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cp 2 > pod 3 > Flashcards

pod 3 Flashcards

1
Q

why do we give meds by different ways?

A

Different absorption and different area (pink eye –> drops)

Sublingual & buccal

Bypass metabolism route

Start to work right away

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2
Q

Eye drops

A

Coach how to put it in themselves

Ointment or drops when ordered

Irritation and inflammation and pain assess before drops

Assess for contact lens

Warm wash cloth, told eye open, drop it in

Order needs to be clear, left or right or both, no irritation, no contact lens (test)

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3
Q

Ear

A

Kids usually

Need to look in the ear canal to ensure intact ear drum (before order)

Ear infection in kids – not uncommon for ear drum to rupture

Ear canal straight in kids (pull ear back and down)

Adults (pull back and up)

Lay down, turn ear up that give meds, pull up and back, drop in drops, cotton ball in to make sure the meds stay in place, keep them laying down for 5 mins

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4
Q

Nose

A

Decongestants, vaccines (flu, covid, narcan)

Nose bleeds = cocaine because it does vasoconstriction

Plug one nostril, spray, inhale at same time

Goes into sinuses

Swab = nasopharyngeal cavity

TEST QT = NARCAN & VACCINES

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5
Q

Sublingual

A

Ativan = work almost the same as subcut

Nitroglycerine

Suboxone

Zofran (anti-nausea)

Works almost immediately

Small liquid = can be absorbed

Highly concentrated methadone in buccal area to manage pain (palliative)

Gloves

Nothing in someone’s mouth who may bite you (kids & seizure disorders)

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6
Q

Topical

A

Subcut butterflies

Fentanyl patches for pain management

Hydromorphone (subcutaneous butterfly catheter)

Butterfly = secured in the skin for a week

Has to be primed with MEDICATION nothing else

Used a lot in semester 4

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7
Q

Medication patches

A

Fentanyl 72 hours

2 witnesses when wasting the used patches

Note on MAR where you put the patch

Take patch off BEFORE you put a new one on

Needs to be in an accessible stop

Belly, upper arms – wherever you can get subcutaneous tissue

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8
Q

Nicotine therapy

A

As nurse, you can initiate first dose of nicotine and then get a doc order

Need to know how much they smoke

Cannot go outside and smoke while have patch on

Will last through shower – try to not get them too wet

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9
Q

Vaginal or rectal

A

Rectal = same mucous membrane as mouth – right into bloodstream, doesn’t go into stomach

Can use for someone who is vomiting

Don’t want to poke/injection

Used a lot in kids

Will melt nicely with no urge to make it feel like BM

Left side, in sims position

Left side = straighten out rectum

Flat end in first to prevent expulsion

Push it quite far

Induce BM = need to have it in for 15 mins

Anti-seizure meds can go rectum

Kids usually

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10
Q

Intervaginal

A

Suppository or cream

Usually let them do it themselves

Applicator, far enough to almost hit cervix

Usually done at night because they are lying down

Have a pad on, because there is going to be an excessive discharge (yeast infection & meds)

Instruct client to do it themselves unless they are older and need help

Intervaginal estrogen on post-menopausal people

Helps with incontinence & helps with vaginal dryness

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11
Q

Into wound

A

Silver, methadone, ketamine, tricyclic antidepressant (that helps with nerve pain)

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12
Q

Bronchodilators first and then the steroid second

A

true

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13
Q

Nebulizer

A

Wheezes and decreased O2 stats *** this is on test

Turn the oxygen to about 7 and let them breath the mist in (medication)

After about 10 mins of the medication being done, do a lung assessment, you should hear no wheezes and make sure the intervention was effective

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14
Q

How is a sublingual medication administered?

A

Placed under the tongue and allowed to dissolve completely

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15
Q

What is an example of a sublingual medication?

A

Suboxone, nitroglycerin

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16
Q

Review the administration procedures of Nitroglycerin spray

A

1 or 2 sprays on or under the tongue at the first sign of an chest pain. Sprays may be repeated every 5 minutes as needed. You must wait 5 minutes before administering a third spray if 2 sprays are used initially.

