Medication Administration Review Flashcards
Actions that ensure safe practice =
Standards
To prevent medication errors, what should be followed every time you administer medication?
The seven rights of medication administration
Ten rights of medication administration?
Right person, route, time, drug, dosage, right to refusal, documentation, client education, indication (assessments), evaluation
How many times do you check the 5 traditional rights?
4 times
How should you check the 5 traditional rights?
Compare the physician’s order to the MAR.
Compare meds when removed from the pyxis.
Compare when preparing medicine (med label against MAR).
Compare label to MAR to label again before administering.
Before administering meds, what should be done for each PT to ensure that you make patient-centered clinical decisions?
A thorough assessment
What are the types of orders?
STAT, Single, Standing, PRN
Topical Meds are applied to-
The skin + mucous membranes
The eyes, external ear, nose, vagina, and rectum are all classified as-
Mucous Membranes
When applying a transdermal patch, what kind of areas should you avoid?
Areas of wrinkling, lacerations, burns, abrasions
When applying a transdermal patch, what kind of areas should you be able to apply?
Clean, hairless areas
Can topical meds enter through the bloodstream?
Yes
What do you drop eye medication into?
The Conjunctival Sac
How close should the eye dropper be to the eye when administering eye drops?
0.4 - 0.8 in
How close should the ear dropper be when administering meds?
1/2 inch away from the ear canal
You have a PT over 3 years old, how would you pull their ear when instilling ear drops?
Pull up and back
You have a PT under 3 years old, how would you pull their ear when instilling ear drops?
Pull down and back
After instilling eye drops, you should gently hold pressure on the nasolacrimal duct for how long to avoid a systemic effect?
30 Seconds
After instilling ear drops, how long should a PT remain on their side for?
5 mins
After instilling ear drops, a small piece of cotton be placed loosely for how long?
15-20 mins
Are sterile solutions used for the ear? Why?
Yes, in case the eardrum is perforated
Before administering nasal meds, should the med be gently shaken?
Yes
How far should you hold the dropper above the nares when administering nasal meds?
1/2 inch
How long should the PT maintain position after nasal med administration?
1 min
Should you avoid blowing your nose for several minutes after being administered nasal medication?
Yes
What are the advantages of suppositories?
Avoids GI upset
Released slow and steady
Avoids bad med taste
Higher blood titers of medication
What position should you be in when being administered a suppository?
Sims position, with upper leg flexed
How many inches should a suppository be inserted?
About 4 inches
After being administered a suppository, PT should remain in Sim’s Postion or Supine for how long to help retain the suppository?
5 mins
How far should a suppository be inserted for an infant or child?
2 in
You should shake an inhaler for how long before administering?
5 Seconds
When administering an inhaler to a PT, their head should be tilted back and they should inhale slowly and deeply for how long while depressing the canister?
3 - 5 seconds
How long should you hold your breath after breathing in the med from an inhaler?
10 seconds
Sterile water, saline, or antiseptic solution are all commonly used to-
Irrigate/ wash out a body cavity
Is it okay for you to be in a side-lying position while taking PO meds?
Yes
Buccal =
Between check and gums
Sublingual =
Under the tongue
What’s a single order?
An order to be completed only one time
What’s a standing order?
Signed instructions of a provider authorized by state law to prescribe how the PT is to be treated for
PRN =
As Needed
What is the tip of the needle called?
The Bevel
Name off the parts of a syringe =
Plunger, barrel, needle adapter, needle hub
Do you always have to clean the top of the vial with an alcohol prep pad?
Yes
What should be used to break an ampule and how should it be broken?
A 4x4 gauze, ampule should be broken away from you
What kind of needle should be used when getting medication out of an ampule?
A Filter Needle
How much medication does an ampule contain?
1-10 mL
What kind of vials must be labelled with the date it was opened?
Multi-Dose Vials
What kind of syringes provide greater patient safety and reduce errors + waste?
Prefilled Syringes
Always use what technique during the preparation and administration of injections?
