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NU 301 Exam 2 Flashcards

1
Q

What provides the exact description of a medication’s make up?

A

The chemical name

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2
Q

What is the name that manufacturers first assing a drug? It is listed as this in the U.S. pharmacopeia.

A

A generic name

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3
Q

What is the name that the drug is marketed under?

A

Trade name

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4
Q
  1. You are caring for a patient who has diabetes complicated by kidney disease. You need to make a detailed assessment when administering medications because this patient may experience problems with:
    A. absorption.
    B. biotransformation.
    C. distribution.
    D. excretion.
A

Answer:
D. excretion.

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5
Q

What factors influence absorption?

A

Route of administration
Ability of a medication to dissolve
Blood flow to the site of administration
Body surface area

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6
Q

What is the definition of a therapeutic effect?

A

Expected or predicted physiological response

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7
Q

What is the definition of an adverse effect?

A

: Unintended, undesirable, often unpredictable

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8
Q

What is the definition of a side effect?

A

Predictable, unavoidable secondary effect

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9
Q

What is the definition of a toxic effect?

A

Accumulation of medication in the bloodstream

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10
Q

What is an idiosyncratic effect?

A

Overreaction or underreaction or different reaction from normal

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11
Q

What is the definition of an allergic reaction?

A

Unpredictable response to a medication

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12
Q

What is the definition of a medication interaction?

A

One medication modifies the action of another

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13
Q

What is the definition of medication tolerance?

A

More medication is required to achieve the same therapeutic effect

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14
Q

What are the oral routes of administration?

A

Buccal and sublingual

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15
Q

What are the topical sites of administration?

A

Skin and mucous membrane

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16
Q

What is the nurse’s role in medication administration?

A

Determines medications ordered are correct
Assesses patient’s ability to self-administer
Determines medication timing
Administers medications correctly
Closely monitors effects
Provides patient teaching
Does not delegate medication administration to AP

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17
Q

What do you do when a medication error occurs?

A

First assess the patient’s condition, then notify the health care provider
When patient is stable, report the incident
Prepare and file an occurrence or incident report
Report near misses and incidents that cause no harm

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18
Q

. If a nurse experiences a problem reading a physician’s medication order, the most appropriate action will be to:
A. call the physician to verify order.
B. call the pharmacist to verify order.
C. consult with other nursing staff to verify.
D. withhold the medication until physician
makes rounds.

A

Answer:
A. call the physician to verify order.

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19
Q

What are the 7 rights to administering medication?

A

Right medication
Right dose
Right patient
Right route
Right time
Right documentation
Right indication

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20
Q

Nurses are legally required to document medications that are administered to patients. The nurse is mandated to document which of the following?
A. Medication before administering it.
B. Medication after administering it.
C. Rationale for administering it.
D. Prescriber rationale for prescribing it

A

Answer:
B. Medication after administering it.

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21
Q

What are some considerations for topical application?

A

Ask patients if they take any topical medications.
When applying a transdermal patch, ask the patient whether he or she has an existing patch.
Wear disposable clean gloves when removing and applying transdermal patches.
If the dressing or patch is difficult to see (e.g., clear), apply a noticeable label to the patch.
Document patch or medication location on the MAR
Document patch or medication removal on the MAR

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22
Q

What are some considerations for eye instillation

A

Avoid the cornea.
Avoid touching eye or eyelid with droppers or tubes.
Use only on the affected eye.
Never share eye medications.

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23
Q

What are some considerations for ear drops?

A

Instill eardrops at room temperature.
Use sterile solutions.
Check with the health care provider for eardrum rupture if patient has ear drainage.
Never occlude the ear canal.

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24
Q

What are some considerations for ear irrigation?

A

Performed to remove cerumen that cannot be removed with wax softeners
Performed only in cases of hearing deficit, ear discomfort, or to visualize the tympanic membrane

