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Nursing Skill Revision > Medication/fluids Administration and Calculation > Flashcards

Medication/fluids Administration and Calculation Flashcards

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1
Q

What does APINCHS stand for?

A

High risk medication:

Antimicrobials
Potassium and electrolyte
Insulin
Narcotics & sedatives
Chemotherapeutic drugs
Heparin and anticoagulants
Systems ( independents double checks & Medication charts)

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2
Q

Six rights of medication

A

Right drug
Right Dosage
Right route
Right date and time
Right patient ( Patient ID and med chart)
Right documentation

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3
Q

When are Second nurse check of medication required?

A

For all parenteral medication (IV, subcutaneous inj)

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4
Q

What does the second nurse need to check for medications?

A

Patient ID
Med chart
Vial of medication / dosage
amount in syringe
Compatible fluids

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5
Q

What other checks are necessary besides the 6 rights?

A
  • allergies
  • expiry date of medication
  • compatibility of fluid to medication
  • does patient have fluid restrictions
  • possible side effects of medication
  • patient with liver/ kidney problems
  • checking vitals beforehand (BP, RR, HR) for certain medication that alter vitals
  • Australian Medication Handbook or online medication site
  • independent double checks
  • patient education
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6
Q

What is Mane?

A

Morning

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7
Q

What is Nocte?

A

Night

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8
Q

What is ac?

A

Before meals

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9
Q

What is pc?

A

After meals

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10
Q

What is BD?

A

Twice a day

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11
Q

What is TDS?

A

Three times a day

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12
Q

What is QID?

A

Four times a day

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13
Q

Routes of administration: sublingual

A

Medication that are placed under the tongue to dissolve

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14
Q

Routes of administration: buccal

A

Medication held in mouth against mucous membranes of cheek

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15
Q

Routes of administration: PICC

A

Peripherally inserted central catheter ( arm to heart)

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16
Q

What are the common subcut regions ?

A

Abdominal umbilical region (5cm away form belly button)
Thighs

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17
Q

How many mls of medication is safe to deliver via subcut inj?

A

0.5 to 1ml

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18
Q

What is the pinch test when deciding the angle of a subcut inj?

A

If less than 25mm of tissue is grasped form the site, insert need at 45 degrees while pinching tissue

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19
Q

A dose of 4500mg of medication ordered. The medication comes in 5g/0.3ml. What volume will you give the patient.

A

Formula: dose required (mg) / stock strength (mg) x stock volume(ml)/1

4500/5000 = 0.9
0.9 x 0.3 = 0.27

20
Q

A dose of 3500mg medication ordered. The med comes in 5g/2ml
What volume is given to patient.

A

3500/5000 = 0.7
0.7 x 2 = 1.4

21
Q

Patient weighs 45kg and prescribed med for 3mg/kg/dose
Stock strength is 2mg/0.5ml. What volume will you give patient?

A

45 x 3mg = 135
135/2 x 0.5 = 33.75mls

22
Q

A patient needs 0.075g of medicine that comes in 30mg tablets. How many tablets will the patient take?

A

1000mg = 1g

0.075g x 1000 = 75mg

75/30 = 2.5

23
Q

The total so volume ordered is 550mls N/S 0.9%. The time which is to be given is 4 hours. The drop factor is 20. How many drops per minute is delivered?

A

550/4 = 137.5mls per hour
137.5/60 = 2.29mls per minute

2.29mls x 20 drop factor = 46 drops per minute

24
Q

1300mL N/Saline 0.9% is running at a 6 hourly rate, which commenced at 1500hrs. At 1630hrs
the doctor requests for the remaining volume to be run over 3 hours. Calculate the mL per hour
for the remaining volume

A

Original rate —> 1300mls / 6 hourly

1.5 hours passed since commencement. 6/1.5 = 4

1300 / 4 = 325mls have been given to patient since commencement

Remaining volume = 1300 - 325 = 975mls

975 / 3 hours = 325mls / per hour

25
Q

1200mL N/Saline 0.9% has been running for 20 minutes at a 2 hourly rate. How many mL have
been administered already?

A

1200mls/2 hourly

2 hours = 120 minutes

20/120= 1/6

1/6 x 1200 = 200 mls administered

26
Q

The dose to be given of a medication is 5mg. The stock strength is 1mg/4mL. Calculate the mL
needed to deliver the medication.

A

5/1 = 5
5 x 4ml = 20mls

27
Q

Your patient is receiving 350MICROg of a medication in 750mL of CSL. How many MICROg per
mL is the patient receiving?

