Medication Administration

Question 1

Physician’s orders must include..

Answer 1

date and time
name of drug
route
dosage
time frequency
duration, if limited
if prn, must have reason
signature

Question 2

6 Rights of Medication Administration

Answer 2

Right dose
Right patient
Right Time
Right route
Right Medication
Right documentation

2 additional: right knowledge, right to refuse

Question 3

What are the 3 checks for medication administration?

Answer 3

1: Check MAR against dr orders
2: Check medications agains MAR (drug, dose, route, time, expiration, allergies)
3: Check meds against MAR again in client room; ID pt, allergies, verify med with pt and MAR

Question 4

Documenting Medications

Answer 4

Cross out time on MAR with single line
initial
ID initials at bottom of page
include assessment info: VS, BG, LOC, Pain level

Question 5

Documenting held medications

Answer 5

circle time

and document why med was held

Question 6

Methods for inhalers

Answer 6

1. Use spacer (optimal; best for steroids)
2. take a drink
   shake inhaler, exhale
   tilt back head slightly
   hold inhaler 2 fingerbreaths from mouth
   activate, breathe in slowly and deep for 3-5 seconds
   hold breath 10 seconds
   exhale slowly
3. NOT PREFERRED; not for steroids!!
   shake, exhale, tilt head back
   place inhaler in mouth, activate
   breathe in slowly, hold 10 seconds

Question 7

absorption

Answer 7

when the med molecules pass into the blood from site of administration

Question 8

factors affecting absorption

Answer 8

route
ability to dissolve
blood flow to site
body surface area
lipid solubility

Question 9

distribution

Answer 9

after absorption medication is moved to body tissues and organs

Question 10

factors affecting distribution

Answer 10

physical and chemical properties of meds
physiology of person taking it
circulation
membrane permeability
protein binding
age/liver disease

Question 11

metabolism

Answer 11

after med reaches site it’s broken down into less active or inactive forms for easier excretion

Question 12

factors affecting metabolism

Answer 12

age

liver disease

Question 13

excretion

Answer 13

med exits body through kidneys, liver, bowel, lungs, exocrine glands

Question 14

factors affecting excretion

Answer 14

renal impairment
liver disease
peristalsis

Question 15

adverse effects

Answer 15

undesired, unintended, unpredictable response to medication
mild to severe
immediate or over time

Question 16

Who are at most risk for adverse effects?

Answer 16

very young or old
women
renal/liver disease
patients with multiple meds
extremely underweight or overweight

Question 17

side effects

Answer 17

predictable and often unavoidable effect produced at usual therapeutic dose

Question 18

most common side effects

Answer 18

N/V
diarrhea
constipation
anorexia
drowsiness

Question 19

anaphylactic reaction

Answer 19

sudden constriction of bronchiolar muscles, edema of pharynx and larynx, severe wheezing, SOB

Question 20

synergistic effect

Answer 20

combined effect is greater than if meds given separately

Question 21

trough

Answer 21

the lowest serum concentration of a medication before the next medication dose is administered

Question 22

peak

Answer 22

time it takes to reach highest level of serum concentration of a medication

Question 23

half-life

Answer 23

time it takes for excretion processes to lower amount of unchanged medication by half

Question 24

onset

Answer 24

time it takes after medication is administered for it to produce a response

Question 25

duration

Answer 25

time during which med is present in concentration great enough to produce response

Question 26

buccal administration

Answer 26

place med in mouth against cheek don't chew, swallow, drink must fully dissolve against cheek alternate cheeks

Question 27

sublingual administration

Answer 27

place med under tongue and fully dissolve | don't chew, swallow, or drink

Question 28

pharmacokinetics

Answer 28

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

Question 29

sub-q volume

Answer 29

0.5--1.5 mL

Question 30

normal needle length and gauge for SQ

Answer 30

25g 5/8" at 45 degrees or 1/2" at 90 degrees

Question 31

IM adult volume

Answer 31

2--5 mL into large muscle

Question 32

IM deltoid volume

Answer 32

< 2 mL

Question 33

What do you do if needlestick injury?

Answer 33

wash with soap and water flush report seek medical tx within 2hrs

Question 34

gauge range for SQ

Answer 34

25--31 gauge

Question 35

needle length range for SQ

Answer 35

1/2--7/8 inch

Question 36

syringe sizes for SQ

Answer 36

1 or 3 mL

Question 37

gauge range for IM

Answer 37

19--23 gauge

Question 38

needle length range IM

Answer 38

1--1.5 inch

Question 39

usual volume for ID

Answer 39

0.1 mL

Question 40

gauge range for ID

Answer 40

25-29 gauge

Question 41

needle length range ID

Answer 41

0.5--5/8 inch

Question 42

Pregnancy category A

Answer 42

okay for pregnancy | no harm in pregnant human studies

Question 43

Pregnancy category B

Answer 43

no harm in pregnant animal studies | human studies failed to demonstrate risk to fetus

Question 44

Pregnancy category C

Answer 44

animal and human studies show adverse effects | or there have been no studies to show effects

Question 45

Pregnancy category D

Answer 45

risk to fetus | benefits of drug outweigh risks

Question 46

Pregnancy category X

Answer 46

positive evidence of fetal abnormalities | contraindicated in pregnant women or women who may become pregnant

Question 47

treatment of anaphylaxis

Answer 47

``` DC drug epinephrine IV fluids steroids antihistamines respiratory support ```

Question 48

drug toxicity sx

Answer 48

``` disorientation dizziness blurred vision memory loss fainting falls ```

Question 49

s/sx of renal impairment

Answer 49

``` decreased urine output increased BUN/creatinine fluid retention fatigue confusion N/V ```