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25
How are vaginal medications inserted?
Inserted with a gloved hand if suppository. Applicator inserter for foam jelly cream
26
How are suppositories administered?
Administered with an applicator inserter
27
What are some considerations for rectal administration?
Thinner and more bullet-shaped than vaginal suppositories Rounded end prevents anal trauma during insertion Contain medications that exert local effects A small cleansing enema may be required before inserting a suppository
28
When is the onset of rapid-acting insulin?
15 minutes
29
When is the peak for rapid-acting insulin?
1-2 hours
30
When is the onset for short acting insulin?
30-60 minutes
31
When is the peak for short-acting insulin?
2-5 hours
32
When is the onset of intermediate-acting insulin?
1-2 hours
33
When is the peak of intermediate-acting insulin?
4-8 hours
34
What are signs of hypoglycemia?
Confusion Irritability Tremor Sweating
35
A nurse floats to a busy surgical unit and administers a wrong medication to a patient. This error can be classified as: A. a poisoning accident. B. an equipment-related accident. C. a procedure-related accident. D. an accident related to time management.
Answer: C. a procedure-related accident
36
What are some factors that influence patient safety?
Patient’s developmental level Mobility, sensory, and cognitive status Lifestyle choices Knowledge of common safety precautions
37
What age children use a rear-facing carseat?
Newborns to age 2
38
What age children use a front-facing car seat?
2 to at least 5
39
What age children use boosterseats?
5 up until seatbelts fit properly
40
What age children use seatbelts?
When booster seat is no longer required
41
While caring for a child, you identify that additional safety teaching is needed when a young and inexperienced mother states that: A. teenagers need to practice safe sex. B. a 3-year-old can safely sit in the front seat of the car. C. children need to wear safety equipment when bike riding. D. children need to learn to swim even if they do not have a pool.
B. a 3-year-old can safely sit in the front seat of the car.
42
What are some other individual risk factors for people?
Lifestyle Impaired mobility Sensory or communication impairment Economic resources Lack of safety awareness
43
What does RACE stand for?
R - rescue A - activate alarm C - confine fire E - extinguish
44
What actions should you perform if a patient has a seizure?
Clear area of all hard or sharp objects. ● Ease person to floor and put something soft under head. ● Remove eyeglasses and loosen tie. ● Time seizure with watch (remember 5 minutes is significant). ● Do NOT try to stop the movements. ● Do NOT put anything into the persons mouth.
45
What is a physical restraint?
manual method, physical or mechanical device that immobilizes or reduces the ability to move arms, legs, body or head freely
46
What are the rules for restraints?
Must have an order for a restraint of any kind. Order must include: reason, type, how long to use. Restraints cannot be ordered on a PRN basis and always have a limited time frame.
47
Where do you tie knots for restraints?
To the bedframe, NOT the bedrail.
48
How often do you assess the skin of a client in restraints?
Every 2 hours
49
How loose should restraint knots be?
Enough to fit 2 fingers
50
A newly admitted patient was found wandering the hallways for the past two nights. The most appropriate nursing interventions to prevent a fall for this patient would include: A. raise all four side rails when darkness falls. B. use an electronic bed monitoring device. C. place the patient in a room close to the nursing station. D. use a loose-fitting vest-type jacket restraint.
B. use an electronic bed monitoring device.
51
What is the definition of infection?
RESULTS WHEN A PATHOGEN INVADES TISSUES AND BEGINS GROWING WITHIN A HOST * COLONIZATION * PRESENCE AND GROWTH OF MICROORGANISMS WITHIN A HOST WITHOUT TISSUE INVASION OR DAMAGE SCIENTIFIC KNOWLEDGE BASE 2
52
What is the definition of colonization?
PRESENCE AND GROWTH OF MICROORGANISMS WITHIN A HOST WITHOUT TISSUE INVASION OR DAMAGE
53
What can be considered a reservoir for infection?
FOOD, OXYGEN, WATER, TEMPERATURE, PH, LIGHT
54
What is a portal of exit?
The route a pathogen takes to exit a reservoir.
55
A PATIENT IS ADMITTED TO A MEDICAL UNIT FOR A HOME- ACQUIRED PRESSURE ULCER. THE PATIENT HAS ALZHEIMER’S DISEASE AND HAS BEEN INCONTINENT OF URINE. THE NURSE INSERTS A FOLEY CATHETER. YOU WILL IDENTIFY A LINK IN THE INFECTION CHAIN AS: A. RESTRAINTS. B. POOR HYGIENE. C. FOLEY CATHETER BAG. D. IMPROPER POSITIONING. Copyright © 2017, Elsevier Inc. All Rights Reserved. 5
C. FOLEY CATHETER BAG.
56
