What is most common CAUSE of medication error
Transcription
Three Checks for medication
1- When the nurse reaches for the container or unit dose package
2- After retrieval from the drawer and compared with the MAR/compared with the MAR immediately before pouring from a multi dose container
3- When giving unit dose to the patient
After administering the medication the nurse should
remain with the patient and make sure that the medication is taken
Record the medication administration
Contraindications to administering oral meds
vomiting
NPO
difficulty swallowing
unconscious
What are the Rights to Ensuring Correct Administration of Medications
Right Patient Right Drug Right Dose/Preparation Right Route Right time Right documentation
What is the single most preventable cause of patient injury
Medication error
they are responsible for about 25% of cases against general practitioners
Medication Errors can be
Prescribing
Dispensing
Administration
Prescribing Errors include
incorrect drug dose strength, rout, quantity
failure to comply with legal requirements for prescription
adverse patient effects
incorrect dosage calculations
incorrect frequency
Dispensing errors
occur at any stage during the dispensing process from the receipt of the prescription in the pharmacy through to the supply of a dispensed product to the patient
dispensing errors include
wrong strength/product
wrong computerized labeling/transposition error (wrong dose, drug, patient)
Administration errors when
there is a discrepancy between the drug therapy received by the patient and the drug therapy intended by the prescriber
Drug administration errors largely involve
erros of omission
What are other types of drug administration errors:
wrong administration technique
administration of expired drugs
wrong preparation administered
wrong landmark
ss
1/2
1 qt
4 cups
1 pt
2 cups
8oz
1/2 pt = 1 cup
IX ss
X ss
9 1/2
10 1/2
What time refers to
what time IS it, has it been signed for as given, and is it a time-limited drug
What is the only reason you would not discard of a medication from stock supply after a patient refused it
CONTROLLED DRUGS
Unopened unit doses may be returned to drawer
What happens to the medications a patient is taking if they go in for an operation
ALL medication orders are discontinued and new orders must be written post operatively by physician
If a patient is an ambulatory risk, what must the nurse do when administering medications
Face patients and remain with them until they swallow
Where are controlled substances stored
double locked in a stationary cupboard at all times
They must be signed for on a registry or computer at the time they are removed from cupboard
What are “time limited” drug classifications
controlled substances
antibiotics
anticoagulants
steroids
Pregnancy category X
cannot give the medication
Pregnancy category A
safe to be given to pregnant lady
What are things you need to remember for liquid medication administrations
solution vs. suspension (adequately shake a suspension)
pour away from the label
hold the medicine cup at eye level
read the bottom of meniscus
wipe “drip” off top of bottle before replacing the cap
Once a medication is prepared it must
remain in your sight until administered
When administering an ampule medication
Break ampule away from you (if you cut self, discard ampule)
Use a filter needle to remove the medication from the vial
Then discard needle and replace it with the correct one
If you are to mix insulin which insulin do you draw first
short acting followed by your intermediate acting
What are Sub Q injection sites
abdominal (2 finger length from umbilicus) Vastis lateralis Behind arm Sub Scapular "Buffin" Top (right over the butt)
What are the IM injection sites
Venterogluteal
Vastis Lateralis
Deltoid
What injection site is no longer used for IM injections and why
Dorsogluteal site - risk for damaging the cystic nerve
What is the only recommend IM site for newborns
Vastis lateralis