Aseptic Technique
Is it okay at times to administer meds from the same syringe to more than one patient?
No
Intramuscular (IM) = how many degrees?
90
Subcutaneous (SC) = how many degrees?
45
Intravenous (IV) = how many degrees?
25
Intradermal (ID) = how many degrees?
10-15
Injection of medication into the correct location can prevent-
Risk of injury to the tissues, nerves, blood vessels, and nodes
Parenteral =
Given via injection
What muscle is easily accessible, but not well developed in many adults?
The deltoid muscle
How many mls can the deltoid muscle take?
2 mLs or less
Injecting the deltoid muscle has potential for injury due to-
Axillary, brachial, radial, and ulnar nerves
The deltoid is used for-
Small volumes of medication + Routine immunization in adults
In order to find the deltoid muscle, you must first-
Find the acromion process (at the top bony joint of the shoulder), the injection site should be about 2 inches below it
What muscle is thick and well developed in adults?
The Vastus Lateralis Muscle
What muscle extends from a handbreadth above the knee to a handbreadth below the greater trochanter of the femur?
The Vastus Lateralis Muscle
What part of the Vastus Lateralis Muscle used for IM injections?
The Middle Third Part
What muscle provides the greatest thickness of the gluteal muscle?
The Ventrogluteal Muscle
The Ventrogluteal Muscle is free of-
Penetrating nerves + blood vessels
The Ventrogluteal Muscle has a-
Narrower layer of fat
What is the preferred and safest site for all adults, children, and infants for larger volumes of meds + meds that are more viscous and irritating?
The Ventrogluteal Muscle
To locate the Ventrogluteal site, the heel of the hand is placed over-
The Greater Trochanter of the PT’s hip
When finding the Ventrogluteal Muscle, what 3 things are supposed to form a V-shaped triangle shape?
The index finger, the middle finger, and the iliac crest
What keeps meds from leaking out of the injection site?
The Z-Track Method
Creates a zigzag like path through tissues =
The Z-Track Method
Should the Z-Track Method be held until all medication has been administered?
Yeah
For SC injections, what should be done to lower the risk of hypertrophy?
The injection sites should be rotated
What are the best sites for SC injections?
The upper arms, anterior aspects of the thighs, and abdomen
Should a SC injection be at a 90 degree angle or 45 degree angle?
Depends on amount of fatty tissue of injection site
Bevel up or down?
Up
Recap a used needle?
Never
A TB skin test = what kind of injection?
Intradermal Injection
The recommended site for TB testing for all ages =
The Forearm
ID = total amount of injectable fluid?
0.1 mL
SC = total amount of injectable fluid?
Up to 1 mL
Up to 0.5 mL (infants + small children)
IM = total amount of injectable fluid?
2-5 mL (Adults)
0.5-1 mL (Children/ infants)
Allergy testing may be performed-
Between the scapulae
When administering an Intradermal injection, older adults have decreased skin elasticity, so the skin should be-
Held taut to ensure the med is administered correctly
ID = Needle Gauge + Length?
25-27 G
3/8” to 5/8”
ID Locations?
Upper third of the forearm
Outer aspects upper arms
Between scapula
SC = Needle Gauge + Length?
25-31 G
1/2” to 5/8”
SC Locations?
Outer Upper Arms, Anterior Thighs, Upper Outer Gluteal Area, Upper Back, Abdomen
What area should be used for PTs with less SC tissue?
The Upper Abdomen
IM = Needle Gauge + Length?
18-25 G
1/2” to 1 1/2”
(Based on age/size of PT + Site used)
IM Locations?
Ventrogluteal, Vastus Lateralis, Deltoid
Preferred site for infants because it’s the most developed muscle =
Vastus Lateralis
What site is recommended adults for IM injections?
The Ventrogluteal Site
What site is recommended for vaccinations in adults?
The Deltoid Muscle
Should you ever pull back the plunger of a syringe (for 5–10 seconds) after inserting the needle, prior to injecting the medicine (Aspirate)?
Nope
