Test 2 Flashcards
Administer ear drops procedure
- Instill 1 cm (1/2 inch above ear canal) 2. People 4 years and older - pull auricle up and out People under 4 years - pull auricle down & back 3. Remain side-lying 2-3 minutes. If cotton ball used, remove after 15 minutes 4. Apply gentle massage or pressure to targus unless contraindicated due to pain
Peak level
Time at which a medication reaches its highest effective concentration
Trough level
Minimum blood serum concentration before next scheduled dose
Absorption rates related to way medication is administered, slowest to fastest
Oral and topical - slower Subq - a little faster, but still slowly absorbed IM - faster IV - fastest
Therapeutic effect
Expected or predicted physiological response
Side effect
Unavoidable secondary effect, predictable, may be harmless or may cause injury
Adverse effect
Unintended, undesirable, often unpredictable, effects are immediate, whereas others take weeks or months to develop.
Toxic effect
Accumulation of medication in the bloodstream develop after prolonged intake of medication, or wen a medication accumulates in the blood because of impaired metabolism or excretion. Excessive amounts sometimes have lethal effects.
Idiosyncratic reaction
over-reaction or under-reaction or different reaction from normal
Allergic reaction
unpredictable response to a medication. Medication or chemical acts as an antigen, triggering release of antibodies in the body
Types of medication orders
*Standing or routine: administered until the dosage is changed *prn: as needed *Single (one-time): given one time only for a specific reason *STAT: Single dose of a med given immediately in an emergency *Now: When a med is needed right away, but not STAT (within 90 minutes) *Prescriptions: medication to be taken outside of the hospital
Medication error and what are the nursing implications and responsibility of care for patient
*Report all medication errors - incident report *the nurse first assesses and examines the patient’s condition & notifies the health care provider asap. Then reports the incident to the appropriate person in the institution
Needle stick prevention
*After drawing medication into syringe, use the scoop method to place cap back on needle. After administering the injection, engage safety cap (if available) and immediately discard in sharps container
Topical medication administration
*Use gloves *Use sterile technique if pt has open wound *Clean skin first *Transdermal patches *Remove old patch *Document location of new patch *Apply label to new patch
Potential complications of immobility
metabolic, atelectasis & hypostatic pneumonia, orthostatic hypotension, loss of muscle mass, urinary stasis, pressure ulcer
Definition of stages of decubitus ulcer
*Stage I-intact skin with nonblanchable redness *Stage II-Partial-thickness skin loss involving epidermis, dermis or both *Stage III-Full-thickness tissue loss with visible fat *Stage IV-Full-thickness tissue loss with exposed bone, muscle, or tendon *Unstageable-if you can’t see how deep it is
Passive ROM
Patient is unable to move independently, and the nurse moves each joint through its ROM
Active ROM
Patient moves all joints through their ROM unassisted
Purpose of trochanter roll
Prevents external rotation of the hips when patient is in supine position.
Purpose of trapeze bar
Allows patient to pull with the upper extremities to raise the trunk off the bed, assist in transfer from bed to wheelchair, or perform upper-arm exercises
Purpose of hand rolls
Maintain the thumb in slight adduction and in opposition to the fingers, which maintain a functional position
Purpose of foot boots
to keep feet in proper alignment and to prevent foot drop
Purpose of compression devices or compression hose
decreases venous stasis by increasing venous return through the deep veins of the legs.
Procedure for logrolling patients
*Place pillow between patient’s knees *Cross patient’s arms on chest *Position two nurses on side of bed which patient will be turned. Third nurse is positioned on other side. *Fanfold or roll drawsheet along side of patient *Move patient as one unit in a smooth, continuous motion on the count of three *Nurse on opposite side of bed places pillows along the length of patient *Gently lean patient as a unit back towards pillows for support *Perform hand hygiene
