Medication Administration Ch. 31 Flashcards
What 3 factors are involved in a medication name?
Chemical: exact description of the composition
Generic: manufacturer who first develops the drug assigns the name (acetaminophen)
Trade (brand): the name under which a manufacturer markets it (Tylenol)
Explain the classification of a medication
Effect of the med on body system
symptoms it relieves
Desired effect
ex. Antipyretic, antihistamine, antibiotic
What is the “medication form”?
Route of administration
ex. Solid, liquid, topical, parenteral
Define Pharmacokinetics
Study of how meds enter the body, reach the site of action, metabolize, and exit the body
Explain the steps of pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
What is the primary body organ involved in biotransformation?
Excretion?
Liver
Kidneys
Explain biotransformation
The body’s enzymes breaking down the medication
DEFINE:
Therapeutic Effect
Adverse Effect
Side Effect
Toxic Effect
Idiosyncratic Reaction
Therapeutic effect: expected/predicted physiological response to a med
Adverse Effect: unintended/unpredictable
Side Effect: Predictable, unavoidable secondary effect
Toxic Effect: Accumulation of med. in bloodstream
Idiosyncratic Reaction: Overreaction/underreaction or different reaction than normal
DEFINE:
MEC
Therapeutic Range
Peak
Trough
Biological Half-Life
MEC: Minimum Effective Concentration: lowest plasma level of a med to have the desired effect
Therapeutic range: between MEC and Toxic concentration- serum concentration range of the med working properly
Peak: highest serum level
Trough: lowest serum level- measured 30 mins before giving the next dose
Biological Half-Life: time it takes for excretion process to lower the serum med. concentration by half
Explain medication interactions
One med modifies the action of another, either diminishes or amplifies
Explain Medication Tolerance
more meds are required to achieve the same therapeutic effect
What type of meds should never be administered with an NG tube?
Enteric coated, sublingual, sustained release, extended release
What are the 4 major sites of parenteral medication routes?
ID= Intradermal
SQ= Subcutaneous
IM= Intramuscular
IV= Intravenous
What 2 parenteral med routes are usually limited to physicians?
Intracardiac
Intraarticular
What is the rebound effect os nasal medication?
Worse congestion after stopping suddenly or after taking the nasal spray for too long
Where should eye meds be administered?
Into the conjunctival sac (inside lower eyelid
How does eardrop administration differ between adults and children?
Adults= pull ear up and back
Children= pull ear down
What are some basic principles of eardrop administration?
-Instill at room temp (cold hurts)
-Sterile solutions only
-Check w/ providor for eardrum rupture if ear has drainage
-Never occlude the ear canal
How should a patient be positioned for a rectal suppository?
On left side (follows colon shape)
What are contraindications of a rectal suppository?
Heart issues/black= vagus nerve risk
Recent rectal surgey
What are the 3 types of inhalation medication?
pMDI (MDI): pressurized metered-dose inhalers
BAI: breath-actuated metered-dose inhalers
DPI: Dry powder inhalers
Why are BAI inhalers less common?
Require strong deep breath from the patient
Which type of inhalation med delivers the most med. to the lungs?
DPIs
What is the purpose of a spacer regarding inhalation medication?
Traps medication in air tube so that the patient can take multiple breaths to get the dose
What is the hardest to prepare but easiest to inhale medication?
Nebulizer
What are some rules regarding the metric system in med. measurement?
Meter, Liter, gram
Never use a trailing 0
Define Medication Error
What are the steps necessary if a med error occurs?
Any preventable event that may cause inappropriate medication use or jeopardize patient safety
Assess patient condition, notify provider
Report the incident to authority when patient is stable
File an incidence report
Report near-misses and incidents, even if they cause no harm
Explain: “Never events”
Things that should NEVER happen, such as a sponge being left in a surgical wound
List the types of med orders
Standing orders/routine med orders
PRN orders (as needed)
Single (one-time) orders
STAT orders (RIGHT NOW)
Now orders (within 90 min)
Prescriptions
List the 7 Med Rights
when are the 3 checks completed?
Med Rights:
1. Right patient
2. Right medication
3. Right dose
4. Right route
5. Right time
6. Right indication
7. Right documentation
(check expiration date once)
3 Checks:
1. After pulling the medication
2. After preparing the medication
3. At the patient’s bedside
Define DOSE
The ordered amount on MAR
Define Supply
What the pharmacy sends/how the med is packaged- concentration of the med in g/mL
Define Volume
The amount YOU calculate (based on supply and dose) to actually give to the patient
What are blunt-tip needles used for?
To draw up medications, not for skin injection
List the hypodermic needles, from 18-25 gauge
List their lengths
18 gauge, 1.5 inch
21 gauge, 1.5 inch
22 gauge, 1.5 inch
23 gauge, 1 inch
25 gauge, 5/8 inch (smallest)
Explain preparation of an injection from an Ampule
Snap off ampule neck
aspirate medication into syringe using a FILTER NEEDLE
Replace filter needle with an appropriate sized needle/device
Administer injection
Explain preparation of an injection from a vial
Inject air into vial first (same mL of air as the dose), then pull up medication
Explain how to mix meds from an ampule and a vial
Prep med from the vial first, use same syringe and filter needle to withdraw med from ample next
what’s important to remember when mixing meds from 2 vials?
DO NOT CONTAMINATE ONE MED WITH ANOTHER
What should you do if there is mediation contamination while mixing meds?
File incidence report, dispose of everything, start over
How are insulin doses measured?
Units
100-Unit syringe or an insulin pen with U-100 insulin
What type of insulin can never be given IV?
NPH
What should you do while preparing an insulin injection?
Verify insulin doses with another nurse
At what angles should each injection method be done? (excluding IV)
IM= 90 degrees
SQ= 45 degrees, maybe 90 if they’re fat enough to pinch 2 inches
ID=15 degrees, with bevel facing up
Explain IM injections
Faster absorption than SQ
90 degree angle
needle tailored to patient, usually 23 gauge, 1.5 inches
What should be done immediately after injecting the needle for an IM injection?
Aspirate (withdraw) a tiny bit to see if blood enters syringe (means you hit a vessel)
What mL (in adults) becomes too much for IM absorption?
4-5 mL are pushing how much a muscle can absorb
List the IM Injection sites
VENTROGLUTEAL site - gluteus medius
(preferred and safest for everyone)
VASTUS LATERALIS
Common for infants/toddlers/children for vaccines
used for everyone
pinching muscle helps if there is low muscle tone
DELTOID
-not well developed- most likely to cause injury- assess muscle mass
-less than 2 mL volume
Explain the Z-track method
Using the ulnar side of the hand to pull skin taut while giving an IM injection, to ensure the entry wound does not line up with the injection site after the hand is released
minimized irritation, med flowing upward into subcutaneous tissue/skin
Explain ID injections
Intradermal
-used for TB/allergy skin tests
-Slow absorption due to lower blood supply in dermis
-Use TUBERCULIN or SMALL HYPODERMIC SYRINGE for skin test
-5-15 degree angle of insertion
-Keep bevel pointed upwards
-Small bleb will form
What method is used to cap needles with one hand?
One hand scoop
Blunt tip needles must be capped when…?
doing anything other than using the needle
