Unit 1 review Flashcards
all the components of a medication order
client name, date and time the order is written, drug name, dose and route, frequency and signature of person order drug
where should narcotics be stored
double locked drawer, a box, room in nursing unit or automated medication dispensing system
what position should the nurse place pt with swallowing difficulties when administering medications and to prevent gastric reflux
high fowlers position, sitting up position
What should a nurse do with medications he/she pulled from the medication room if they notice the patient is not in the unit?
If a client is not on the unit at the time of medication administration, the nurse returns the medications to the medication cart or room. Leaving medications unattended may result in their loss or accidental ingestion by someone
If a medication error occurs, what should the nurse do FIRST?
As soon as an error is recognized, the nurse checks the client’s condition and reports the mistake to the prescriber and the supervising nurse immediately.
When educating an older adult client about medications at discharge, if a nurse notices the patient is having difficulty understanding the instructions, what intervention should the nurse follow to ensure the patient’s safety?
If an older person has difficulty comprehending information about medication routines, include a responsible person in the discharge instructions to ensure client safety. A referral for skilled nursing visits is appropriate for homebound older adults who need additional instructions about medication routines after discharge.
Ask patient to repeat back instructions,reinforce verbal instructions with written ones at their intelligence level
Generic drug names refer to the
a chemical name not protected by a company’s trademark, which is written in lowercase letters
what is the primary purpose of the MAR
Written or computerized form used to document drug administration, to provide a space for documenting when a drug is given, along with a place for signature, title,& initials of each nurse who administers a medication
XR means
extended release tab/capsule
SR means
sustained release tab/capsule
CR means
continuous release, dissolve slowly and be released over time
SA means
sustained action tab/capsule
how should the nurse educated pt on how to take an enteric-coated medication
(a solid drug covered with a substance that dissolves beyond the stomach) are manufactured for drugs that cause irritation of the stomach. Enteric-coated tablets are never cut, crushed, or chewed because when the integrity of the coating is impaired, the drug dissolves prematurely in gastric secretions.
enteric-coated medications should not be
cut, crushed or chewed
If a patient is receiving scheduled pain medication, which important medication administration
“right” would the nurse check first before administering the medication? If all medication rights are listed, be able to choose the correct one needed for a scenario provided.
right drug, right dose, right route, right time and right patient
If you (the nurse) notice a medication order is not complete and the provider is no longer present on the floor you are working, what would be the appropriate nursing action?
Medication errors are serious. Nurses never implement a questionable medication order until after consulting with the person who has written the order.
Should nurses administer medications prepared by another nurse? Why or why not?
Because they don’t know if all the rights were confirmed while being prepared
Describe transdermal medication application
refers to drugs that are applied to and absorbed through the skin. Examples include skin patches and pastes.
Where should a transdermal patch be applied?
Transdermal patches are typically applied to the chest, buttocks, stomach, and upper arms.
To distribute eye medication over the surface of the eye, the nurse should ask the client to
When administering eye medications, it is important to ensure that the medication is distributed over the surface of the eye. The first instinct may be to rub the eye, but this would cause further trauma and irritation. Instead, have the client blink to distribute the eye medication.
When instilling ear drops a nurse should know that the manipulation of straightening the auditory canal varies with adult vs pediatric patients
Child is pulling the ear down and back vs adult is up and back
when would be ideal time to administer a vaginal medication for an elderly patient
after bladder have been emptied
A metered-dose inhaler has a canister that
delivers aerosolized medication, which is a liquid drug forced through a narrow channel via a chemical propellant.
A ______ would help maximize the absorption of the drug in a client who is having problems coordinating his breathing with the inhaler use
spacer
How can a nurse prevent self-contamination during application of nitroglycerin paste?
Always use gloves when applying patches and pastes, and wash hands with soap and water after glove removal. This prevents accidental absorption of the drug by the provider.
rectally administered medications are most commonly administered in what form
suppositories
What nursing action must the nurse do prior to administering another dose of nitroglycerin paste?
Remove one application before applying another and remove any residue remaining on the skin. Careful application prevents excessive drug levels.
Rotate the sites of medication placement. Site rotation reduces the potential for skin irritation.
Remove the application if the client becomes flushed, hypotensive, or develops a severe headache.
