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Skills > Medication Administration chp 25 > Flashcards

Medication Administration chp 25 Flashcards

1
Q

the transmission of medications from the location of administration to the bloodstream

A

absorption

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2
Q

Oral: barriers to absorption

A

medications must pass through the layer of epithelial cells that line the GI tract

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3
Q

Subcu and IM: barriers to absorption

A

capillary walls have large spaces between cells. Therefore, there is no sign. barrier

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4
Q

Highly soluble medications have rapid absorption times between __ to ___

A

10-30 mins

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5
Q

sites with high blood perfusion have ____

A

rapid absorption

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6
Q

IV absorption pattern

A

immediate: enters blood directly
complete: reaches blood in its entirety

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7
Q

The transportation of medications to sites of action by bodily fluids

A

distribution

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8
Q

Factors influencing distribution: (3)

A

circulation
permeability of the cell membrane
plasma protein binding

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9
Q

changes medication into less active forms or inactive forms by action of enzymes.

A

metabolism (biotransformation)

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10
Q

A ___ ___ level is in the therapeutic range when it is effective and not toxic.

A

plasma medication

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11
Q

Short half- lives leave the body in:

A

4-8 hours

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12
Q

when giving short-dosing intervals or MEC drops between doses you can

A
  • give medications at longer intervals without a loss of therapeutic effects
  • medications take a longer time to reach a steady state
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13
Q

the interactions between medications and target cells, body systems, and organs to produce effects.

A

Pharmacodynamics

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14
Q

oral or enteral medications should be given __ - ___ before meals and ___ after meals

A

30 mins-1hr

2 hrs

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15
Q

kids are dosed based on their body weight until they reach ____kg

A

50kg

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16
Q

Secondary effects of Pharmacodynamics are:

A

Unintended
non therapeutic
usually: predictable, harmless, or harmful

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17
Q

Harmful, unintended, usually unpredicted reactions to a drug administered at the normal dosage.

A

Adverse reactions

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18
Q

When the immune system identifies medication as a foreign substance that should be neutralized or destroyed

A

allergic reaction

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19
Q

POLAR OPPOSITE of what you would expect to happen when giving a drug. ( Benadryl can make you wired when its really supposed to make you tired)

A

Idiosyncratic reaction

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20
Q

Drug Interactions:
when drugs are mixed and cause deterioration of one or both drugs. (Aderol mixed with something else in IV.. forms precipitate)

A

Incompatible drugs

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21
Q

Components of the medication order/prescription. Must be on there ( 6)

A
  1. client’s full name
  2. date and time
  3. name of med
  4. dosage size, frequency, # of doses
  5. route of administration
  6. signature of prescriber & DEA #
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22
Q

Common Medication errors are caused by:

A
  • lack of knowledge or info
  • faulty communication
  • equipment errors
  • calculation and measurement errors
  • similar names of medication OR patient names
  • nurse fatigue, distraction, interrupted
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23
Q

What’s the first thing you do if you commit a med errors?

A
  1. ASSESS THE PT!
  2. Report findings to the primary care provider!
  3. Report it to your preceptor or charge nurse
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24
Q

When do yo perform the 3 med checks?

A
  1. Before you pour- at the med cart compare the label and MAR
  2. After you pour- verify the label against MAR
  3. At bedside- before you administer
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25
Q

Buccal and Sublingual medications are meant to be absorbed in the ___ not the ___

A

mucous membrane

not the GI tract

26
Q

What’s one thing that you absolutely DON’t do when giving medication through a Enteral tube?

A

Don’t give HYDROPHILIC meds through feeding tubes. Attract water & will solidify in tubes

27
Q

When administering Parenteral medications, you should always make sure you do what two things for safety:

A
  1. Avoid recapping a dirty needle

2. Use sharps containers

28
Q

Examples of:
IV push-
IV piggyback-
Medicated drips-

A

push: single dose over a few minutes (steroids, pain med)
piggyback: antibiotics infused over a certain amt time
drips: insulin, ativan, antihypertensive drips, drips to lower inter-cranial pressure

29
Q

Stages of Cognitive Development:

A
  1. Preoperational (2-7 yrs old)
  2. Stage of Concrete Operations (7-11yrs old)
  3. Formal Operational (11-older)
30
Q

Schedule I narcotic:
Schedule II narcotic:
Schedule III narcotic:

A

I; ^ abuse, no medical use
II: acceptable medical use, ^ potential abuse
III: medically acceptable drugs that may cause dependency

31
Q

What type of drug should be given when you want a longer acting effect?

