Personal Safet and Medication Adminstration Flashcards
1
Q
What should you do if you receive a handwritten order that you are not able to read?
A
Clarify with the person who gave the order -> NEVER ASSUME
2
Q
Review the unacceptable abbreviations in master notes
A
3
Q
In order to begin documentation, what must you do?
A
- Scan patients ID band
- Scan medication
4
Q
When should documentaiton begin and where should it be done?
A
As soon after medication is given - must be done at the bedside
5
Q
T/F: If there is an emergency, it is okay to document that medication was given before it was actually administered
A
False, Medications should NEVER be recorded before they are given
6
Q
What 5 things must you document when giving a medication?
A
- Name of medication
- Dose
- Route
- Time given
- Name of person administering the medication
7
Q
If giving PRN medication, what must you include?
A
reason for adminstration
8
Q
What must you document If medication was refused/unable to be taken by patient?
A
record reason for refusal/reason why patient oculd not take it + notify healthcare team
9
Q
What must you document if medication was adminstered through enteral feeding tube?
A
record
- total water volume
- liquid medication volume
10
Q
What must you docuemnt if you are giving an IV infusion?
A
record rate of adminsitration
11
Q
What must you be sure to do if a patient experiences unusual reactions to a medication?
A
if the reason is an adverse reaction, you must notify healthcare provider
12
Q
If adminstiering an injection, topical/transdermal applicaiton, narris, eye, or ear medications, what must you be sure to include in your documentation?
A
site used
13
Q
T/F: Follow up documentation is required for reponse of medication
A
True
14
Q
What 2 things must you document if you are wasting a controlled substance medication>
A
Record waste and pain scale used
15
Q
What types of medication may require cosignature if you are wasting?
A
narcotic
16
Q
What are the 5 rights?
A
PMDTR
- Patient
- Medication
- Dose
- Time
- Route
17
Q
When giving medication, what precautions should you follow?
A
Standard precautions
- Hand Hygiene
- Wear gloves (do NOT touch pills with bare hands)
18
Q
T/F: You must have gloves on when opening meds
A
False, you are able to have gloves off when opening meds
19
Q
The 5 rights include: right patient, medication, dose, time, and route. What are the 4 extra considerations you should take into account?
DARE
A
DARE
- Documentation
- Allergies
- Reason
- Expiration date
20
Q
When do you perform the 3 checks?
A
- When the nurse reaches for the unit dose package or container
- After retrieval from the drawer and compared with the eMAR/MAR
- Just before giving medication to the patient
21
Q
What 7 things should the nurse check to ensure they are receiving a complete order?
A
- Full name of patient
- Date/time order was written
- Drug name
-> Using generic name = safest option - Dosage
- Route (PO, IV, etc)
- Frequency
- Signature of healthcare provider
22
Q
Routine Order
A
carried out as specified until canceled by another order
23
Q
One-time order
A
carried out only once
24
Q
Stat order
A
carried out once and immediately
25
**PRN order**
given as needed
26
What are the 3 types of orders?
- Written
- Verbal
- Telephone
27
Be sure to clarify the order and repeat back the order if given _____ or ______ order
- verbal
- telephone
28
T/F: Student nurses are permitted to accept verbal orders
False
29
You are about to administer medication, but you realize there is no medical order in the patient’s chart. What should you do?
Do not give the medication; no medication may be given without a medical order from a licensed practitioner
30
The provider’s order is handwritten and unclear. You think you know what it says. What is your next step?
you MUST clarify the order before administration
31
You notice a medication in the patient's drawer that could also be used to treat a new symptom they’re having. Should you give it?
No. You can only give medications that are ORDERED
Call the provider to ask if the order can be changed to account for the new symptoms
32
You have a medication in hand that another nurse prepared. The patient is ready for it. Should you give it?
No. Only give medications that you have prepared.
33
You are walking by and notice the medication dispensing machine is left open. What should be your concern?
Medication dispensing machines must be locked at all times
34
You are a student nurse and don’t have an access code. Should you be accessing the medication dispensing machine?
No. Only licensed personnel with access codes may access it
35
While administering medication, Nurse Karen places the cup on the bedside table and walks away to get water. What was her mistake?
Medication must be in view at all times. She should have taken the medication with her.
36
You gave the wrong dose of medication but the patient seems fine. Should you still report it?
Yes. Report errors IMMEDIATELY.
37
T/F: Providing patient education on the medications they are taking are the roles of the doctor and pharmacist
FALSE, nurses are responsible for education the patient on their medications
38
You override the medication system to give a dose quickly during a busy shift. You’ve done this a few times before without issues. What is the risk of continuing this behavior?