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17
Q

What does buccal mean?

A

cheek

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18
Q

How is a buccal medication administered?

A

Placing solid medication in the mouth and against the mucous membranes of the cheek until the medication dissolves

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19
Q

What should the psychiatric nurse consider prior to administering any dermatological medications?

A

Before applying a transdermal patch, remove the old patch if it is still in place. Clean area thoroughly.

Observe for signs of skin irritation at old patch and document as per agency policy.

Assess for allergies and skin integrity

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20
Q

What type of administrative system is a patch and how does it work?

A

Topical and has systemic effects that allows the transfer of medication through the skin

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21
Q

What should the psychiatric nurse consider before applying the patch medication?

A

Assess skin integrity, previous site – sites should be rotated, and assess vitals prn

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22
Q

What kind of medications can be given via the transdermal route?

A

Nicotine, nitroglycerin

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23
Q

Describe how to apply a transdermal medication patch

A

Remove the patch from its pouch and peel off half of its protective liner. Place the adhesive side on the skin, then peel off the other half of the liner. Press the skin patch firmly with the palm of your hand for at least 30 seconds, making sure it adheres to the skin, especially at the edges.

24
Q

Identify aspects of the assessments of the client, prior to administration of ophthalmic (eye) instillations

A

Irritation and inflammation and pain assess before drops

Assess for contact lens

25
Q

Describe how to administer eye instillations such as eye drops or eye ointments

A

Roll meds in hand to resuspend

Ask pt to look up at ceiling to reduce blinking reflex

Do not touch eyelid or tip of applicator to eye

With dominant hand resting on pt forehead, hold med approx 1-2cm above conjunctival sac

Use cotton to absorb medication that escapes eye

26
Q

Why does the nurse wipe/clean the clients\’s eye from the inner canthus to the outer canthus?

A

not to introduce debris or dirt into the lacrimal ducts that could cause an infection.

27
Q

What are the purposes of instilling otic (ear) medications?

A

Treat ear infections and used to prevent infections

28
Q

What is the technique for administering ear medications for an adult and for a child?

A

Children = down and back

Adults = up and outward

29
Q

Describe how to administer otic medications

A

Straighten ear canal by pulling the auricle (outside of ear) down and back for children 3 years or younger or upward and outward for adults

Hold medication 1cm above the ear canal and instill medication drops

30
Q

Describe how to administer nasal medications

A

Nasal drops

Resuspend medication

Instruct pt to clear/blow nose

Put pt in supine position & position head properly to facilitate nasal passages

Instruct pt to breathe through mouth, which reduces chance of aspirating

Hold dropper 1 cm above nares to avoid contamination, administer drops

Have pt remain supine for 5 minutes to prevent premature loss of medication

Nasal spray

Assist pt to high fowlers position

Administer spray with pt head upright, tipping the opening of nasal spray container downward to administer

31
Q

What kinds of medications are given by inhalation?

A

Bronchodilator used first to open airway and then steroid

Ventolin

Flovent

32
Q

What is the purpose of the extender or spacer, which is attached to the metered-dose inhaler?

A

Traps medication released

Slows down medication particles, enhancing the amount of medication received by pt

33
Q

Describe how you would administer a nebulizer

A

Pour nebule of medication into nebulizer chamber and place nebulizer mask on pt face

Turn up oxygen to 6L or until steady mist is achieved

34
Q

What are some clinical signs of hypoxia?

A

Apprehension, restlessness, decreased LOC, dizziness, vital sign change (increased pulse, increased rate & depth of respiration), cyanosis

35
Q

Identify psychiatric nursing interventions that will enhance the respiratory function of a client

A

Apply oxygen and titrate to keep SPO2 >92%

Position patient in upright high fowlers

Use pulse oximeter to measure oxygen saturation

Encourage patient to perform deep breathing and coughing

36
Q

What is the sequence for chest auscultation that allows for comparison of sounds from left to right?

A

Bilateral listening from apexes to bases

37
Q

When would the nurse teach deep breathing and coughing exercises?

