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Pharm 313 > Non parenteral Med Admin > Flashcards

Non parenteral Med Admin Flashcards

1
Q

7 components of Medication Order

A
  1. patient name
  2. date time/ rx
  3. provider name/ signature
  4. type of medication
  5. dose of medication
  6. route of medication
  7. frequency of dose
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2
Q

Where do you usually see reason for med?

A

only in long term care, not acute

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3
Q

Types of med orders (4)

A
  1. written
  2. verbal
  3. telephone
  4. protocols
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4
Q

Help prevent error with telephone and verbal?

A

write down, read back

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5
Q

safest type of RX

A

written

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6
Q

When do you use verbal order?

A

emergency

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7
Q

example of protocol RX

A
  • set protocol to give nitro if patient has chest pain

- NURSE CAN INITIATE

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8
Q

Routine rx (frequency)

A

-give until you have an order to stop

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9
Q

one time only rx (frequency)

A

-use with surgery frequently

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10
Q

stat rx (frequency)

A

-administer this medication immediately because the patient is in dire straights

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11
Q

now rx (frequency)

A
  • sense of urgency but it is not life or death

ex: give laxative to get patient to poop so they can be D/C

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12
Q

PRN rx (frequency)

A

as needed w/in a TIME INTERVAL + INDICATION stated in order

-can only give PRN med for reason stated in order

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13
Q

Who checks medication order after provider writes it?

A

pharmacy

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14
Q

Who checks medication order after pharmacist?

A

RN

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15
Q

What info do you need to know in order to give medication safely?

A
  • action of drug
  • contra/indication
  • drug interactions
  • w/ food/sitting up
  • normal dose range
  • normal route
  • adverse effects
  • how to check for therapeutic effect
  • patient teaching
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16
Q

What do you do to patient before giving med?

A

Physical assessment

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17
Q

What are you considering in physical assessment before giving med?

A
  • patient alert?
  • able to swallow?
  • need to crush? can crush?
  • NPO?
  • ability to follow instructions
  • GI motility
  • Muscle mass for IM injections
  • water @ bedside
  • VS***
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18
Q

What VS to check

A

B/P (HTN)
Pulse (cardiac med)
Pain rating (pain med)
Temp (antipyretic)

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19
Q

Admin time window

A

30 min before and after due

-daily med = maybe more room in in admin window vs med due every 4 hours

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20
Q

Labs and med admin

A
  • check prior to admin

- know which labs to check for which meds

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21
Q

Where do you look for meds?

A
  • mobile cart
  • automated medication dispensing system (pyxis)
  • self- administration
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22
Q

What is special about controlled substance medication storage and disposal?

A
  • med count before and after taking dose that is recorded
  • wasted medications must be WITNESSED and DOCUMENTED by another nurse
  • inventory done by 2 nurses at set intervals
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23
Q

First step in medication preparation

A

wash hands

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24
Q

Where do you assemble meds?

A

in medication room/ mobile cart

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25
Q

When you remove the meds from the drawer what do you check?

A
  • drug expiration date

- 5 rights against MAR - not what you copied from the MAR

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26
Q

When do 3 checks against MAR occur

A
  1. before preparing med
  2. after preparing med
  3. at the bedside
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27
Q

5 rights

A

drug, dose, patient, route, time

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28
Q

Why do most med errors occur?

A

failing one of the 5 rights

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29
Q

Who do you ask to verify name and DOB is patient is nonverbal?

A

-ask family member in room

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30
Q

5 rights for Drug

A
  • compare drug to MAR
  • not expiration date
  • know indication
  • know nursing considerations
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31
Q

5 rights for Dose

A
  • validate calculations of divided doses with another urse
  • check high alert medication with another nurse
  • know the usual dose and question dose outside of safe range
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32
Q

5 rights route- what do you do if change of route is needed?

A

request new order from provider

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33
Q

When administering med when do you take medication out of packaging unless it needs to be removed to prepare it?

A

bedside

34
Q

Considerations for syringes- what do you do if not in original packaging?

A

LABEL if not in original container before removing from emd room

35
Q

What to verify with patient before admin?

A
  • identity
  • 5 rights
  • allergies
  • education
36
Q

What do you tell patient before giving med about the med?