It can lead to medication error. Do NOT make it a habit
39
Before giving a medication, a nursing student asks you what it’s for and you’re not sure. What responsibility are you neglecting?
Know the medications you are administering
40
You administered a medication and the patient later had an adverse reaction due to a dosage error made by the medical doctor. Who is responsible?
If you gave it, you are responsible. Nurses are the last line of defense
41
You’re unsure about a newly ordered medication. Where can you find up-to-date information?
Medication Data Base — it provides up-to-date medication information
42
**Match the description to its correct law**:
**Laws**:
A. Controlled Substance Act
B. Nurse Practice Act
**Descriptions**:
- Regulates the distribution of narcotics and other drugs of abuse
- State
- Federal
- Regulates the nursing profession and defines the legal responsibilities and scope of practice
**Controlled Substance Act**
- Federal
- Regulates distribution of narcotics and other drugs of abuse
**Nurse Practice Act**
- State
- Regulates nursing profession and defines the legal responsibilities and scope of practice
43
What is the primary function of the Food, Drug, Cosmetic Act (FDA)?
Make sure drug is safe (can take years)
44
T/F: The Controlled Substance Procedure is federally regulated and creates strict policies regarding wasting that all hospitals must follow
False, this procedure varies by hospitals. Each hospital may have different policies regarding wasting
45
How to you make sure you have the adequate amount of liquid medication when using a med cup?
Go to eye level & measure at center of meniscus
46
Some liquid medications can be given via med cup, ______, and _____________ __________, but that one is usually used for pediatrics
- Dropper
- Med Spoon
47
1 tsp = _____ mL
1 Tbs = _____ mL
1 oz = _____ ml
1 tsp = **5** ml
1 Tbs = **15** ml
1 oz = **30** ml
48
You’re passing meds at 9:00 AM. By what time must you administer them to stay within the proper window?
Between 8:30 – 9:30
Medication must be one time and you get a one hour window to administer drugs
49
You’re about to give medication, but a coworker starts chatting with you. Why should you minimize this interaction?
interruptions increase the risk for error
50
Before giving a med, you check that the patient is AAOx4 and get their BP, HR, and RR. You also check their labs. Why is this important?
To ensure that everything is wtihin parameters
(Ex: BP, HR, RR)
51
Your patient is having persistent vomiting and diarrhea. What should you consider before giving oral medication?
Patient may be unable to take their med
52
You are about to give medication to a patient who is NPO for surgery. What should you do?
Most meds won’t be administered, but ask provider for clarification
53
Why is it important to know if a patient is able to swallow meds before giving it to them?
You may need to crush their meds and give it with pudding.
They might also be aspiration precautions, whcih means you will need to sit them upright at 90 degrees and keep them there for at least 30 minutes after medication adminstration.
54
You are giving an oral med to a patient in bed. What should you do to minimize the risk of aspiration?
Sit pt upright when administering the medication
If aspiration precautions, put bed 90 degreees.
55
Your patient is NPO but has an order for a sublingual medication. What should you do before administering it?
provide oral care
(ensures tab will dissolve appropratley)
56
Where should you place the medication if it is ordered to be given sublingually?
under the tongue
57
You’re giving a buccal medication. Where exactly should you place it?
Place medication between the cheek and gum
58
When giving a patient a sublingual or buccal medication, why is it important to offer the patient water before adminstration of the drug?
it will help to make sure the tab dissolved appropriatley
59
Nurse Karen is about to apply a topical ointment. Nurse Karen cleans the area with soap/detergent and water. What is her reasoning for doing this?
Clean surface enhances absorption
60
After cleaning the skin, how do you apply a topical ointment?
Rub medication on the surface
61
Before applying a new transdermal patch, what step must you take first?
Remove previous patch & wash the area & shave the area (no hair)
62
You just removed an old patch and are choosing a spot for the new one. What must you check for before placing the patch?
Make sure it's clean, dry, and free from hair
63
After placing a transdermal patch, how long should you press it? What should you avoid?
Firmly press for 30 secs (DO NOT MASSAGE)
64
Where should you place the medical tape in relation to the transdermal patch?
Place medical tape near the patch but not on it
65
What do you write on the tape when applying a transdermal patch?
Write your initial, date, and time of administration on tape
66
T/F: It is okay for a nurse to write directly on the transdermal patch
False, DO NOT WRITE DIRECTLY ON THE MEDICATION PATCH
67
Where should you **not** place a transdermal patch with estrogen?
Should not be placed on breast tissue because there is an associated risk of breast cancer
68
How should you go about administering eyedrops?
