Medication Administration and Glucose Testing Flashcards
What are the six rights of medication administration?
Right patient,
right medication,
right dose,
right time,
right route,
right documentation.
What are the three checks during medication administration?
- Check meds with EMAR when retrieving them.
- Check meds against EMAR before entering the patient’s room.
- Final check at bedside before administration.
How should high-risk medications be verified?
Use two licensed nurses to verify the dose according to facility protocol.
When should gloves be worn during medication administration?
When handling medications directly or if contact with bodily fluids is possible.
What should you do if a patient questions an unfamiliar pill?
Verify the medication with the pharmacy or drug guide before administering it.
What is the correct position for administering rectal suppositories?
Sims’ position (left side with right knee drawn up).
What should be done if a medication drops on the floor?
Discard the medication following OSHA and HIPAA guidelines.
How are eye drops correctly administered?
Place drops in the conjunctival sac, avoid touching the eye, and press the lacrimal duct for 30 seconds.
What is the proper method for administering sublingual medications?
Place the medication under the tongue to allow rapid absorption and avoid liver metabolism.
Ex nitroglycerin → angina
How should transdermal patches be handled?
wear gloves. Remove the old patch, cleanse the skin, and apply a new patch in a different location. (check for skin irritation) dispose of old patch in med waste
What is the process for nasal spray administration?
Clear the nose, occlude one nostril, and spray the medication into the other nostril.
What should be done if the patient vomits after taking a medication?
Notify the physician and follow instructions regarding re-administration.
How should medications be documented after administration?
Document in the EMAR immediately after confirming the patient has taken the medication.
How are ear drops administered in adults?
Pull the ear up and back, apply drops along the canal wall, gently massage tragus to move drops into ear and have the patient remain on their side for 10 minutes. cotton ball
What should you do if the patient refuses a medication?
Document the refusal according to facility policy and notify the physician promptly.
What are examples of medication groups?
Scheduled (routine)
PRN (as needed)
unscheduled (on hold)-post op
Continuous infusions (IV)
Discontinued medications
what are two reason rectal suppositories are given?
NPO or constipation
do we document pre or post med. administration assessments?
both
what is involved with med research?
-diagnosis/history
-why receiving?
-pre assessment
-calculations
can we give controlled substances?
yes, with instructor present
how do we cut up a patients meds?
with their own disposable pill cutter
what is it important to focus on when pulling meds from a dispensary machine?
verify medication, dosage and expiration date only on packages while withdrawing drom dispensary machines
is it ok to give meds another nurse has already put into a cup?
no
what is the minimum for patient teaching?
-what is the med
-action of med
-potential common and LT adverse effects
how do we verify a nonverbal patients id?
verify name and second identifier, utitilize family
match arm band against EMAR
can you meds on pt. bedside to take later?
no
if patient refuses med what do we do?
uncheck the box and explain the risks of not taking the med
follow up with HCP, RN
what can be used to help with patients who do not swallow meds well?
applesauce or pudding or crushing meds
what is pocketing?
keeping meds in mouth to spit out later
can you leave meds on a cart unattended?
no
when pouring liquid med we measure at the ________
meniscus
what meds cannot be crushed?
enteric coated
extended release (ER)
sustained release (SR)
CD CR
how to give buccal med
why effective?
btw gum and cheek
rapid action, very vascular
avoids first pass effect
ointment for the eye should be applied how?
applied inner canthus (corner of eye) to outer in a thin line
what is the most common reason vaginal suppositories are given?
yeast infection
how to give a vaginal suppository
back lying, legs spread, insert med into canl, allow to absorb 5-10 minutes before getting up
if a pt. is nauseous when you arrive to administer meds. what is your best action?
hold meds until nausea is dealt with
what do you write on a transdermal patch?
date, time and initials
you go to give you pt. meds but the pt. has left for radiology. what should you do?
hold onto meds in a safe place (in packages) and try to give later
What is the rationale for bedside blood glucose testing?
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Monitor patients at risk for hypoglycemia or hyperglycemia.
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Monitor the effectiveness of insulin or oral antidiabetic drug therapy.
Who is at risk for hypoglycemia or hyperglycemia and requires bedside blood glucose testing?
Diabetics
Patients taking steroid medications
Patients on total parenteral nutrition (TPN)
Patients with other illnesses that affect glucose levels
When should bedside blood glucose testing be performed?
As ordered by the doctor
Typically before meals (AC) and at bedtime (HS)
More frequently for unstable patients
In crisis situations, such as decreased level of consciousness
Front: What patient assessments should be considered before bedside blood glucose testing?
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Prior blood glucose results (trends) off
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Any signs or symptoms of hypoglycemia or hyperglycemia
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Risk for bleeding, especially if the patient is on anticoagulants
- crisis sit. w/ decreased LOC
- unstable pt.
-pt. assessment
-MD order
-before meals and at bedtime
What should be done in case of hypoglycemia?
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If blood glucose is less than 60 mg/dL with symptoms, give some form of glucose.
what are some forms of glucose for hypoglycemia?
oj (PO)
dextrose IV (NPO)
glucagon (at home)
What should be done with unusual results of bedside blood glucose testing?
-correlate values w/ assessment
-lab confirmation of critical
-insulin sliding scales
-notify RN
what is an insulin sliding scale?
made by physician for individual pt. so that he doesn’t have to be notified about every glucose check
what is given with insulin at bedtime?
a snack so that blood sugar doesn’t plummet
how is the glucose testing site cleaned?
soap and water or alcohol
where is a glucose check preferred to be taken?
sides of finger pad, rotate sites
what eqipment is uded for glucose testing?
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Gloves
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Sterile lancets
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Cotton balls or 2x2 gauze pads
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Glucose test strip
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Glucose meter
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Soap and water or alcohol swabs
how is hemostasis used in glucose testing?
cotton ball or gauze to stop the bleeding
what is a normal glucose range?
70-110 or 120
how are glucose results uploaded?
automatically by meter, still must tell RN the results promptly (w/ sticky note)
