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z_NUR112: MIDTERM_NOTES > Notes Ch: 32 - Medication Administration > Flashcards

Notes Ch: 32 - Medication Administration Flashcards

1
Q

What are the Six Rights of Medication Administration?

A
  1. Right Patient
  2. Right Drug
  3. Right Dosage
  4. Right Route
  5. Right Time
  6. Right Documentation
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2
Q

What are the three checks for Medication Administration?

A
  1. Order to MAR
  2. Medication to MAR
  3. Patient to MAR
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3
Q

Name and detail the first check of Medication Administration

A
  • First step is compare Order to MAR
  • When you do this, apply the six rights
    • Patient
    • Drug
    • Dosage
    • Route
    • Time
    • Documentation (confirms that all match)
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4
Q

Name and detail the second check of Medication Administration

A
  • Second check is comparing the medication to the MAR
  • Confirm that the medication, dosage, route, and time are match
    • At this point note any special conciderations for the drug such as vitals/allergies, etc
    • ex. special direction to not give drug if BP is <60. Must check pulse and if lower, withhold, if above, proceed
  • Confirm that the medication is sealed
  • Confirm that it is not expired
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5
Q

Name and detail the third check of Medication Administration

A
  • The third check is Patient to MAR
  • Confirm that the patient is correct w/ Bracelet IDx2
  • Ask for allergies (Do you have any allergies to any medication, food, latex or anything else?)
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6
Q

Outline the overall process of Medication Administration

A

Acquire Order

  • Perform first check
  • Perform second check

At patient

  • Hand hygiene
  • Greeting/ID confirmation
  • Provide privacy
  • Perform third check
  • Perform any precautions (vitals, etc)
  • Administer appropriate drugs
  • Goodbye
  • Hand hygiene
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7
Q

Define Generic drug name

A

The manufacturer who first develops the drug assigns the name, and it is then listed in the U.S. Pharmacopeia

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8
Q

Define Trade drug name

A
  • Known as the brand or proprietary name.
  • Name a manufactuer markets the medication
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9
Q

Define Pharmacokinetics

A

The branch of pharmacology concerned with the movement of drugs within the body.

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10
Q

What are the four phases of pharmacokinetics?

A
  1. Absorption
  2. Distribution
  3. Metabolism
  4. Excretion
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11
Q

Define pharmacokinetic absorption.

A

The ability of a drug to be absorbed by cells, tissues, organs, systems and alter physiological functions

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12
Q

What are five factors that influence absorption?

A
  1. Route of administration
  2. Ability to dissolve
  3. Blood flow
  4. Body surface area
  5. Lipid solubility of medication
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13
Q

Order the following routes from fastest to slowest rates of absorption:

  1. Mucous membranes/respiratory tract
  2. Topical
  3. IV administration
A

3, 1, 2

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14
Q

True or False

When the site of administration contains a rich blood supply, medicaation is absorbed at a slow rate.

A

False

It will be absorbed quickly

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15
Q

Pharmacokinetic distribution depends on what four factors?

A
  1. Chemical properties of the drug
  2. Circulation
  3. Membrane permeability
  4. Protein binding
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16
Q

What are four factors to consider in drug metabolism?

A
  1. Medications are metabolized into a less potent or an inactive form
  2. Biotransformation occurs under the influence of enxymes that detoxify, break down and remove active chemicals
  3. Most biotransformation occurs in the liver
  4. Kidneys, blood, intestines and lungs all play a role
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17
Q

What is drug excretion?

A

The method the body uses to rid the body of a drug.

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18
Q

Medications are extreted through:

A
  • Kidney
  • Liver
  • Bowel
  • Lungs
  • Exocrine glands
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19
Q

The organ of excretion is determined by…

A

the chemical makeup of a medication

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20
Q

What are the 7 types of medication action?

A
  1. Therapeutic effect
  2. Side effect
  3. Adverse effect
  4. Toxic effect
  5. Idiocyncratic reaction
  6. Allergic reaction
  7. Syngerstic
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21
Q

Define: Therapeutic effect

A

Expected or predicted physiological response

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22
Q

Define: Side effect

A

Unavoidable secondary effect

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23
Q

Define: Adverse effect

A

Unintended, undesirable, often unpredictable drug effect

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24
Q

Define: Toxic effect

A
  • Accumulation of medication in the bloodstream
  • Frequent use can cause accumulation
25
Q

Define: Idiosyncratic reaction

A
  • Over-reaction or under-reaction or different reaction from normal
  • Will require further follow up to discover why (mixed with other drugs, etc)
26
Q

Define: Allergic reaction

A

Unpredictable resonse to a medication

27
Q

Define: Synergistic effect

A

The combined effect of two medications is greater than the effect of the medications given separately.

