Nutrition/Medication Administration

Question 1

What are the assessments of nutritional status?

Answer 1

Nursing History
Diet History
Measurements
Lab Data
  -CBC(complete blood count)
  -transferrin level = proteins available to bind & carry iron
  -albumin, globulin, total protein
  -BUN(blood urea nitrogen)  
  -Creatinine= reflects muscle metabolisma

Question 2

What is parenteral feeding/TPN(total parental nutrition)?

Answer 2

Unable to use gut

Question 3

TPN must be given via?

Answer 3

Central line

Question 4

What veins are used?

Answer 4

Subclavian or jugular

Question 5

TPN can give hypertonic solutions containing what?

Answer 5

Glucose, amino acids, electrolytes, and lipids

Question 6

Glass bottles are used for what in TPN?

Answer 6

Amino Acids: Make sure fluid is not cloudy

Lipids: can be run peripherally or piggyback with TPN

Question 7

If IV infiltrates or TPN is discontinued, hang what?

Answer 7

10% Dextrose IV Bag

Question 8

What are some nursing cares for TPN?

Answer 8

Suddenly stopping causes hypoglycemia
2 RNs must check solution prior to hanging
Monitor Blood Glucose q6h
Strict Sterile Technique
Inspect for particulate

Question 9

What are the assessments of TPN?

Answer 9

Line is sterile & functioning
Check IV Site and for oily layer
Only by IV not gravity
Hypoglycemia if turned off

Question 10

What is enteral feeding?

Answer 10

Into GI tract via use of the gut

Question 11

What are the types of tubes in enteral feeding?

Answer 11

NG tube
DobHoff Tube
Gastrosomy or PEG tube
Jejunostomy or J-tube

Question 12

Indications for enteral feeding?

Answer 12

Respiratory failure
Head/Neck/Upper GI cancer
Neuro disease
Inflammatory bowel disease
Inadequate oral intake
Dysphagia/Aspiration- check residuals q4h, raise bed 30 degrees
Diarrhea/Dehydration

Question 13

SL

Answer 13

sublingual

Question 14

IV

Answer 14

intravenous

Question 15

IM

Answer 15

intramuscular

Question 16

PO

Answer 16

By mouth

Question 17

ODP

Answer 17

Orally disintegrating tablet

Question 18

PRN

Answer 18

As needed

Question 19

HS

Answer 19

At bedtime

Question 20

Types of medication orders

Answer 20

Routine
Standing Orders(prewritten by MD)
PRN
Single
STAT
Discharge prescriptions

Question 21

Intradermal(aspirating)

Answer 21

Used for Skin testing(TB, Allergy)
Potent meds used- slow absorption in dermis
Insert bevel up, bleb should appear
Common Sites:
 - forearms
 -chest
 -back

Question 22

Subcutaneous

Answer 22

Given in loose connective tissue under dermis
Decreased absorption dude to decreased blood supply
45-90 degrees
Do NOT need to aspirate

Question 23

Intramuscular (deep into body of a muscle)

Answer 23

10-20 minute absorption
Max of 3 mL in large muscle. feel for bony landmarks to find site. Aspirate to assure not a vessel
Sites:
-away from nerves, bones, large vessels, scars or bruises

Question 24

Needle size Length

Answer 24

Length (<1 inch. up to 2 inches) SQ vs. IM; site (muscle size)

Question 25

Needle gauge

Answer 25

smaller gauge is large size; large gauge is smaller size

Question 26

Vastus Lateralis

Answer 26

often used in PEDIATRICS | Landmark: Between hip and knee outer side

Question 27

Ventrogluteal

Answer 27

Away from major nerves and blood vessels | Landmark: Hip. Thumb facing belly button

Question 28

Deltoid

Answer 28

Use for small medications, 1 mL or less NOT always developed in in adults Potential for injury Landmark: 2 inches below acromion process

Question 29

Z trach method

Answer 29

Decrease skin irritation from medications Move skin aside Recommended for IM injections

Question 30

Role of the Pharmacy

Answer 30

1. Stock Med Rooms 2. Enter Med orders into computer MAR(medical administration record) 3. Dispensing - correct med - proper dosage - accurate label 4. Watch for: - allergies - drug interactions - toxicity - compatibility

Question 31

Role of Prescriber

Answer 31

1. order is transmitted by nurse 2. computer physician order entry 3. verbal orders 4. telephone orders 4. read back policy 5. NURSING STUDENTS CANNOT TAKE ORDERS. CAN ONLY GIVE NEWLY ORDERED MEDS VERIFIED BY RN.

Question 32

Role of Nurse

Answer 32

``` ASSESMENT Patient History Allergies Current Medication Diet History Patient Deficits Present Condition Attitude of meds Knowledge and learning needs Height & Weight ```

Question 33

5+5 Rights of Medication

Answer 33

``` Right Patient Drug Dose Time Route Assessment Documentation Educate Evaluation To Refuse ```

Question 34

6 rights of medication administration

Answer 34

Patient, Drug, Dose, Time, Route, Documentation

Question 35

Medication Errors

Answer 35

``` NOT given as ORDERED NOT APPROPRIATE for patient NOT accurate DOCUMENTATION IV med. given at WRONG RATE WRONG DOSE of med. give INCORRECT TIME NOT LABELED properly ```