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The "Fun" class > Skills Exam 5 part 1 > Flashcards

Skills Exam 5 part 1 Flashcards

1
Q

to safely and accurately administer medications, you need knowledge related to

A
  • legal aspects of health care
  • pharmacology
  • life sciences
  • pathophysiology
  • human anatomy
  • mathematics
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2
Q

drug names: chemical

A

provides the exact descriptions of medications composition (rarely used by nursing)

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3
Q

drug names: generic

A

the manufacturer who first developed the drug assigns the name, and it is then listed in the U.S Pharmacopeia
ex: acetaminophen

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4
Q

drug names: trade

A

also known as brand or propriety name. this is the name under which the manufacturer markets the medication
ex: tylenol

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5
Q

how do you classify medications?

A
  • effects of medication on body systems
  • symptoms the medication relieves
  • medications desired effect
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6
Q

combination medications

A
  • a medication that includes two or more active ingredients combines in a single dosage form
  • the medication lists the trade name, followed by the generic name of each drug
  • the medication will list the dosages of each drug in order of generic names
    ex: Norco (Hydrocodone- Acetaminophen) 5mg/325mg
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7
Q

absorption

A

passage of medication molecules into the blood stream from the site of administration

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8
Q

what are some factors that influence absorption?

A
  • route of administration
  • ability of a med to dissolve
  • blood flow to the site of administration
  • body surface area
  • distribution
  • metabolism
  • excretion
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9
Q

therapeutic effect

A

expected or predicted physiological response

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10
Q

adverse effect

A

unintended, undesirable outcome

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11
Q

side effect

A

a predictable secondary, typically undesirable, effect

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12
Q

toxic effect

A

accumulation of medication in the bloodstream causing undesirable outcomes

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13
Q

idiosyncratic reaction

A

adverse effects that cannot be explained by the known mechanisms of action of the drug, do not occur in most patients, and develop unpredictable in susceptible individuals only

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14
Q

allergic reaction

A

unpredictable response to a medication

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15
Q

medication interactions

A

one medications modifies the action of another

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16
Q

medication tolerance

A

more medication is required to achieve the same therapeutic effect

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17
Q

medication dependence

A
  • physical

- psychological

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18
Q

what is polypharmacy?

A
  • takes two or more medications to treat THE SAME ILLNESS
  • takes two or more medications from THE SAME CHEMICAL CLASS
  • uses two or more medications WITH THE SAME OR SIMILAR ACTIONS to treat several disorders simultaneously
  • mixes nutritional supplements or herbal products with medications
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19
Q

who are the providers?

A
  • physicians
  • nurse practitioners
  • physicians assistants
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20
Q

what is their role?

A
  • determine the medication the pt needs

- place the order for the medication

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21
Q

what can orders be?

A
  • written

- verbal/telephone

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22
Q

each medication order must include what?

A
  • pt’s name
  • order date
  • medication name
  • dosage
  • route
  • time of administration
  • drug indication
  • prescriber’ signature
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23
Q

standing or routine order

A

administered until the dosage is changed or another medication is prescribed

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24
Q

single (one time)

A

given one time only for a specific reason

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25
Q

now

A

when a medications is needed right away, but not STAT

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26
Q

PRN

A

given when the pt requires it

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27
Q

STAT

A

given immediately in an emergency

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28
Q

prescriptions

A

medications to be taken outside of the hospital

29
Q

what is the pharmacists role?

A

prepare and distribute medications

30
Q

what is the nurses role?

A
  • determine medications ordered are correct
  • ensure medication to be administered is correct
  • determine medication timing
  • administer medication correctly
  • closely monitors effects
  • provides pt teaching
  • does not delegate medication administration to assistive personnel
31
Q

medication frequency refers to …

A

how often a medication can be given

32
Q

if an order is written for “____ times a day”…

A

you should pay attention to when it was last given and try to space is out as evenly as possible, even though there isn’t a specific time associated with the order

33
Q

the nurse has a window to give scheduled medications

A

may give scheduled medications up to an hour before and up to an hour after scheduled time

34
Q

tip!

A

use critical thinking to organize skills to group medication administration together is possible. cluster your care!

35
Q

order: give 2mg
available: 0.5mg tablets
how many tablets will you give?

A

4 tabs

36
Q

review basic medication dosages

A

slide 20

37
Q

medication error

A

any preventable event that may cause inappropriate medication use or jeopardize pt safety

38
Q

when an error occurs

A
  • first assess the pt condition, then notify the provider
  • when pt is stable, report the incident
  • prepare and file an occurrence or incident report
  • report near misses and incidents that cause no harm
39
Q

medication errors

A
  • wrong pt
  • wrong medication
  • wrong dose
  • wrong preparation
  • wrong route
  • wrong time
  • medication expired
  • forgetting to sign off correctly
40
Q

what are the seven rights of administration?