A

lipid-soluble drugs

32
Q

Acid drugs are more rapidly absorbed in the:

Basic drugs are more rapidly absorbed in the:

A 
stomach 
small intestines (sodium bicarbonate)
33
Q

Ionized molecules are:

Nonionized molecules are:

A

lipid insoluble- cant pass through phospholipid bilayer

nonionized easily absorbable

34
Q

An example of when an ionized medication is taken and can be antagonized by another medication in stomach

A

Taking an antacid before an aspirin
antacid increases the pH of the stomach, aspirin becomes more ionized which impairs its absorption and reduces its effects

35
Q

Diabetic patients can’t metabolize sugars effectively, so they should never be given:

A

an elixir ( ^ sugar content)

36
Q

___ increases the potential for adverse reactions and dangerous drug and food interactions?

A

Polypharmacy

-administering many drugs to treat different conditions

37
Q

Other Rights for patients receiving medication include: (3)

A
  1. Right reason- given the medication for the right reason
  2. Right to Know- tell pt name of med, why given, actions, & potential side effects
  3. Right to Refuse- pt has the right to refuse meds
38
Q

To prevent choking in infants/toddlers when administering liquid medication you should:

A
  • have mom sit them up or semi-sitting position.
  • use a medicine dropper or syringe to place med between the gum & cheek.
  • avoid giving too much too fast
39
Q

What are some examples of a localized topical med and a systemic topical med?

A

local: zinc oxide put on butt to reduce irritation from bowels/bladder incontinence
systemic: estrogen patches, transdermal medication)

40
Q

to prevent infection when applying otic medications, what should be done if tympanic membrane is ruptured or surgical procedure has been done?

A
  • use sterile technique
  • don’t irrigate with warm saline
  • don’t use a metal syringe
  • don’t use oral jet irrigation
  • don’t use “ear candling” with hot wax
41
Q

what can happen with long-term use of nasal decongestants?

A

rebound effect- medication is effective but congestion will recur and ^ when the effect of the decongestant wears off

42
Q

What are the disadvantages to rectal medications?

A
  • absorption is slow & erratic bc of rectal contents, local drug irritation & uncertainty of drug retention in the rectum
43
Q

What is the main advantage to rectal medications?

A
  • may provide for higher blood levels of medication compared to oral
44
Q

When is a rectal medication preferred over an oral?

A
  • has a bad taste/odor
  • not safe to use oral (GI issues etc)
  • pt has vomiting or unconscious
45
Q

When is it ok to delegate a rectal medication?

A
  • when it’s a glycerine suppository (non-medicated)
46
Q

What are the 4 types of Nebulizers?

A
  1. Atomizers- medication in large droplets
  2. Aerosol spray- gas (O2 spray)
  3. Ultrasonic (handheld) nebulizer- med (1ml) mixed with saline (3mL)
  4. Metered Dose- measured dose delivered each time
47
Q

What is the main advantage to using a Meter-dose inhaler?

A

rapid delivery- produces local effects directly in the airway while avoiding systemic effects

48
Q

When would you not use a Dry powder Inhaler?

A

young kids or elderly

- need for dexterity so its hard for those who can’t control hand movements precisely

49
Q

What are some disadvantages to parenteral medication?

A
  • tissue damage can occur if PH, osmotic pressure, or solubility of med is not appropriate for that tissue
50
Q

It’s recommended to add air into needles for certain situations (0.2mL at top of syringe) (2)

A
  1. when the med is irritating to subcutaneous tissues the air will drive med deep into the tissue
  2. when you change needles after drawing up the medication
51
Q

Absorption of subcutaneous injections is ___ than IM injections

A

slower than IM

** less blood supply than muscle** going into fat

52
Q

Subcut injection is faster in the site __ and __ and slower in the ___ and ___ sites

A

faster: abdomen & arms
slower: thigh & upper butt

53
Q

What should you check before administrating a heparin shot?

A

activated partial thromboplastin time (aPTT)

- check for signs of bleeding (gums, IV injection sites) or cover bleeding (urine & stool)

54
Q

For subcutaneous medications, only small amounts of _____ medication should be administered. What should you avoid doing with subq shots?

A

water-soluble meds
avoid creating sterile abscesses (hardened, painful lumps under skin) from administering in the same spot over and over again.

55
Q

Heparin is only given by the ___ and ___ route. If given by ___ route it can cause:

A

IV or subcut

IM route: hematoma & pain (esp older women)

56
Q

When administering IM injection, ____ site is #1. You should avoid using the ___ site bc ___

A

Ventrogluteal site

Dorsogluteal site bc of its proximity to the sciatic nerve & superior gluteal artery

57
Q

what is the preferred site for IM injection for:
infants-
children-
adults-

A

infant: vastus lateralis (avoid deltoid)
child: anterolateral thigh (deltoid can if they have enough muscle mass)
adults- deltoid 4 vaccines, Ventrogluteal for all other IM

58
Q

what is a protein and will be destroyed if administered through PO (GI tract)?

A

Insulin

59
Q

Categories of Insulin:

A

Basal- cover body’s energy needs w/o taking diet into account
Prandial & Preprandial- given to prevent ^ bld glucose
Correction: reduce an elevated bld glucose level

60
Q

Examples of when to hold TB skin testing:

A
  • when pt has history of skin reaction/allergy
  • pt is pregnant, receiving chemotherapy, or severe eczema
  • pt has topical anesthetic cream on skin (apply on site with no anesthetic cream or reschedule)
  • pt received live vaccine @ time of TP skin testing
    ( TB skin test should be deferred for 1 month post vaccine)

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