28
Q

Medication Interactions occur when…

A
  • one medication modifies the action of another.
  • one medication increases or diminishes the way another medication is absorbed, metabolized or eliminated
29
Q

Alcohol has a synergistic effect on _____, _____, _____, and _____ because it is a central nervous system depressant.

A
  • antihistamines
  • antidepressants
  • barbituates
  • narcotics
30
Q

What six factors make up a medication dose response?

A
  1. Onset
  2. Tough
  3. Plateau
  4. Peak
  5. Duration
  6. Biological half-life
31
Q

Define: Onset

A

Time it takes for a medication to produce a response

32
Q

Define: Trough

A

Minimum blood serum concentration before the next scheduled dose

33
Q

Define: Plateau

A

Point at which blood serum concentration is reached and maintained

34
Q

Define: Peak

A

Time at which a medication reaches its highest effective concentration

35
Q

Define: Duration

A

Time medication takes to produce greatest result

36
Q

Define: Biological half-life

A

Time for serum medication concentration to be halved

37
Q

What are the 5 routes fo medication administration?

A
  1. Oral
  2. Topical
  3. Inhalation
  4. Parenteral
  5. Intraocular
38
Q

Define the two oral routes.

A
  • Sublingual: under the tongue to dissolve
  • Buccal: side and back of mouth to be immediately swallowed.
39
Q

Inhalation is via the ______ route.

A

endotracheal

40
Q

What are three methods of administration for inhalation?

A
  • Inhale/sniff
  • Nebulizer (drop in vapor)
  • Endotracheal
41
Q

Method of administration for intraocular?

A

eye drops

42
Q

Parenteral administration is administered by _____.

A

injection

43
Q

What are the four parenteral methods of administration?

A
  1. ID; Intradermal
  2. Sub-Q; Subcutaneous
  3. IM; Intramuscular
  4. IV; Intravenous
44
Q

Name the sites and angle for an IM injection.

A

Sites:

  • Ventrogluteal (side of butt)
  • Vastus Lateralis (top of thigh)
  • Deltoid (shoulder)

Angle:

  • 90°
45
Q

Describe the Z-track method of IM injection.

A
  • stretch skin to one side
  • inject at 90° into muscle layer
  • when the skin is released, the injection tract seals and is offset from the muscle tract helping to seal site.
46
Q

Ventrogluteal site is is recommended for volumes greater than __ mL

A

2

47
Q

Sub-Q injections are are absorbed more _____ than IM injections.

A

slowly

due to low blood supply

48
Q

Where are the sub-q injection sites located?

A
  • Lateral surface of the upper arm
  • Upper back at the lower end of the scapula and down about 6”
  • upper ventral/dorsal gluteal areas (top of butt)
  • Belly under naval area
49
Q

What are the angles of entry for IM, Sub-Q, and ID shots?

A
  • IM = 90°
  • Sub-Q = 45° - 90°
  • ID = 5 - 15°
50
Q

Regarding IM and Sub-Q injections, which do you pinch and which to you spread?

A

Sub-Q = pinch

IM = spread

51
Q

Give the typical volume amounts for the following injections:

ID

IM

Sub-Q

A
  • ID = < 0.5mL
  • IM = < 2mL for small muscles, <5mL for large muschles
  • Sub-Q = < 1mL, (but up to 2mL is safe)
52
Q

What are the requirements for the disposal of narcotics?

A

2 nurses (LPN ok) must be present.

53
Q

What are the 6 types of orders MD’s use for medication administration?

A
  1. Standing/Routine
  2. Single
  3. Now
  4. PRN
  5. STAT
  6. Prescriptions
54
Q

Define: Single order

A

Given one time only for a specific reason

55
Q

Define: Single order

A

One time administration given for a specific reason

56
Q

Define: Now order

A
  • When a medication is needed right away, but not STAT
  • w/in 90 minutes
57
Q

Define: PRN order

A
  • Given when a patient requires it
  • Will still need to refer to timing to see when it can be administered
58
Q

Define: STAT order

A

Given immediately in an emergency

59
Q

Define: Prescription orders

A

Medication to be taken outside of the hospital

z_NUR112: MIDTERM_NOTES (14 decks)

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