module 5 Flashcards
how many people die in the us every year to medication errors?
100,000
in order to prepare for a medication administration, you need to do what 4 things?
- ) Be able to located the information about each drug,
- )consistently calculate drug dosages accurately
3) devise a method for consistently using Six Rights of medication
4) recognize the nursing implications for each drug administered.
nursing implications
points you nee to remember about the drug or teach to the patient
generic name
name not protected by trademark
trade name
name protected by a trademark like Advil
Classifications of a drug are defined by what?
by the effect of the drug on a body system
the symptoms the drug relieves
the drugs desired effects
ISMP, Institute for Safe Medication Practices
an organization devoted to safe medication practices and the prevention of errors
who can prescribe medications?
physicians, dentists, osteopaths, veterinarians
proof of use
is a record that accounts for each dose dispensed to the nursing unit.
5 standards that must be met by manufactures to admit drugs
purity- types and concentrations of substances other then the drug that can be in the tablet, capsule, suspension
potency - amount of active drug in the preparation contriuting to its strength
bioavailaility - drugs ability to dissolve, be absorbed, and e transported in the body to its desired site of actioin
efficacy- lab studies providing proof that the drug is effective for its intended use
safety - side effects, adverse effects, toxic reactions
what are drugs used for?
used in the treatment, palliation, diagnosis, cure, and prevention of disease/
barbiturates do what?
depress the function of cell groups in the central nervous system, causing drowsiness.
antineoplastic drugs do what?
have the ability to block cell division
the rate of absorption is affected by what ?
body weight, age, sex, disease conditions, genetic factors, immune mechanisms, and physiologic and emotional factors
why do infants display a lower tolerance for drugs then children?
the immaturity of organs needed to detoxify and excrete the drugs
how does weight effect the drug absorption?
an increase in body fat tens to delay rug distrubtion, the less a patient weighs, the more concentrated the drug will e in the tissues, and consquently the more powerful the effect.
degrade
break down of drugs
what happens when the liver function is decreased due to disease or aging?
the drug may be eliminate more slowly than usual, resulting in an accumulation of the drug that could lead to toxic levels
what is essential for the patient to eliminate drugs properly
adquate fluid intake of 50ml per day
pharmacodynamics
the study of drugs effect on cellular physiology and biochemistry and its mechanism of action
primary effect
is the desired effect
secondary effect
may be desirable or undesirable causing side effects or adverse effects
side effects
unintended actions
adverse effects an an example of one
undesirable effects with more serious consequences ; nausea produced by an antibiotic when its desired action is to kill pathogenic organisms or an allergic reaction such as hives
peak action
occurs when the highest blood of plasma concentration of the drug is achieved
what is the duration of action
the length of time the drug exerts a pharmacologic effect
peak
highest concentration
trough
lowest concentratio n
agonist
drugs that produce a response
antagonist
drugs that block a response
drugs have what 4 type of reactions
- stimulation or depression - direct action on a receptor site
- replacement- such as injected insulin for people who do not produce their own
- inhibition or killing - action of an antibiotic when it blocks synthesis of the bacterial cell wall
- irritation- such as that produced by a laxative on the colon wall, resulting in peristalsis and defecation.
anaphylaxis
severe allergic reaction; which could lead to death
therapeutic range
is the range of levels of the drug in the blood that will produce the desired effect without causing toxic effects.
toxic effects
harmful effects
black box warning
is an FDA warning designated to say the drug may have serious side effects
what can food do to affect the drug
it can speed up, reduce, or even prevent the absorption of the drug into the bloodstream
the acidic juices may affect what?
may affect the rate of breakdown of tablets an may prevent the drug from reaching the intestinal wall
doses are based on what for a chlld?
the child’s weight and age and are not given in a standardized amount
what do you say when giving a child medication?
explain it in short sentences with simple language at the child’s level of understanding what the drug is fo and how it is to be given
what can be caused from a decreased level of albumin in elderly?
it causes a greater potential for unbound drug in the system an a risk for increase drug activity and toxicity
what can happen to elderly when taking diuretics
they can become dehydrated and experience electroylte imbalances.
signs of toxicity
appetite loss, confusion, fatigue, and depression
reasons why patients show noncompliance
the patient may not comprehend the drugs action or why it is being taken, lack of money, in the male, urinary retention and sexual dysfunction are common reasons for noncompliance
medication reconciliation
is a process of identifying all the patients meds and communicating this info to the patient and the staff
contraindications
reasons not to administer
the six rights of medication administration
- the right drug
- the right dose
- the right route
- the right time
- the right patient
- the right documentation
a nurse is admin a dose of digoxin, before giving the med what should the nurse do?
check the apical heart rate
the nurses are legally responsible to have knowledge about the medication they are administering to the patient, what do you they need to know?
the correct dose, the route y which it should be given, desired effects, side effects, interactions with other medications, and any contraindications.
on discharge from the unit the patients need to know what?
how often to take each drug, whether the medication should be taken before or after meals, whether certain foods or fluids should be avoided, the expected effect, what to do about side effects if they occur, and what to do if they forget to take a dose at the prescribed time.
medication order or drug order is what?
the written prescription for a drug
a complete drug order should include what things?
the patients full name,, the name of the drug, the dosage to be given, the route of administration, how often it is to be given, the date and time written, and the prescriber’s signature.
what is a standing order?
it is carried out until it is canceled by the heath care provider or until the prescription has been given
what is a PRN? and give an example
an order written for when the patient requires it. Example may be; analgesics to control pain, or laxatives for constipation
what is a one-time single order?
an order is written for a drug to be given just one time. such as before surgery or a diagnostic procedure.
a stat immediate order?
is for a single dose of a medication to be given right away without delay, such as Benadryl for an allergic reaction.
orders by protocol are found where?
they exist in specialty units such as emergency units, labor and delivery, or intensive care units.
abbrev. I.D. I.M. I.V. I.V.P.B.
intradermal, intramuscular, intravenous, intravenous piggyback
K.V.O mEq MDI NGT
keep vein open, milliequivalent, metered-dose inhaler, nasogastric tube
PCA pc PR
patient-controlled analgesia, after meals, per rectum
Rx SR
take, sustained release
the selected route of administration depends on what factors?
the patients condition, the nature of the drug(taste, stability, and so on), and the rate of absorption via one route versus another.
