T2-Important Notes (based of document) Flashcards
What do we do for liquid meds?
Nurse pours liquid med into medicine cup for accurate dispensing and lines up the meniscus to a predetermined line on the cup
The meniscus is the true level of liquid medication because surface tension draws liquid up to the sides of the med cup, distorting the level
How do we do ear drops for child younger than 3?
The nurse should pull the pinna down and back
How do we do ear drops for children and adults?
Pull the pinna upward and outward
Ear drops: Why do we do those techniques for ear drop administration?
Doing them straightens the ear canal for proper channeling of the medication
Ear drops: What position is the person in when giving ear drops?
Side-lying position with appropriate ear facing before instillation
Buccal: What does the nurse instruct the client to do?
Hold the medication between the cheek and gums to administer a buccal med properly
What is medication administered under the tongue?
Sublingual
Where do buccal medications dissolve?
Between the cheeks and gums
What position is the patient in for suppository?
The left side-lying Sim’s position
Why do we put the patient in left Sims for a suppository?
Exposes the anus and helps the patient to relax the external anal sphincter, while lessening the likelihood that the suppository or feces will be expelled
Why does the nurse instruct the client to apply the new patch to a different site?
To prevent tissue irritation and to promote the intended rate of med absorption
When is subcutaneous site appropriate?
Small amounts of injectable heparin and insulin
What is the usual site for deep IM meds on adults?
Ventrol Gluteal
Which IM site is no longer considered appropriate and why?
Dorsogluteal; sciatic nerve too close
What IM injection is only suitable for small med volumes when other sites are inaccessible?
Deltoid
What is the IM preferred site for children?
Vastus lateralis
The recommendation for pediatric IM injection sites includes use of the vastus laterals for infants until the have been _____.
Walking for a year
What gauge and length needle is usually used for adults?
20-22; 1.5 in
What gauge and length needle is used for infants and young children?
22 gauge; 1 in
A normal, well developed adult can safely tolerate ____ in larger muscles such as the ventrogluteal. Even though they can tolerate that much, it is unusual to administer more than ___ of medication in a single injection because the body does not absorbed it well
3-5 mL; 3 mL
Elderly adults and thin patients often tolerate ___ mL in a single injection.
2 mL
What does aspiration of blood indicate?
IV placement of the needle
What happens if you aspirate blood?
Immediately stop injection
Remove needle
Prepare a new syringe of med for administration
What route provides the most rapid absorption and why?
IV; because meds given this route are immediately absorbed into the systemic circulation
If a client is obese, how do you insert a SQ injection?
90 degree angle
Do we need to aspirate for SQ? Why or why not?
No; aspiration is unnecessary for SC injections because the tissue is avascular
Should we or client massage the site after SC injection? Why or why not?
No, neither should. We want to avoid massaging the injection site after administering meds to prevent the formation of large hematoma and to decrease the risk of additional bleeding and tissue damage
To minimize the pain and bruising associated with low-molecular weight heparin, it is given SC on the right or left side of the abdomen, at least ___ away from the umbilicus.
2 in
Insulin: What is the order for putting in air and withdrawing med?
Air in cloudy, air in clear, withdraw clear, withdraw cloudy
Why is it important to let the alcohol on wiped skin dry before injecting a med?
The drying kills the microorganisms
The needle can carry alcohol into the puncture, cause pain, and skew the results
What is a glass container for a single dose of medication?
Ampule
What must the nurse use for drawing up med out of an ampule?
Filter needle
MUST REMEMBER TO CHANGE AND DISCARD THE FILTER NEEDLE BEFORE ADMINISTERING TO PATIENT
Why do we pull the clients skin before injection a needle using Z-track technique?
To prepare the seal for the medication after injection
When the skin is released after the needle is withdrawn, it assumes its original place and helps to contain the medication
Do we aspirate with Z-track?
Yes
Z-track:Why do we hold the needle in place 10 seconds after administration?
So med can disperse evenly
A tuberculin skin tests indicating the presence of antibodies results in a ___, ___ area at the injection site greater than ___ mm in diameter for a recent immigrant from southeast asia because many immigrants from that area are exposed to TB.
Palpable, indurated
10 mm
If a client is tested after receiving the TB vaccine, the ID skin test will be ____. (positive or negative)
Positive
TB skin test: Clients with no known risk factors have a positive test with a __ mm induration
15 mm
TB skin test: Clients who are immunocompromised have a positive test with a ___ induration
5 mm
Documentation: The nurse records their name and administration time immediately after _____ to maintain an up0to-date and accurate client medical record
After medication administration
Documentation: 4 steps
- Assess client
- Administration medication if indicated
- Documents the assessment with the administration
- Preforms post administration assessment
What is the most important nursing assessment?
To check vital signs–especially BP and HR
Why is BP and HR especially important VS to check?
The therapeutic response of an antihypertensive medication is a lower BP; as reflex action, the heart rate can increase the BP as the BP drops to compensate for the drop in CO
What are narcotics?
Controlled substances
Where are narcotics kept?
A double-locked med drawer for control of inventory
Frequently used schedule II drugs, such as ibuprofen, are stored in the ____.
Stock supply
Other prescribed meds may be stored in a ______ in the patients room or med cart
Locked cabinet
To avoid needlestick injuries, the nurse should place the uncapped needle, pointing ____, directly into a specially marked, puncture proof container
Downward
Recapping a needle should only be done when no other feasible alternative is available. If recapping is necessary, how do you recap?
One-handed scoop
Where should drug allergies be listed on a MAR?
On each page
What are the 3 places drug allergies should be made aware?
Every page of the MAR
Patients med record
Patient wear allergy bracelet