A
  • right medication
  • right dose/amount
  • right pt
  • right route
  • right time
  • right documentation
  • right indication
41
Q

TRAMPED

A
  • time
  • route
  • amount
  • medication
  • patient
  • expiration
  • documentation
42
Q

the pt’s rights

A
  • to be informed about a medication
  • to refuse a medication
  • to have a medication history
  • to be properly advised about experimental nature of medication
  • to receive labeled medications safely
  • to receive supportive therapy
  • to not receive unnecessary medications
  • to be informed if medications are part of a research study
43
Q

medical history

A
  • allergies
  • medications
  • diet history
  • compliance to therapy
  • pt’s perception of problems
  • pt’s current condition
  • pt’s attitude about medication use
  • pt’s understanding of and adherence to medication therapy
44
Q

frequency is not part of the TRAMPED process but is it a part of the order

A

when a medication is scheduled, there is no need to mention the frequency

45
Q

before administering medications, always assess the pt first

A
  • make sure the pt is awake and alert, ready for meds
  • get a set of vitals and a head to toe if possible
  • go to nurses station to prepare for med pass
  • check orders before grabbing any meds
  • collect appropriate meds for the time
  • collect appropriate supplies
  • perform TRAMPED twice by yourself
  • get instructor for third TRAMPED
  • after third TRAMPED, prep each med
  • after meds are prepared clean area
  • ask name, DOB, allergies and compare to MAR
  • educate pt on what your giving them
  • administer meds
  • document
46
Q

do you need to document in your narrative every scheduled medication that you gave?

A

no, you don’t have to document at all, unless the patient gives you trouble/refuses or if you can’t give the medication based on assessment findings

47
Q

when should you document medication administration in the narrative charting?

A
  • PRN medication administration

- why? because you give a PRN for a specific reason/complaint

48
Q

scheduled medications

A

initial box for correct date/time

49
Q

PRN medications

A
  • initial box for correct administration

- include time administered

50
Q

ensure full name, credentials, and initials are included on MAR signature box

A

only need to perform this once per MAR

51
Q

random pieces of information

A
  • never leave any medications unattended, even if you are staying in the same area and simply turning your back
  • never sign off medications until the patient has taken them completely
  • if you notice a trend with your patient and medication refusal, ask your patient if they will take their medications before you go prep them all
  • bring your patient’s favorite drink to wash down their medications
  • if a patient with dementia initially refuses medications, try a different approach versus giving up
  • walk away and come back
  • if a patient with dementia doesn’t know their name, DOB, allergies – still ask. Then verify with instructor or staff member.
52
Q

keys to accuracy

A
  • avoid distractions and follow the same routine
  • administer only medications you prepare, and never leave prepared medications unattended
  • document medications immediately after administration
  • use clinical judgment in determining the best time to administer prn medications
  • when preparing medications, check the medication container label against the medication administration record (MAR) three times
  • TRAMP in order of the MAR
53
Q

what are the controlled substances we need to know for med pass?

A
  • tramadol
  • hydrocodone
  • oxycodone
  • ativan (lorazepam)
  • norco (hydrocodone with acetaminophen)
  • percocet (oxycodone with acetaminophen)
54
Q

controlled substances

A
  • all controlled substances are locked up
  • as soon as you access a controlled substance for a pt, you must verify the count
  • if you walk away before verifying, you are responsible if the count is wrong
  • TRAMP the med with all other medications to be administered
  • document that count, sign/time/date
  • if you waste the medications, another nurse must witness that you wasted it
55
Q

when comparing the log with the medication in hand, what must the nurse look at to ensure accuracy?

A
  • pt’s name
  • pt’s DOB
  • medication name
  • medication dose
  • medication route
  • once the above has been matched correctly, then analyze the ending count on the log with the amount of pills in the blister pack
56
Q

medication routes: oral

A
  • easiest and most desirable route
  • medication is swallowed, enters GI tract, gets digested and absorbed
  • this route is avoided if pt is experiencing GI issues, pt cannot swallow, or is unconscious
  • food sometimes affects absorption
  • you must protect pt’s from aspiration
57
Q

types of oral meds

A
  • pills

- liquids

58
Q

crushing oral medications

A
  • may be crushed to be swallowed more easily
  • crushing reduces the risk for aspiration
  • after meds are crushed, place in food or fluid for pt to consume
59
Q

NEVER crush

A 
extended release (ER)
enteric coated (EC)
60
Q

additional oral routes

A

all of these routes avoid the GI system and are absorbed directly into the blood through the oral tissue

  • sublingual (under the tongue)
  • buccal (place against the cheek)
61
Q

medication routes: topical

A
  • apply to skin

- ointments, lotions, paste, transdermal patches

62
Q

transdermal patches

A
  • assess skin
  • ask if pt has an existing patch
  • apply gloves before removing or applying a new patch
  • remove old before applying new
  • cleanse the area
  • apply new patch in a different location
  • document location of new patch
63
Q

medication routes: oral inhalation

A
  • medications are administered for nasal congestion/allergies/ sinus issues
  • they do not have any effect on the lungs and bronchioles
64
Q

how to administer

A
  • help pt into upright position with head tilted slightly forward
  • insert tip into the appropriate nare and occlude other nare with finger
  • point spray tip toward side and away from the center of the nose
  • spray and inhale at the same time
  • help pt remove nozzle from nose and instruct to breath through the nose
  • offer face tissues, but caution against blowing for several minutes
65
Q

medication routes: oral inhalation

A
  • medication inhaled through mouth to enter lung tissue

- they are not considered PO medications because they do not enter the GI tract

66
Q

general instructions for inhaler

A
  • instruct pt to breath out through the mouth
  • place inhaler to lips, seal lips around mouthpiece
  • take a deep, slow breath in
  • keep lips sealed and hold breath for about 10 seconds
  • release breath and remove inhaler from lips
67
Q

metered dose inhalers

A
  • inhaler is pressurized and will release medications when the container is pressed down on
  • requires hand strength and hand-breath coordination
  • pt must inhale as they simultaneously press down on the medication container
  • may use a spacer with this
68
Q

dry powder inhalers

A
  • diskus inhalers
  • activated by pt’s breath
  • delivers more medications to the lungs

The "Fun" class (12 decks)

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