PO
by mouth oral medication
topical medications
in form of eye drops, eardrops, or appie as oitments, pastes, or lotions to the skin or mucous membrane
the rectal route is often used on who?
on children or for patients who are vomiting
you shouldn’t rely on what that was printed at the beginning of the shift?
the hard copy of the MAR
a medication card has what information on it?
the patients name and room number, the physicians name, the drugs name, dosage, route, and time of administration; the date the order was written, and the initials of the person making the card.
CPOE System
it decreases the potential for transcription errors, they could information such as allergies, lab results, and vital signs.
what is the unit dose system
it refers to drugs package in single, indiv doses.
what are some benefits to the unit dose system?
the pharmacy supplies the exact dose of medication ordered, and each dose is opened and administered at the bedside, enhancing patient safety and reducing med errors. It saves time for the nurse. the patient is only charged for the meds that are used.
ointments
are medicines manufactured in an oily base, such as petrolatum or lanolin, which keeps the drug in prolonged contact with the skin surface to obtain a soothing and anti-inflammatory effect
pastes
are stiffer in consistency than ointments and do not melt at body temp. aluminum paste and zinc oxide are examples of pastes that are used to asbord secretions and protect the skin.
lotions
calamine lotion, used to cool, soothe, and reduce inflammation or itching of the skin.
suppositories
inserted through rectum, vagina, urethra, or an ostomy stoma
overall goals of medication administration are?
all medications ordered will be safely administered to each patient on time.
serious side effects of medication will be indentified quickly.
the medication will be effecitve
no allergic reaction will occur
the patient will understand why the drug is being subscribed
spansule
time-released pellets put into a capsule
oral drugs may be supplied how?
a tablet, capsule, a spansule, a lozenge, or a liquid in the form of syrup, an elixir, or a suspension
when giving a tablet or capsule drug what should you do??
offer sufficient water with which to swallow the medicatoin
make sure that all water intake with the medication is trasnported where?
in the intake and outtake form
the exact level of the dose in a cup is read where?
it is read at the lowest point of the meniscus, which is the curved upper surface, of the liquid in the cup when held at eye level
sublingual medications
under the tongue and should never be swallowed.
buccal medications
are placed in the pocket between the teeth and the cheek. swallowing them can alter there abosrption and could make them totally ineffective
opthalmic (eye) medications may in the form of what?
drops, ointments, or an eye disk
what must be removed in the patients eye before prep of a medication and why
there contact lens, they could stain the lens, and ointments will coat the lens, and they may have to be thrown out.
otic (ear) medications are used mostly on who?
children to decrease the pain of otitis media,
how should you postion the ear for a children compared to an adult when putting in medication
the for child, pull the earlobe downward to straighten the canal, in the adult, pull the top of the pinna out and upward
an atomizer bottle can contain what?
decongestant, antihistamine, anitbiotic, or steroid, depending on the patients need
what is the correct position and direction of a patient when your about to give nasal drops?
they should lie down face up, with the head off the bed and the neck hyperextended. the patient should squeeze the bottle while breathing in and repeats on other side. and they should remain in that position for a few minutes
drugs used for inhalation therapy are always what and why?
water soluble to ensure quick absorption into the respiratory system without creating tissue inflammation.
patient teachings for using a MDI
shake the canister several times to mix it up, breather out through the mouth, emptying the lungs, always sit or stand to use it, hold the breath for 10 seconds and try not to cough,
topical solution is introduced into the vaginal cavity for what purposes?
to cleanse the vagina in prep for surgery, to supple antiseptics to reduce bacterial growth, to remove odors or foul discharge, to apply heat or cold to sooth inflammed tissues or reduce oozing of blood
suppositories are used for what?
prevent vomiting, soothe hemorrhoids, prevent bladder spasms, promote bowel evacution, reduce fever.
transdermal
through the skin
things to know about skin patches
they should be applied to areas where there is aqeuate circulation such as the chest, shoulders, or upper arms. they should be applied to a new spot every time a new patch is being put on. hair should be removed before applying a patch.
a scopolamine patch is applied where?
behind the ear
root cause analysis
is used to investigate a sentinel event, which is an occurence that causes a patients death or serious injury.
an elder patient with arthritis has been taking antiinflammatory drugs they should monitor what?
gastrointestinal bleeding and anemia
ROUTE is SKIN
slow
ROUTE is MUCOUS MEMBRANE
quick
ROUTE is RESP TRACT
quick
ROUTE is ORAL
slow
ROUTE is INTRAMUSCULAR
dependson form of drug
ROUTE is SUBCUTANEOUS
slow
ROUTE IS IV
most rapid
when receiving a liquid medication, the nurse should asses what
the gag reflex
1mg equals how many mcg?
1000
1 tsp equals how many Ml
5 mL
teach the patient about the drug
what it looks like, its intended action, possible side effects, and how to take it. explain why it should be taken with food or on an empty stomach and why itis important to take it on the schedule.
toxic effects of a drug occur when?
when the blood level of a drug rises above the therapeutic range and causes unintended damage to normal cells
what should anaylze about a drug before giving it to the patient
anaylze the orde and determine whether the drug, the dose, and the timing of the drug are appropiate for the patient