What are the steps in the chain of infection?
infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host
57
What are HAI's
healthcare-associated infections
58
What are airborne precautions?
Used for diseases spread through air, Private, monitored negative pressure room with door always closed. N95 required. Air from room is filtered before it exits.
59
What is required for droplet precautions?
Droplet precautions require the wearing of a surgical mask when within 3 feet of the patient, proper hand hygiene, and some dedicated-care equipment.
60
How is MRSA transmitted?
Person-to-person contact * Contaminated devices (IV poles, over bed tables, exercise equipment and shopping carts) * Linens * Clothing
61
What are 5 moments for hand hygiene?
Before touching a patient, before clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings.
62
YOU ARE CARING FOR A PATIENT WHO UNDERWENT SURGERY 48 HOURS AGO. ON PHYSICAL ASSESSMENT, YOU NOTICE THAT THE WOUND LOOKS RED AND SWOLLEN. THE PATIENT’S WBCS ARE ELEVATED. YOU SHOULD: A. START ANTIBIOTICS. B. NOTIFY THE PROVIDER. C. DOCUMENT THE FINDINGS AND REASSESS IN 2 HOURS. D. PLACE THE PATIENT ON ISOLATION PRECAUTIONS.
B. NOTIFY THE PROVIDER.
63
What are s/s of a local infection?
Swelling Redness Heat Pain Tenderness
64
What are s/s of a systemic infection?
Fever * Leukocytosis –WBC > 10,000/mcl (normal 4,500 – 10,000) * Malaise * Anorexia * Lymph node enlargement
65
Define medical asepsis
Reduces the number of organisms present *Hand washing *Cleaning used equipment (a used bed pan is considered contaminated).
66
Define surgical asepsis (sterile)
Eliminates all microorganisms *Sterile fields *An area is considered contaminated if an unsterile object touches the field
67
What are the body's normal defenses against infection?
Normal floras, inflammation, tissue repair, inflammatory exudate, vascular and cellular response
68
What increases the risk of healthcare-associated infections?
Invasive procedures Antibiotic administration Multidrug-resistant organisms (MDROs) Breaks in infection prevention and control activities
69
What are examples of standard precautions?
hand hygiene, gown, gloves, goggles.
70
Why are isolation precautions used?
To protect patient from microorganisms
71
What factors contribute to skin ulcer formation?
Age, mobility, sitting/lying position, nutrition, sensation level, infection, tissue perfusion.
72
Define a stage 1 pressure wound
non-blanch-able erythema of intact skin. No skin break, may be red, blue, or purple.
73
Define a state 2 pressure wound
Partial thickness skin loss that extends to the dermis.
74
Define a stage 3 pressure wound
Full-thickness skin loss. Adipose exposed
75
Define a stage 4 pressure wound
Full thickness skin and tissue loss. Muscle/bone visible.
76
Define an unstageable pressure wound
A pressure wound with too much slough/eschar to determine depth.
77
What is serous edudant drainage?
Straw colored
78
What is sanguineous drainage?
Bloody colored
79
What is serosanguineous drainage?
mix of bloody and straw colored
80
What is purulent drainage?
Yellow, pus filled
81
A postoperative patient arrives at an ambulatory care center and states, “I am not feeling good.” Upon assessment, you note an elevated temperature. An indication that the wound is infected would be: A. it has no odor. B. a culture is negative. C. the edges reveal the presence of fluid. D. it shows purulent drainage coming from the incision site.
D. it shows purulent drainage coming from the incision site.
82
What precautions should you take for heat and cold therapy?
Patient's temperature tolerance
83
. A surgical wound requires a Hydrogel dressing. The primary advantage of this type of dressing is that it provides: A. an absorbent surface to collect wound drainage. B. decreased incidence of skin maceration. C. protection from the external environment. D. moisture needed for wound healing.
D. moisture needed for wound healing.
84
What are the early signs of hypoxia?
Tachypnea and tachycardia Restless and anxious Pale skin and mucous membranes Use of accessory muscles, nasal flaring
85
What are the late signs of hypoxia?
Stupor Cyanotic Bradypnea Hypotension Cardiac dysrhythmia
86
What physiological factors influence a patient's oxygenation?
Decreased oxygen-carrying capacity Hypovolemia Decreased inspired oxygen concentration Increased metabolic rate
87
What conditions can influence oxygenation?
Pregnancy, obesity, neuromuscular disease, musculoskeletal abnormalities, trauma, neuromuscular disease, CNS alterations
88
How much oxygen and what percentage does a nasal canula deliver?
Can deliver 1-6L of O2 (delivers 24%-44% oxygen)
89
How much oxygen and what percentage does a simple mask deliver?