A
  • name of med
  • dosage
  • indication
  • pertinent patient teaching
37
Q

What happens in post administration

A
  • documentation

- monitor effect

38
Q

When do you document med given?

A

as soon as possible AFTER med is given

39
Q

What to document in med administration

A
  • time administered
  • client response
  • med given
  • dose
  • route
  • if not given or refused - put reason why
  • prn meds - response
  • 1st time given - response
40
Q

2 times it is vital to chart response to medication

A

PRN or first time given

41
Q

What do you do when you make a med error?

A

1= patient assessment (v/s)

  • notify provider, charge nurse/manager
  • incident report
42
Q

Most common medication route

A

Oral

43
Q

What kind of oral meds can NEVER be crushed?

A
  • sustained release
  • enteric coated
  • controlled substance
44
Q

Can half doses of capsules be given?

A

No and they cant be crushed but they can be opened and mixed into food

45
Q

> ____ pills to make a dose should use caution

A

3

46
Q

Can you leave before patient has taken meds?

A

No, must watch take all meds

47
Q

types of oral meds

A 
capsule
time released
elixir
syrup
liquid
tincture
powder
suspension
troche
48
Q

How do you measure liquids?

A

eye level

49
Q

How do you pour liquid med?

A

so it doesnt spill on label

50
Q

Syringes for liquid oral meds?

A
  • can draw up in syringe

- only administer with oral syringe

51
Q

Buccal oral med

A

place med b/w cheek and teeth to let dissolve

52
Q

Sublingual oral med

A

dissolve under tongue

53
Q

Which kind of oral med is exempt from first pass effect?

A

Sublingual

54
Q

Lozenge

A

dissolve in mouth

55
Q

Where do you use patch based medication?

A

-apply to nonhairy intact skin

56
Q

Special considerations for nurse with topical medication

A
  • take care not to touch topical medication with ungloved hands
  • essential to wear gloves to administer
57
Q

When applying a patch to patient make sure….

A

previous dose is removed

58
Q

How to administer opthalmic med

A
  • client look toward cieling
  • pull down skin of lower eyelid
  • instill medication in conjunctival pouch
  • clean/dry from inner to outer canthus
59
Q

Opthalmic meds: make sure not to touch…

A

any part of eye with dropper

60
Q

How to prevent systemic circulation of opthalmic med?

A

place hand over inner canthus

-only necessary for med that cant go to systemic circulation

61
Q

Temp for otic medication

A

room temperature

62
Q

Patient position for otic med

A

sidelying

63
Q

Adults vs children ear canal straightening

A

AdUlts: pinna UP and back

chilDren <3 : pinna DOWN and back

64
Q

What do do after otic med administered?

A

-place cotton ball in ear and lay on side for 5-10 minutes

65
Q

How to administer nasal med

A
  • patient head down and forward and sniff in

- want med to go to nasal mucosa

66
Q

Meter Dose Inhaler use

A
  • breathe out
  • inhale slow and steady while pushing med
  • hold breath
  • exhale slowly
67
Q

How long to wait b/w doses for inhalant?

A

~1 minute

68
Q

MDI spacer

A

chamber attached to end of inhaler that assists the patient in receiving a higher % drug with each inhale

69
Q

Nebulizer

A

type or inhaled medication

-aerosolized med given by hand held device or face mask

70
Q

How many pills to crush at once for enteral tube?

A

1!

71
Q

Empty tummy and continuous tube feed

A

-stop tube feed 15-30 min prior/after dose

72
Q

Before giving enteral med in tube always check

A

tube placement and flush with water

73
Q

When to flush?

A

before med, after med, and final flush

74
Q

Suction NG tube and meds

A

-turn off suction, give med, wait 30 min before turning on suction

75
Q

Patient position for vaginal medication

A

dorsal recumbent or Sim’s position

76
Q

After vaginal med patient…

A

stay in position for 15-20 minutes to med can be absorbed

77
Q

Patient position for rectal med

A

sims position

78
Q

For vaginal and rectal meds it is important to provide

A

lubrication

79
Q

How far to insert rectal med

A

-push in as far as you can and then it gets sucked in

80
Q

After rectal med…

A

patient stay in position and “hold it” if for bowel fxn to increase effect of med

Pharm 313 (26 decks)

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