midterm Flashcards
chemical medication name
provides the exact description of medications composition
generic medication name
the manufacturer who first developed the drug assigns the name ex. acedominiphone
trade medication name
also known as the brand name, the name under which a manufacturer markers the medication ex.tylonol
Medication classifications
-effect of medication on the body system
-symptoms the medication receives
-medications desired effect
medication forms
solid, liquid, buccal, sublingual, topical, parenteral, suppositories
absorption
passage of medication molecules into the blood from the site of administration
factors that influence absorption
-route of administration
-ability of a medication to dissolve
-blood flow to the site of administration
-body surface area
-lipid solubility
distribution of medication
circulation, membrane permeability, protein building
medication metabolism
-medications are metabolized into a less-potent or an inactive form
-biotransformation occurs under the influence of enzymes that detoxify, break down, and remove active chemicals
excretion
kidney, liver, bowel, lungs, exocrine glands
therapeutic effect
expected or predicted psychological responce
adverse effect
unintended, undesirable, often unpredictable
- side effect, toxic effect idiosyncratic reaction
side effect
predictable, unavoidable secondary effect
toxic effect
accumulation of medication in the bloodstream
idiosyncratic reaction
overreaction or underreaction or different reaction from normal
medication interactions
one medication modifies the action of another
medical dependence
physical and psychological
physical dependence
body shaking and symptoms bc your body needs it withdraws symptoms
psychological dependence
brain wants it for other reasons then need
biological half life
how long it takes for meds to hit peak
four major sites of injection
intradermal, subcutaneous, intramuscular, intravenous
other parenteral routes
epidural, intracathrcal, intraosseous, intrapleural, intracardiac, intraarticular
nasal instillation methods
spray, drops, tampons
pressurized metered-dose inhalers
require hand strength and hand-breath coordination, may be used with spacer
breath-actuated metered-dose inhalers
release depends on strength of patients breath on inspiration
dry powder inhalers
activated by patients breath, deliver more medication to the lungs
preparing an injection from an ampule
use a filter needle
before injecting, what do you need to know?
volume of meds, viscosity, and location of site, minimize pt discomfort
Subcutaneous injections
-placed into loose connective tissue under dermis
-arms, abdomen, thigh
-25-gauge at 45 degree angle
ex. insulin
intramuscular injections
ex. flu, penicillin
-90 degree angle
-23-gauge
-depending on age and size of pt, use different length and amount
psa-you can split into different injections
z-track method
pull back skin, inject and release the skin to “close it” so the meds don’t come back up
IM injection sites
-ventrogluteal site is #1 spot
-vastus lateralis, used for adults and children
-deltoid, not well developed in many adults and can cause injury if given
intradermal injections
ex. tb test
27 gauge
nurses administer medications intravenously by the following methods
-infusion of large volumes of IV fluid containers that contain medications mixed, labeled and dispensed by pharm ex. iv fluids
- injection of a bolus or small volume of medication through an existing IV infusion line aka iv push
-piggyback- infusion of a solution containing the prescribed medication and a small volume of iv fluid through an existing line
continuous iv fluids vs saline lock
continuous is connected to something where a saline has nothing
needle safety with intravenous administration- blunt tip must be capped when?
-adjusting dose
-removing air bubbles
-labeling syringe
-transporting medications
-blunt tip goes straight to Sharpe
osmosis
passive transport where the lower solute transport into higher solute for equal
osmolality
the concentration of solutes in body fluids
filtration
higher to lower
medical history assessment for volemia
-burns and heart failure can cause hypo bc it docent pump right
hypovolemic pt symptoms
small veins, low bp, eye bags, dark urine, delay of capillary refill, high heart rate
hypervolemic pt symptoms
swollen, high bp, clear urine, fluid sound in lungs
acute care for volemic pts
-replacements of fluids to increase drinking
-restriction of fluids
-total parenteral nutrition ( goes straight to veins)
IV access
-peripheral- hand, arm, foot
-centeral venous catheters- goes straight to heart (central line)
how do you know the infusion rate?
lexicomp
how do you manage a line?
