Non-Parenteral Meds Flashcards
Pharmacological Components
Med names (generic mostly used)
classification (group of meds similar and treat same conditions)
med forms (pills, injections, supplements, topical, drops
Adverse Drug Reactions
unintentional and undesired effects at a normal dose
Side effects= are predictable, intensity dose-dependent, and varies
Toxicity
severe ADR
-excessive drug dosing or therapeutic drug dosage
Drowsy with antihistamine
Gastric irritation with aspirin
Is it a sign of what?
Adverse Drug Reaction
Respiratory depression from morphine
Is it a sign of what?
Toxicity
Allergic Reactions
immune response
the intensity of the reaction vary
not based on dosage
sensitivity of drug change over time
Idiosyncratic
uncommon response due to genetic disposition
Paradoxical
opposite effect of intended effect
Iatrogenic
disease caused by drugs
Teratogenic
cause of birth defects
Physical dependence
adapt to drug exposures
-opioids, barbituates, amphetamines, psych meds
-abstinence syndrome
Abstinence syndrome
warm pt of abrupt discontinuing
harmful effects if continue abruptly
Identification of symptoms
when occurred?
symptoms leave after discontinued
harmful effects if continue abruptly
Ways to mimimize ADR
education
early id
monitoring
black box warnings
Oral Meds
tablets/caplets/capsules
Modified release
syrups
suspensions
Modified release
-Delayed-eneteric coated
-Extended-controlled relase, sustained, and long-lasting
-oral disintergrating
Administering Oral Meds
pt position from semi-fowler’s to high fowlers
assess for potential aspiration
open packaged meds in the room
offer within 1-3 if doable
administration of solids and liquids
Always supervise swallowing
always where gloves
Always watch the pt swallow drugs why?
may swallow or pocket drugs in cheeks
If they have difficulty with scored or crushed tablets, put them in
applesauce or ice cream
How do you test pt for aspirations?
before ask them to take a drink of water
The higher the HOB, the
better ability to swallow
At what level does the cup need to be to have the right amount
eye level
Avoid PO meds if
Change in LOC
NPO status
Altered GI function (HG tube with suction, N/V)
Dysphagia
EC
Enteric coated
SR
Sustained release
TR
Time released
CR
Controlled delivery
SL
Sublingual
DO NOT RUSH to
CRUSH
How do you use the pill-splitter?
clean pill splitter with an alcohol swab before and after use
use gloves
remove pill from packaging
position pill to be split where scored
If you do not know if you should split, what do you do?
Call pharmacy
Topical Meds
medications applied to body surfaces or mucous membranes
Topical Medications include
skin application
eye instillation
ear instillation
vaginal instillation
rectal instillation
Types of Topical meds
powders
creams/pastes/gel/ointments
drops
ointments
aerosols/sprays
medicated patches
suppositories
Administering Topical Medications
assess skin integrity prior to application
clean previous and present areas well
avoid shaving
measure if needed (usually an inch)
apply as directed on the bottle
Always wear gloves
Cover with dressing if order allows
Transdermal Medicated Patches Steps
Remove and Clean the previous area before replacing
Replace patch in a new location without hair or irritation noted
Date, Time, and Initial patch
Always wear gloves
Most are DO NOT CUT
Remove for MRI and AED
Avoid heating pads
Rectal Suppositories
Ask if they need to go to the bathroom
Explain procedure
Left lateral side-laying (SIMS)
Don gloves - remove the packaging
Prep the med (water-soluble lubrication)
Relaxation techniques (deep breaths)
Proper insertion (1 and 1/2 inches)
Patient teaching (stay laying like that for 10 mins - and don’t push out)
Vaginal Medications
Explain Procedure
Do peri-care if incontinent
Lithotomy Position
Don gloves - remove the packaging
Proper insertion/application (lubricate)
Patient teaching (pt may administer own, may need perineal pad)
How far do you insert the vaginal medication?
2-3 inches gently further in vagina
Eye drops are commonly used for
eye infections
Administering EYE Medications
know the med and why
Explain the procedure and instructions
Don gloves
Position pt and eyelid (holding hand on the lower eyelid down)
Instill as prescribed (ointment is spread on the bottom inside lid)
Tissue and pressure on the lacrimal duct part of eye for a few seconds to prevent going systemic
The tip of the bottle or tube must not touch the eye or lashes because
contamination
Ear drops are commonly used for
ear infections
What temperature do the ears and the medications need to be to prevent irritation?
warm or room temp
Administering ear medications
Explain the procedure and instructions
Don gloves
Turn your head or lie on the unaffected side
Position auricle
Instill prescribed amount
Adult ear positioning
back and up
Child ear positioning
down and back
Inhalants common use
infections
asthma
COPD
Administering Inhalers
pre-post assessment (listen to lungs)
Explain procedure
Position pt and inhaler/spacer (sitting up)
Shake the MDI 5-6 times
Instruct them to deep breaths and then exhale
Tilt head back slightly
depress the canister once and then inhale slowly
hold your breath for 5-10 secs +
Wait 1 min then repeat if prescribed
Rinse Mouth especially if steroid
MDI Spacers are used for
older adults and children
How do you use an MDI Spacer
attach the mouthpiece of an inhaler to the spacer
shake inhaler
pt seals mouth on the spacer
press inhaler then inhale
Remove inhaler from spacer and recap both
DPI
usually has dose counter
pull the lever back to load inhaler
hold it flat like hamburger (do not tilt)
put mouth around mouthpiece after exhaling
quickly inhale and hold breathe
take empty capsule and throw away
clean mouthpiece
If strong medication tastes in the mouth
you did not do it correctly
If they have multiple inhalers
wait at least 2-5 mins between medication
1st - Bronchodilators
2nd - Steroids
Rinse
When do you check the verification steps
Acknowledge Prescriber’s Orders
Check eMAR vs Meds at Pyxis
Check eMAR vs. Meds and pt at the bedside
Components of Drug Label
expiration date
lot number
drug form
manufacturer
generic name
brand name
dosage
What do you teach the pt about their meds?
name of meds (trade and generic)
dosage
route
frequency
reason
possible side effects
Full step of administering meds
1)Acknowledge Prescriber’s Orders
2)Perform hand hygiene and gather supplies
3)Correct meds vs eMAR at pyxis
4)Knocked, AIDET, hand hygiene
5) Carry meds to bedside (keep in sight at all times)
6)Allergies
7) Verify pt with name and DOB and scan armband
8)Perform Qualified Nursing checks prior to admin meds
9)Advise pt on meds and needed information
-Questions/Concerns/Refusal
10)Scan each med before administering
11)Administer meds correctly
12)Save meds and document
13)Safety and 4Ps
14)Hand hygiene and out the door
