Medicine Administration Flashcards
What does the route of a med mean ?
how it enters the body
What does the absorption of a med mean ?
how it gets from the site into the bloodstream
What does the distribution of a med mean ?
how it gets from blood into cells, tissues or organs
What does action of a med mean ?
how does it alter the physiological functions of the body
What does the metabolism of a med mean ?
how does it get changed to prepare for excretion
What does excretion of a med mean ?
how it exits the body
What does therapeutic effect mean ?
the expected affect (physiological response) of a med
- can have more than 1 therapeutic effect
What does side effects mean ?
unintended, secondary reactions to a drug
- usually not life-threatening
What does adverse effects mean ?
undesirable and potentially dangerous responses to a medication
- Ex.) seizures
What does toxic effect mean ?
specific risks and manifestations of toxicity
- develop when med accumulates in the blood
What does idiosyncratic reaction mean ?
abnormal/unexpected response to over or under reaction to a medication
- peculiar to an individual pt
What does an allergic reaction mean ?
hypersensitivity to a medication
What is a drug-drug interaction ?
when one medication modifies the action of another
What is a synergistic effect ?
combined effect of 2 meds is greater then the effect of the meds given separately
What does serum half-life mean ?
time for serum medication concentration to be halved through metabolism
What does onset mean ?
time it takes for a med to produce a response
What does peak mean ?
time at which a med reaches its highest effective concentration
- IV vs PO
What is trough level ?
lowest concentration of drug reached in the body after it falls from its peak level
What does duration of action mean ?
length of time the concentration of a drug in the blood or tissue is sufficient to elicit a response
What does plateau mean ?
blood serum concentration is reached and maintained
What are the 10 rights of med administration ?
- right client: 2 identifiers (full name and DOB)
- right drug: need order, match with MAR
- right dose
- right route
- right time: institutional (each facility has different standards for what is considered “late”
- right assessment (allergies, contraindications, VS, diet)
- right documentation: after its given
- right to refuse
- right education
- right evaluation
What do you do if a pt refuses a med ?
you educate the pt further as to why they should take the med and investigate further as to why they don’t want to take the med
- don’t just give up immediately
What does every medication order have to include ?
- pt’s name
- order date
- med name
- dose
- route
- time of administration
- drug indication
- and prescriber signature
What are important things about medication orders ?
- prescriber can be physician, NP, or PA (physician assistant)
- orders can be written (hand or electronic), verbal, or given by telephone
- use of abbreviations can cause errors so use caution
- don’t make any assumptions
What is a standing or routine order ?
administered until the dosage is changed or another medication is prescribed
What is a PRN order ?
given when the pt requires it
What is a single (one-time) order ?
given one time only for a specific reason
What is a STAT order ?
given immediately in a emergency
- within 30 mins
What is a now order ?
when a medication is needed right away
- not a STAT
- 30-60 mins
What is a prescription order ?
medication to be taken outside of the hospital
What is the RN’s role in med administration ?
- assess pt’s ability to self-administer
- determine whether they should receive med (don’t just give because it’s ordered but evaluate them too and if something seems wrong then call for physician)
- administer med correctly
- closely monitor effects
- DO NOT delegate task
Why are avoiding interruptions important when administering medication ?
it can generate med errors
What is the standard to ensure you have the right med ?
read labels at least 3 times and compare to MAR
What is the RN’s role in medication errors ?
- report all med errors (incident report and to provider)
- have to report near misses too
- documentation is required
- incident report has to be accurate, factual of what occurred and what was done
What are examples of enteral/oral med routes ?
- sublingual and buccal
What are examples of paraenteral med routes ?
- IV, IM, Sub-Q, ID
What are some factors affecting oral meds ?
- convenience vs. tolerance
- easy to give
- often produces local or systemic effects
What are some characteristics of injection meds ?
- infection risk
- needles
- bleeding
- rapid absorption
What are some characteristics of skin/topical meds ?
- painless
- caution w/ abrasions/cuts
- provides local effects
- only apply to affected areas
What is a characteristic of a transdermal med ?
(patch)
- prolonged systemic effects
What is a characteristic of a mucous membrane med ?
- sensitive
- less pleasant
What are characteristics of inhalation meds ?
- rapid effect for local respiratory effect
- potential serious side effects
What is a caplet ?
coated for easier swallowing
What is a capsule ?
powder, liquid or oil in gelatin shell
What is a tablet ?
compressed powder
What is a enteric coated med ?
dissolves in small intestine
What is a time release med ?
granules with different coatings, or some tablets that dissolve slowly
- releases a steady amount of the med in your system for a period of time
What is a lozenge ?
dissolves in mouth
What is a elixir ?
mixed with water or alcohol and a sweetener
What is a syrup med ?
sugar solution
What is a suspension med ?
drug particles in a liquid medium
What is a solution med ?
mixed in water
- can be sterile for dressing changed (normal saline) or for IM, SQ, or IV routes
What is a lotion med form ?
liquid suspension for skin
What is a ointment med ?
semisolid (salve another name)
What is a paste ?
semisolid, but thicker than ointment
- slower absorption
What is a transdermal disk or patch ?
semi-permeable membrane disk or patch with drug applied to skin
- avoids 1st pass effect
- no GI symptoms because you don’t ingest
What is a suppository ?
solid drug mixed with gelatin that is inserted into body cavity to melt
- rectum or vagina
What are spacers used for with inhalers ?
when pt’s unable to coordinate breaths
- can’t press button and at the same time breathe in med and hold breathe
What do you need to use a pressurized metered-dose inhaler (pMDIs) ?
need sufficient hand strenth for use
How are dry power inhalers (DPIs) used ?
activated by patient’s breath (pt inhales to get it out)
- requires deep inhalation to release med
Why is the Z-track method used for IM injections ?
prevents tissue irritation caused by medication leaks into subcutaneous tissue
- prevent leakage of of med into SubQ tissue
What are the landmarks for a deltoid injection ?
acromion process and axillary line
- 2 to 3 finger widths below acromion process
- potential for injury because of proximity to brachial artery and radial nerve
For a deltoid injection what needle size do we use for adults and kids ?
do not use deltoid for kids younger than 3 yrs old
- adults: 1- 1.5 inches
- children: 0.5-1 in
What are intradermal (ID) injections for ?
skin testing and for local anesthetics
- best sites are inner forearm or upper back
- almost parallel to pt’s skin and bavel faces up
At what degrees do you administer a IM injection ?
90 degrees
At what degree do you administer a ID (intradermal) injection ?
15 degrees
What are SubQ injections for ?
for meds that are intended to absorb slowly
- this tissue is less vascular then muscle so its absorbed slowly
- rotate sites to avoid tissue damage
- do not aspirate for this injection
At what degree do you administer SubQ injections ?
- 45 degrees if you can pinch 1 inches of skin
- 90 degrees if you can pinch 2 inches of skin
What are IM injections administered for ?
deposits meds quickly into the muscle which is highly vascularized, so it absorbs rapidly
- aspirate for blood
- leave needle in for 10 secs to let med disperse
Where are sublingual meds administered ?
under the tongue
- quickly absorbed through mucous membrane for systemic effects
Where are buccal meds administered ?
toward the back of the mouth between to upper and lower molars and the cheek
- quickly absorbed through mucous membrane for systemic effects
For liquid meds where should you measure for accuracy ?
base of meniscus
- not edges
What are the landmarks for a ventrogluteal injection ?
head of greater trochanter and the anterior superior iliac spine
What are the landmarks for a vastus lateralis injection ?
head of greater trochanter and the knee
