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NRSG Patho/Pharm Quiz 1 > Medication Safety > Flashcards

Medication Safety Flashcards

1
Q

6 Rights

A

RIGHT:

  1. person
  2. time
  3. drug
  4. dose
  5. route
  6. documentation
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2
Q

The 3 checks for med safety should occur when?

A
  1. When pulling the drug from Pyxis
  2. When putting it in the med cup (or sometime
    between med room and giving it to the pt).
  3. At the bedside, just prior to giving the medication.
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3
Q

What are the 2 patient identifiers?

A
  1. Patient’s name

2 DOB

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4
Q

What are some common med errors?

A

Monitoring issues (BP, vital signs, labs)
Non standard times
Preparing drugs for multiple patients
Oral liquids in parenteral solutions

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5
Q

What is negligence?

A
  1. Duty of care - must exercise a reasonable standard of care.
  2. Standard of Care - is the act reasonable? Ex: checking allergies/labs before med administration.
  3. Scope of practice
  4. Liability - action or inaction caused pt harm
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6
Q

How are med errors prevented?

A
  1. Know scope of practice.
  2. Know the med - why admin? What would make you hold it? Pharmacokinetics/dynamics/side effects and CI. Monitor vs post admin.
  3. Verify 6 rights/3 checks/2 identifiers.
  4. Avoid workarounds.
  5. LIMIT DISTRACTIONS!
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7
Q

By verifying 6 rights/3 checks and 2 identifiers, you are preventing?

A

medication admin errors

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8
Q

Steps after a med error occurs?

A
  1. Notify supervisor.
  2. Notify provider.
  3. Occurrence/incident report
  4. Monitor the patient!
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9
Q

What information should not be included in the patient’s chart?

A

That an occurrence/incident report was filed.

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10
Q

Drugs have how many names?

A

3 -

Chemical, generic, and trade

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11
Q

When should a patient’s medications be reconciled?

A

Three times!

  • admission
  • any time a patient changes floors/units
  • at DC
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12
Q

Drugs not used for medicinal purposes with a high addition potential is what schedule?

A

Schedule I

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13
Q

Drugs with the least risk of abuse or dependence are classified as what schedule?

A

IV

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14
Q

Schedule II drugs are?

A

Used for medicinal purposes, high risk of dependence/abuse. Ex: morphine.

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15
Q

What are the types of orders?

A
  1. routine scheduled
  2. prn
  3. stat
  4. one time dose
  5. standard orders
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16
Q

Orders must contain

A
  • date and time order was written
  • name and dose of the drug
  • route and frequency
  • any specific instructions (ex: hold if SBP
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17
Q

What are the identifiers?

A
  • name, date of birth
  • identification bracelet
  • MAR
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18
Q

What is the procedure for wasting narcotics?

A

Must have someone witness the waste.

19
Q

It is ok to give meds prepared by another nurse T/F?

A

FALSE. Unless it’s still in the package!

20
Q

Can enteric coated or SR medications be crushed?

A

No

21
Q

If a provider prescribes a med, you have to follow it T/F

A

False. Remember, the BON rules trump the facility’s scope of practice.

22
Q

What are the enteral routes of med administration?

A 
PO
Gastric tubes (NGT/GT/JT)
23
Q

What are the parenteral routes of med administration?

A 
- by needle!
SQ or SC
IM
IV
Intradermal
24
Q

Scored tablets only can be broken T/F

A

TRUE

25
Q

What tablets cannot be crushed?

A

enteric coated, SR, ER, -contin, LA, XL, XR, SA

26
Q

What should be checked prior to administering meds via gastric tube?

A
  1. CHECK PLACEMENT
  2. HOB at 30 degrees
  3. Flush
  4. Check residual
27
Q

What is the best site for adult IM injection?

A
  1. ventrogluteal ( 2-3 mLs)
  2. Deltoid (up to 1 mL)
  3. Vastus lateralis (2-3 mLs)
28
Q

What is the best site for child IM injection?

A
  1. vastus lateralis (for children not walking yet)
29
Q

What should be assessed with IV sites?

A
  1. Check for PATENTCY!
    • blood return
    • easy flush
  2. check for phlebitis (streaking)
  3. infiltration/extravasation
  4. infx
30
Q

What is the timeframe that vitals can be used if giving meds, i.e. BP?

A

Vitals can be used if within one hour, otherwise vitals should be checked prior to med admin (BP med).

31
Q

Causing a patient harm by an action performed would be what kind of negligence?

A

Liability. Ex: giving a patient insulin w/out checking blood sugar. Ex: giving dixogin when levels are already at toxic.

32
Q

Not checking for allergies prior to admin a med would be under what type of negligence?

A

Standard of Care. Would another under the same circumstances think action is reasonable?

33
Q

Not knowing what types and forms of medications that can be administered as a nurse is a breach of what?

A

Scope of practice. Ex: doing a procedure not in scope, designated by BON.

34
Q

Duty of Care

A

must exercise a reasonable standard of care

35
Q

What abbreviations must never be used?

A
  1. U for unit. Must write it out.
  2. IU for international unit.
  3. QOD for every other day.
  4. QD for daily.
  5. MS for morphine sulfate
    * *dosages must have leading and following zeros.
36
Q

What site should be used if giving an IM injection that is 1 ml or less?

A

Deltoid. 3 finger breadths below acromion process.

37
Q

You are giving a 2-3 mL IM injection to an adult. Where is the best site?

A

Ventrogluteal

38
Q

Using the vastus lateralis for 2-3 mL IM injections is best for?

A

Children not yet walking.

39
Q

What needle length should be used for an IM injection?

A

1-3” Usually 1.5 is average.

40
Q

What gauge needle should be used for IM injections?

A

19 -23. (larger number = smaller the lumen).

41
Q

What 3 things must you know before administering a drug via an IV push?

A
  1. RATE
  2. DILUTION
  3. COMPATIBILITY WITH RUNNING MEDS
42
Q

Signs of an infiltrated IV site?

A

Edema and coolness around site.

43
Q

What should you know before admin IVPB?

A

Compatibility with running med.

- PB must be higher than primary.

NRSG Patho/Pharm Quiz 1 (3 decks)

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