Know the priority assessments the nurse should perform before and after administering a prescribed inhaled bronchodilator
Monitoring the heart rate and blood pressure of older adults who use inhaled bronchodilators is important because these medications commonly cause tachycardia and hypertension. Either or both of these effects increase the risks for complications, especially in older adults with an underlying cardiovascular disease.
Count the client’s respiratory rate for a full minute.
Observe the client’s pattern of respirations such as effort, nasal or mouth breathing, position used to enhance breathing, and use of accessory muscles.
Establish if the client feels comfortable or anxious with regard to breathing.
Measure the client’s hemoglobin saturation with a pulse oximeter.
Determine techniques the client uses to restore quiet, effortless breathing.
If a patient is prescribed TWO inhalers, how long must they wait in between administration of each inhaler?
One minute between puffs and 5 minutes between medications
for topical medications, the nurse should educate the patient to _____ inadvertent absorption through the hands to reduce
use gloves, use cotton applications and wash hands
what nursing action should the nurse instruct the patient to do after administration of a steroid inhalant medication
Clean the inhaler (holder and mouthpiece) daily by rinsing it in warm water and weekly with mild soap and water. Allow the inhaler to air-dry. Have another inhaler available to use while the first is drying.
What is the MOST appropriate action for a nurse to take to ensure proper administration of a sublingual medication has occurred?
the client is instructed not to chew or swallow the medication. Eating and smoking are also contraindicated during the brief time needed for a solid medication to dissolve.
Place it in correct spot, do not chew
Know the degree angle when administering injections (intradermal, subcutaneous, intramuscular, intravenous)
Intradermal instilling medication shallowly at 10-15 degree angle, between the layers of skin
Subcutaneous: beneath the skin but about the muscle. Insert 45 (thin clients) -90 (normal or obese) degrees angle,
Intramuscular: use a 90 degree angle to pierce the skin, can also use a z-track technique
Intravenous: injections instilled into veins
what kind of syringe to choose to accurately administer heparin subcutaneously
use a tuberculin syringe or prefilled
Describe subcutaneous injection route, what is the purpose of bunching the tissue?
bunched between the thumb and fingers before administering the injection to avoid instilling insulin within the muscle.
Following administration of an injection, what intervention should the nurse perform to reduce discomfort and provide quick relief?
use smallest gauge needle appropriate, change the needle before administering a drug that is irritating to tissue, select a site that is free of irritation, rotate injection sites, numb the skin with an ice pack before the injection, insert and withdraw the needle without hesitation, instill the medication slowly and steadily, use the z-track technique for IM injections, apply pressure to the site during needle withdrawal, massage the site afterward if appropriate
Know the landmarks for administering an injection in the deltoid site
Have the client lie down, sit, or stand with the shoulder well exposed.
Palpate the lower edge of the acromion process.
Draw an imaginary line at the axilla.
Inject in the area between these two landmarks.
Most common site for administering an intradermal injection
A common site for an intradermal injection is the inner aspect of the forearm. Other areas that may be used are the back, posterior upper arm, and upper chest
for which client can the nurse admminister a subq injection at a 90 degree angle
normal to obese pt
which injection route utilizes the z-track technique
IM, technique for manipulatng the tissue to seal medication, especially an irritant in the muscle
describe how to administer Z-track method
Stretching the muscle laterally forming a “Z”
Manipulating the plunger
Insert needle directly at a 0- degree angle
The released tissue seals the pathway of injected medication
how far from previous injection site to the area should the nurse administer the injection
keep injections 1 inch from previous site
the needle gauge, or diameter, refers to
width of the needle
removing the needle at the same angle at which it was inserted to administer medication
minimizes tissue trauma and discomfort
what is the max volume that the nurse may administer by subq route
up to 1ml
describe administering an intramuscular injection
90 degree angle, dart like motion
to reduce risk of needle stick injuries, the nurse should immediately
Before administering an injection, the protective cap covering a needle is replaced by using the scoop method & After administering an injection, the needle is left uncapped and deposited in the nearest biohazard container
If a needlestick injury occurs, what is the PRIORITY nursing action?
Report the injury to a supervisor immediately.
Document the injury in writing.
Identify the client if possible.