A

Increase inhalation, increase chest expansion, moves more air through the lungs

Coughing mobilizes secretions

Breath in slowly through your nose for 3 counts, keeping mouth closed

Exhale slowly through mouth and cough at the end of exhale

38
Q

What does pursed lip breathing do?

A

Simplest way to control SOB

Easy way to slow your pace of breathing

Improves ventilation

Releases trapped air

Keeps the airways open longer

Causes relaxation

39
Q

Describe how to teach the client pursed lip breathing

A

Relax neck and shoulders

Breath in slowly through your nose for 2 counts, keeping mouth closed

Pucker or “purse” lips as if you are going to whistle while counting to four

40
Q

Why is an incentive spirometer used?

A

Encourages voluntary deep breathing by providing a visual feedback

Prevents or treats atelectasis in post op pt (lung collapse)

Aim is to encourage pts to breath their normal inspiratory capacity

41
Q

When would a client use an incentive spirometer?

A

Every hour while awake

42
Q

Describe how you would teach a client to use an incentive spirometer

A

Put the mouthpiece in mouth and close lips tightly around it

Inhale slowly and deeply through mouthpiece to raise indicator

When you can’t inhale any longer, remove mouthpiece and hold breath for at least 5 secs

Exhale normally

43
Q

What safety precautions are used with oxygen therapy?

A

fire hazard

44
Q

Why do clients with COPD (chronic obstructive pulmonary disease) that are receiving oxygen therapy need to be observed carefully?

A

Supplemental O2 removes a COPD patient’s hypoxic (low level of oxygen) respiratory drive causing hypoventilation which causes higher carbon dioxide levels, apnea (pauses in breathing), and ultimately respiratory failure

45
Q

What types of oxygen delivery systems are available?

A

Low flow

Oxygen prongs, simple face mask, nonbreahting mask

Refers to oxygen mixing with room air

High flow

Venturi mask or star wars mask

Deliver O2 rates above normal inspiratory flow rate and provided a fixed F2O2 regardless of pt inspiratory flow and breathing pattern

Used for pts who require larger flowrates of oxygen to maintain saturations (face masks are generally temporary for transport or until RT can setup high flow systems)

46
Q

What is the flow rate associated with a nasal cannula?

A

1-6L/min

47
Q

What does a simple face mask consist of and how is it applied?

A

Side port openings located on either side of mask to allow room air to mix with delivered O2 and allow exhaled air to escape

48
Q

What is the flow rate associated with a simple face mask?

A

5-8L/min

49
Q

What are some important nursing responsibilities associated with oxygen therapy?

A

Perform a focused respiratory assessment including airway, respiratory rate, pulse oximetry rate, and lung sounds.

50
Q

What is Star Wars high flow oxygen?

A

High-flow nasal cannula (HFNC) therapy is an oxygen supply system capable of delivering up to 100% humidified and heated oxygen at a flow rate of up to 60 liters per minute.

51
Q

When and why are sputum specimens collected?

A

Used to identify microorganisms growing in the sputum & to identify drug resistance and sensitivity

Takes 24-48 hours for results

Assess effectiveness of treatment

Assess for TB

Assess for cancer in lungs

52
Q

Describe how you would collect a sputum sample from a client

A

Position pt in high fowlers (promotes full lung expansion & facilitates ability to cough)

Provide sterile appropriate container

Instruct pt to take slow deep breath & cough after a full inhalation

Instruct pt to expectorate sputum directly in container

Label with date, time, initials, and what sample is

Best done in the morning

53
Q

Why are throat cultures collected?

A

Identify microorganism

54
Q

Describe how you would collect a throat culture sample from a client

A

Ask person to tilt head back, open mouth

Depress person’s tongue and ask them to “ahhh”

Collect culture by rubbing sterile swab tip on surface of tonsils

Label specimen with date, time, initials and type of sample

55
Q

How is proper oral airway size determined?

A

Measure distance from corner of mouth to angle of jaw below ear

Too small = tongue won’t be held in place

Too big = may force tongue toward epiglottis & obstruct airway

If gag reflex intact you don’t put it in as this means pt can protect airway

cp 2 (6 decks)

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