A

0.5MICROG per mL

28
Q

A child who weighs 5kg is ordered 0.5g/kg IV, 4 hours before surgery. The solution strength is
2mg/mL. How many mL per hour do you administer?

A

5kg x 0.5g = 2.5g

2.5g = 2500mg

2500/2 = 1250mg

1250\4 hrs = 312.5mls

29
Q

1.5L N/Saline 0.9% is running at a 12 hourly rate, which commenced at 0800hrs. At 1200hrs the
doctor requests for the remaining volume to be run over 4 hours. Calculate the mL per hour for
the remaining volume.

A

Original rate: 1.5L / 12 hourly

4 hours have past since commencement. 12/4 = 3
1.5/3 = 0.5L has been administered to patient.

1.5 - 0.5 = 1L volume remaining

1L / 4 =
New rate: 0.25mls / hr

30
Q

A child who weighs 14kg is ordered 55MICROg/kg IV, 2 hours before surgery. The solution
strength is 2mg/mL. How many mL do you administer?

A

14 x 55 = 770 microg

770 microg / 2000 microg = 0.385 mls

31
Q

A child who weighs 5kg is ordered 0.5g/kg IV, 4 hours before surgery. The solution strength is
2mg/mL. How many mL per hour do you administer?

A

5kg x 0.5 = 2.5g

2.5g = 2500mg

2500mg / 2mg = 1250mls

1250mls / hour

32
Q

What does hypotonic IV fluids do ? And give example

A

Fluids goes into cells to expand the cell and increase total body fluid volume

Example: 0.45% normal saline

Hypotonic solutions have a lower concentration of dissolved solutes than blood - the 0.9% solute concentration (homeostasis) in blood is lowered so fluid need to move into cells intracellular space

33
Q

What does isotonic IV fluids do? And give example

A

The fluid replenishes cells from a fluid loss without changing shape

Example: 0.9% normal saline,

Because the concentration of the IV fluid is similar to the blood, the fluid stays in the intravascular space and osmosis does not cause fluid movement between compartments

34
Q

When is hypotonic fluids used ?

A

DKA

TO increase total body fluid of patient

Cellular dehydration ( if you don’t have enough water circulating through your body, water will be drawn from the inside of the cells due to increased osmotic pressure — causing those cells to shrink)

35
Q

When is isotonic solution used in patient ?

A

HYPOVOLAEMIA
hypotension
Burns
Blood loss
Anaphylaxis
Sepsis
Dehydration

36
Q

What does hypertonic IV fluids do ? Give example

A

Fluid goes out of cell to shrink cells and to decrease fluid levels (dehydrate cells)

Example: 3% normal saline

Hypertonic solutions have a higher concentration of dissolved particles than blood
causes the osmotic movement of water out of the cells and into the intravascular space to dilute the solutes in the blood

37
Q

When is hypertonic fluid used?

A

Fluid overload
Cerebral oedema
Ketosis

38
Q

What nursing consideration are needed for hypertonic and isotonic IV fluids ?

A

Hypervolaemia fluid overloading

39
Q

What is used to treat severe Hypernatremia?

A

Hypernatremia occurs due to net water loss or excess sodium intake

Hypotonic solution 0.45% normal saline provide

40
Q

What nursing consideration is needed for hypotonic IV fluids ?

A

Hypovolaemia x low fluid volume in body

41
Q

What is considered in an Independent double checks

A

Medication
Prescription
Dose
Rate
Diluent compatibility
Labels - expiry

42
Q

What’s checked at the bedside double checks

A

Patient ID
Allergies
Infusion lines
Pump settings

43
Q

Writing medication dose as whole numbers

A

500mg ✅
0.5g 🚫

125mcg ✅
0.125mg 🚫

NEVER USE A TRAILING 0 example: 1.0g 🚫
ALWAYS WRITE 1g

44
Q

Common symbols abbreviations used when nurse does not administer medication

A

A - Absent
F - Fasting
R - Refused
V - Vomiting
W - Withheld
N - Not available (med)

45
Q

Patient due for 1.5g Vancomycin antibiotics
Stock strength is1g reconstituted with 20mls water for injection

Stock strength —> 1000mg / 20mls = 50mg/ml

Calculate how many mls you will need to draw up to obtain required dose of 1.5grams

A

1500/ 50 = 30mls

46
Q

What does a ratios of strength 1:1000 for adrenaline represent ?

A

1g of adrenaline in 1000mls of solution.

Amount of unit per volume = 1mg/ml

1mg/ml is common IM dose for Anaphylaxis

Nursing Skill Revision (12 decks)

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