NUR350: Medication Administration 1 & 2

Question 1

What is the main formula often used to figure out how much medication is to be given

Answer 1

(Dose Desired/Dose on Hand) X Quantity on hand = Amount to Administer

Question 2

How many milliliters do we need to administer if the following was true for an order:
Order = Morphine 4 mg subcut
Available in ampule 10 mg/mL

Answer 2

(4mg/10mg) X 1 mL = 0.4 mL

Question 3

What is “reconitution”?

Answer 3

Adding diluent or solvent. (Diluent or solvent is a liquid used to dissolve a powder )

Question 4

Prescriber’s order reads: Amoxil 0.5 g po qid
Drug is available in a suspension of 250 mg in 5 mL.

How many millilitres (mL) would the nurse administer?

Answer 4

10 ml

Question 5

Physician’s order reads: Keflin 250mg IM qid
Drug is available in a strength of 500 mg/2.2 mL.

How many millilitres (mL) would the nurse administer?

Answer 5

1.1 ml

Question 6

According to the hospital formulary, acetaminophen (Tylenol) can be administered 10 mg/kg (minimum) q4-6h, not to exceed 65 mg/kg/24h. The child weighs 6 kg.

Calculate the minimum 24 hr dose and the maximum 24 hr dose.

Answer 6

240 - 390 mg/24 hours

Question 7

The CPS states that a child’s dose of amoxicillin (Amoxil) is 25 mg/kg administered in equally divided doses q8h. The child’s weight is 18 kg. Liquid amoxicillin is available in 1 mL = 50 mg.

How many mL will be administered every 8 hours?

Answer 7

3 ml

Question 8

What are some components of a complete medication order?

Answer 8

Patient’s full name – may include unique identification number in a hospital
Date and time the order is written
Medication name (may use generic or trade name)
Dose
Route of administration
Time and frequency of administration
Signature of prescriber

Question 9

List the nurse’s role in medication administration

Answer 9

Administration, dispensing, medication storage, inventory management, disposal

Question 10

Registered Nurses and Registered Practical Nurses require an order for a medication practice when:

Answer 10

A controlled act is involved
Administering a prescription medication
It is required by legislation that applies to a practice setting

Question 11

What are some of the “RIGHTS” of medication practice?

Answer 11

RIGHT patient  
RIGHT medication (3 checks)
RIGHT reason
RIGHT dose
RIGHT time and frequency
RIGHT route
RIGHT documentation
RIGHT to refuse
RIGHT patient education
RIGHT evaluation

Question 12

What are some considerations or information you should know to give medication safety?

Answer 12

Drug classification
Why is it being given
Normal dosage range
Usual routes of administration
Usual action of the medication
Expected side effects
Potential harmful side effects and what do do if they happen
Peak action and duration
Time of onset of action depending on route

Question 13

How will you administer a medication with the label stating “IM”

Answer 13

Intramuscular injection

Question 14

A medication label states “q4h”. How often will you administer this medication?

Answer 14

Every 4 hours

Question 15

What are some considerations for medication administration when working with children?

Answer 15

Variations in size, weight, body surface area
Ask child’s parent or guardian about how to best administer the medication
Use simple language
Try different forms of medication
Use a disposable syringe for accuracy

Question 16

What are some considerations for medical administration when working with older persons?

Answer 16

Physiological changes associated with aging
Simplify the medication plan
Older adults may be more sensitive to medications
Encourage fluids if not contraindicated
Be mindful of polypharmacy

Question 17

What is a medication error?

Answer 17

Any preventable event that may cause or lead to inappropriate medication use or client harm while the medication is in the control of the health care professional, client or consumer
Can be errors of commission or errors of omission

Question 18

What are some causes for medication errors?

Answer 18

Lack of verification of 10 rights
Miscommunication among healthcare professionals (written and verbal)
Lack of drug knowledge & drug miscalculations
Ambiguities - product names/appearance
Interruptions/distractions

Question 19

What are High Alert Medications?

Answer 19

Drugs that bear a heightened risk of causing significant harm when they are used in error

Question 20

Give an example of a High Alert Medication

Answer 20

Drug classes – opiates, antiarrhythmics, antithrombotic agents, dextrose, dialysis solutions, oral hypoglycemics, total parenteral nutrition solutions

Question 21

What is medication reconciliation?

Answer 21

Formal process of :

1) Obtaining a complete & accurate list of each current medications – including name, dosage, frequency and route
2) Using list when writing admission, transfer and/or discharge medication orders, and
3) Comparing the list against the admission, transfer and/or discharge orders, identifying and bringing any discrepancies to the attention of the prescriber and, if appropriate, making changes to the orders. This list should accompany the patient to the next care site.

Question 22

What are some steps you should take if you made a medication error?

Answer 22

Notify prescriber
Determine how long client must be monitored and if treatment is needed
Treat and/or monitor adverse reaction and document in chart
Report error (incident report)
Corrective actions
Advocate for systems that reduce risk of error
Check hospital policy re disclosure to client

Question 23

What is best practise in disclosing medication errors?

Answer 23

-Know disclosure policy and procedure of institution
-Disclose as soon as possible to patient or family
-Choose an appropriate setting
-Describe the course of events – nature of mistake, consequences
and corrective actions
-Express regret and apologize, if appropriate
-Elicit concerns and questions and commit to addressing them
-Provide follow-up
-Provide personal and professional support and guidance to staff
if necessary
-Learn what happened using an open approach
-Communicate incident to ISMP (Institute for Safe Medication
Practices)

Question 24

Physician’s order reads: Hyoscine 0.38 mg IM stat.
Drug is available in a strength of 0.4 mg/mL.

How many mL of this drug would the nurse administer?

Answer 24

0.95 ml

Question 25

Physician’s order reads: Ilosone 140 mg po qid
Drug is available in a suspension with each 5 mL containing 125 mg of Ilosone.

How many mL would the nurse administer?

Answer 25

5.6 ml

Question 26

Physician’s order reads: Decadron 3 mg po bid
Drug is available in 0.5 mg/5 mL solution.

How many mL of this solution would the nurse administer?

Answer 26

30 ml

Question 27

Physician’s order reads: Carnotine HCl 1100 mg po daily.
Drug is available in 550 mg tablets.

How many tablets does the nurse give to the client?

Answer 27

2 tablets