Can deliver 6-12L of O2 (delivers 35%-50% oxygen)
90
How much oxygen and what percentage does a non-rebreather deliver?
Can deliver 10-15L of O2 (delivers 60%-90% oxygen)
91
What causes oxygen toxicity
Result from high concentrations of oxygen (above 50%) for 24-48 hours.
92
What nursing interventions are taken for oxygen toxicity?
Use lowest levels of O2 needed *titrate as ordered Monitor O2 sat and ABG’s. Monitor respiratory pattern.
93
What are the s/s of oxygen toxicity?
nonproductive cough, substernal pain, nasal stuffiness, N/V, fatigue, H/A, sore throat, uncontrolled coughing, muscle twitching
94
How much urine can you release at one time?
1,000mL
95
What are the four major sites of injection?
Intradermal, Subcutaneous, Intramuscular, Intravenous
96
What are some considerations for nasal instillations?
For decongestants: Caution patients to avoid the rebound effect Serious systemic effects also develop if excess decongestant solution is swallowed, especially in children
97
What is the procedure for preparing an injection from an ampule?
Snap off ampule neck Aspirate medication into syringe using filter needle Replace filter needle with an appropriate size needle or needless device Administer injection
98
What is the procedure for preparing an injection from a vial?
If dry, use solvent or diluent as needed Inject air into vial Label multidose vials after mixing Refrigerate remaining doses if needed
99
What are some specific risks to a patient's safety within the health care environment?
Falls, patient-inherent accidents, procedure-related accidents, equipment-related accidents, workplace safety.
100
What are some nursings diagnoses for patients with safety risk?
Risk for fall, risk for injury, confusion, risk for poisoning, risk for trauma, impaired home maintenance.
101
What kind of infection is MRSA?
Skin infection
102
What are reverse isolation techniques?
Goal is to protect patient from exposure to microorganisms. * Positive airflow room * No fresh flowers / fruit
103
What determines the classification of a medication?
Effect of medication on body system Symptoms the medication relieves Medication’s desired effect
104
Define absorption
Passage of medication molecules into the blood from the site of administration
105
How does medication exit the body?
Kidney Liver Bowel Lungs Exocrine glands
106
A nurse is administering an oral tablet to a patient. Which of the following steps is the second check for accuracy in determining the patient is receiving the right medication? A. Logging on to the AMDS or unolcking the medicine drawer or cart. B. Before going to the patient's room, comparing patient's name and name of medication on label of prepared drugs with MAR or computer printout. C. Selecting correct medication from tADMS, unit-dose drawer, or stock supply and comparing name of medication on label with MAR or computer printout. 4. Comparing MAR or computer pintout with names of medications on medicationl labels and patient name at patient bedise.
B.
107
An older adult states that she cannot see her medication bottles clearly to determine when to take her perscription. What actions should the nurse take to help hte older adult patient? Select all that apply A. Provide a dispensing system for each day of the week. B. Provide larger, easier-to-read labels. C. Tell the patient what is in each container. D. Have a family caregiver administer the medication? E. Use teach-back to ensure that the patient knows what medication to take and when.
A,B, and E.
108
Which of the following guidelines must a nurse use for taking verbal or telephone orders? (Select all that apply) A. Follow the health care agency guidelines regarding authorized staff who may recieve and record verbal or telephone orders. B. Clearly identify patient's name, room number, and diagnostic. C. Read back all orders to health care provider. D. Use clarification questions to aboid misunderstandings. E. Write VO (verbal order) or TO (telephone order) including date and time, name of patient, and complete order, sign the name of the health care provider and nurse.
A, B, C, D, E.
109
Which aspects of the patient's care related to the administration of heparin can the nurse delegate to the nursing AP? A. Notify the nurse if there are any signs of bleeding. B. Assess the vital signs for possible for possible symptoms of bleeding. C. Assess bleeding sites and apply appropriate pressure to the stites. D. Notify the nurse if there is blood noted in the patient's urine. E. Notify the nurse if there is oozing from any puncture sites.
A., D., E.
110
What are some common methods of nasal instillation?
Spray, drops, and tampons

NU 301 (8 decks)

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