know when it is done, flush clean and make sure its safe and check for reactions
complications of Iv therapy
-circulatory overload of IV solution
-infiltration (extravasation)
-phlebitis
-local infection
-air embolism
-bleeding at venipuncture site
extravsastion
when damage occurs atom infiltration
phlebitis
inflammation of the vein- red, swollen, tender
albumin
protein, keep fluid where it is
universal recepient
AB+
universal donor
O-
blood implementation
-2 IV sites
- filter tubing with saline
-2 RN check
- stay with pt for 15 min
-increase rate after 15 min
-rate and hang time max 4 hrs
hemolytic transfusion reaction
-low back pain
-hypotension
-tachycardia
-fever and chills
-chest pain
-tachypena
-hemoglobinuria
-immediate onset
AC
before meals
ad lib
as desired
bid
twice a day
pc
after meals
prn
when needed
q am
every morning
Qh
every hour
q4h
every 4 hours
qid
4 times per day
tid
3 times per day
angles of injections
muscular- 90
subcutaneous- 45 or 90
-dermal- 15
who makes the patient safety goals?
Joint commission
what are the joint commission goals?
-2 pt identifiers
-improve staff communication
-med saftey
-use alarms safely
-prevent infection
-identify pts at risk for suicide
-prevent mistakes in surgery
promoting safety
-encourage collaberation
-acknowledge high risk situations
-encourage blame-free environment
-commitment to addressing safety concerns
oxygen tanks
-highly flammable!!!
-store in side bc if falls over will explode because its pressurized
-avaliability when traveling
-carbon monoxide
-proper ventilation
temperature
-hypothermia
-frostbite
-heat exhaustion/ stroke
homeless, no air or heater
physical hazards
-stairs, lose rugs, chords, climbing on counters, furniture, pets
-kids away from meds/ cleaning supplies, kitchen appliances/ utensils
hazards in work environment
-construction, health care, work outside
fall risk factors
-occupations with height
-alcohol/drugs-bp meds, opioids, muscle relaxers
-socieconomic factors- crowded home
-underlying factors-orthostatic hypotension (-20/-10)
-polypharmacy
-physical inactivity
-poor mobility
-unsafe env. physical hazards
-feet and shoes
fire rescue
R- rescue
A- alarm
C- contain
E-evacuate
fire extinguish
P- pull
A-Aim
S-squeeze
S-sweep
natural disaster
-disaster plan
-away from windows
-staffing issues
-supplies
-communication
HAI
healthcare associated infection
CAUTI
Cath. associated uti
CLABSI
central line associated blood stream infection
HAPI
healthcare associated pressure injury- check pt/more q2h or more
colonization
presence/grown of microorganisms that live within a host without tissue damage/invasion
chain of infection
-infectious agent
-reservoir
-portal of exit
-modes of transportation
-portal entry
-susceptible host
reservoir
food, oxygen, water, temp., ph, light
portal of exit
skin and mucous membrane, respiratory tract, go tract, urinary tract, reproductive, blood
body defenses against infection
-normal flora(gut biomes)
-body system defenses
-inflammation
inflammation defenses
-vascular and cellular responses
-inflammatory exudate (pus)
-tissue repair (responding)
HAI’s occur as the result of
-invasive procedures
-antibiotic administration
-multidrug-resistant organisms
-breaks in infection prevention and control activities
factors influencing infection prevention and control
-age
-sex
-nutritional status
-stress
-disease process
health promotion
-nutrition
-hygiene
-immunization
-adequate rest and regular exercise
medical asepsis
-control or elimination of infectious agents (cleaning and sterilization)
-protection of the susceptible host
-control and eliminate of reservoirs of infection
-control of portals of exit/entry (cough correctly)
-control of transmission
isolation
-standard precautions
-transmission based precautions
-psychological implications of isolation
-isolation environment
-PPE
-specimen collection
-bagging trash
-transporting patients
transmission based precautions
-airborne, droplet, contact, and protective environment
airborne precautions
wash hands, N95, close door, neg. air in room
droplet precautions
wash hands, mask, goggles/shield, usually combination with contact
contact precautions
dedicated disposable equipment
order of putting equipment on
gown, mask, goggles, gloves
order of taking PPE off
gloves, goggles, gown, mask
airborne diseases
measles, chickenpox, rubeola
droplet diseases
flu, strep, meningitis, rhinovirus, tdap, pneumonia,
contact diseases
VRE, MRSA, c-diff, shingles, scabies
protective environment diseases
allogeneic hematopoietic stem cell transplants
lozenge
cough drop
exposure issues
-accidental needlesticks
-blood or other potentially infectious materials
-airborne and droplet diseases