1. Tilt pt head back
2. Hold dropper close to the pt eye, but avoid touching the eye
3. Drop drops in middle of conjunctival sac
69
Where do you apply eye ointment?
Apply ointment from inner canthus to outer canthus
70
What should you tell the patient to do after applying eye ointment?
Advise pt to close & move eye to spread out the ointment.
(**DO NOT RUB EYE**)
71
What temporary effect might eye ointment have?
temporary blurred vision
72
How should you position the patient before administering ear drops?
Lay patient on unaffected side
73
How do you position the ear in an adult before administering otic meds?
Pull the pinna up and back
74
Where should you aim the drops?
Allow drop to fall on the side of the canal.
(**AVOID INSTILLING IN THE MIDDLE TO AVOID INSTILLING DROPS DIRECTLY ONTO TYMPANIC MEMBRANE**)
75
How should the patient be positioned for vaginal medication?
Position pt on their back w/ knee flexed
76
After lubricating the vaginal applicator/finger you are now ready to apply the vaginal cream. How do you do this.
Insert full length of the vagina and push cream out of the applicator
77
After lubricating the vaginal applicator/finger you are now ready to apply the vaginal suppository. How do you do this.
Insert the rounded end along the posterior wall and length of your finger
78
What should you tell the patient to do after insertion of vaginal cream or suppository?
Ask patient to remain in position for 5–10 min after insertion
79
What (3) conditions should you avoid giving patients rectal medication?
- recent rectal/prostate surgery
- thrombocytopenia or neutropenic
- at risk for dyshythmias (due to vasovagal response)
80
What position should the patient be in for rectal suppository administration?
Left side sims position
81
Describe the steps in which to give a rectal suppository
1. Place patient in left side sims position
2. lubricate index finger and suppository
3. Quickly insert 3-4 inches into rectum (must be done quick to prevent suppository from melting/dissolving)
4. Have pt remain on their side for 5 minutes
82
Describe the full step-by-step process for administering a pulmonary metered-dose inhaler (MDI)
1. Have pt take deep breath and exhale before inhaler use
2. Place inhaler b/w the lips **OR** 1–2 inches away
3. Inhale slowly & deeply
4. Have pt hold their breath for 10 seconds
5. Then exhale slowly thru pursed lips
6. Wait 1–5 minutes before administering the next puff
83
How can you help an older adult manage their medication schedule?
Assist with medication schedule — associate meds with activities
(ex: take meds before breakfast)
84
Why might an older adult need help with opening medication containers?
may have certain disease conditions like rheumatoid arthritis, which can make it difficult to open pill bottles/containers. these patients may require assistance
85
Sensory deficits come with the aginst process. How can you assist a visually impaired patient in understanding their medications?
Utilize labels w/ large print
86
Sensory deficity comes with the aging process. How can you assist a patient with auditory impairment?
- Teach-back (ensure understand material)
- Utilize written material
87
What happens to drug metabolism in the liver as we age, and how does this impact drug toxicity?
↓ drug metabolism → ↑ time stays in body → ↑ risk of drug toxicity
87
How does decreased renal filtration affect drug excretion in older adults?
↓ renal filtration → ↓ drug excretion → ↑ risk of drug toxicity
88
With aging, there is slower, less complete absorption through the GI System. How can altered absorption through the GI system affect the patient?
Altered absorption → stomach irritation & gastric ulceration
89
Older adults have an increase proprition of fat to lean body mass. What happens with fat-soluble drugs in elderly patients with increased body fat?
↑ Accumulation of fat-soluble drug → prolonged action → ↑ risk of drug toxicity
90
Older adults have an increase proprition of fat to lean body mass. How does a decrease in lead body mass affect drug distribution?
↓ distribution of water soluble drugs → ↑ risk of drug toxicity
91
When giving a patient medication, it is important to educate them on which drugs to take, when to take it, its purpose, and symptoms to report. If a patient is taking an antihypertensive, what should you mention during your education?
- Antihypertensive: ↑ risk for falls -> Tell pt to stand up slowly to avoid orthostatic hypotension
92
T/F: You can crush capsules & extended release medications
False: Never crush capsules or extended release medications
93
T/F: You should administer every medication in the g-tube at the same time
False; you want to administer medications one at a time and flush b/w administrations to pvt unknown compounding & clogging
94
Why are patients who visit multiple pharmacies more prone to drug errors?
pharmacies may accidentally give a double prescription if they are ordered by different HCP. this means the patient would be taking two of the same medications, which can be dangerous. this is why medication reconcilliation is important. encourage patient to have all perscriptions filled out at one pharmacy.
