Week 1, Ch 3 Flashcards
Drug administration
A patient is given a dose of penicillin to treat an infection. A minute after the injection is given, the patient is experiencing shortness of breath, hypertension and tachycardia. Based off of this reaction, the patient is experiencing what?
Anaphylaxis due to an exaggerated histamine response
What are the 5 rights of the patient in drug administration?
-Right Patient
-Right Medication
-Right Dose
-Right Route
-Right Time (of delivery)
There are 3 checks of proper drug administration before giving it to the patient. What are these 3 checks a nurse must do?
-Check with the MAR
-Check the drug when handling it (preparing, mixing, taking it out of the container).
-Check the drug before administration
What trick with the EMAR fulfills all three checks at once?
“Scanning them in” at the EMAR.
Taking a medication in the manner in which it is prescribed is called what?
Compliance.
What is patient compliance?
A patient taking a drug in the manner in which it is prescribed.
What are some reasons why a patient may have difficulty with drug compliance?
-Cost of the drug
-Annoying side-effects
-Forgetfulness
-Fear of dependancy
Which of the following fulfills the definition for the order: STAT
a.) As needed for “x”
b.) Within 30 minutes of the written order
c.) Once, right now.
c.) STAT means to give one dose, right now; Immediately.
a.) PRN means as needed
b.) ASAP means within 30 minutes of the written order
in regard to drug administration, ALL written drug orders for a nurse should have information on what 3 things?
-Frequency
-Route
-Dose
What is a “Standing Order” for drug administration?
A drug order written in advance of a situation that is to be carried out under certain circumstances.
CNS drugs and antihypertensive drugs are best administered during what period of the day?
Bedtime
How often are drug orders reviewed?
Generally, every 7 days
A patient tells you “Oh, just leave those pills on my bedside table, I’ll take them when I’m done with my tv show.” What would be the best response?
a.) Sure, just remember when you take them and tell me, ok?
b.) How about we take them during the commercials, and I’ll hang out until then?
c.) I’ll come back in about 15 minutes to see if you are ready then, ok?
d.) Bitch, if you don’t take these pills, I will throw you through that fuckin’ wall!
d.)
Just kidding, it’s C.
Never leave pills unattended in a patient room. Always document if a patient took their pills or not.
What are the 3 broad routes of medication administration?
-Enteral
-Parenteral
-Topical
If a nurse needed to give a patient medicine in the form of a capsule, or a tablet, which route would be best?
Enteral route
Which route of medication administration involves the GI tract?
Enteral route
A Nasogastric Tube, or a Gastronomy tube would be examples of what type of administration route?
Enteral route, because it involves the GI tract
A nurse administers tablets sublingually and buccally. What do these routes mean for the location of the tablet?
-Sublingually is under the tongue
-Buccally is via the cheek
If a tablet is “enteric coated” what is important for it to remain?
In-tact or non-crushed
A sustained release tablet is designed to what?
Dissolve very slowly
The 1st thing that you must do before giving the patient an enteral administration, is what?
Assess for their alertness and ability to swallow.
Sublingual medication administration is rapid onset because of what?
The rich blood supply under the tongue allows for rapid absorption and distribution.
If a patient is receiving multiple medications, should they ingest their sublingual/Buccal medicine before or after the other meds?
After the other meds have been taken.
True or False:
Sublingual and Buccal administration drugs have to consider the First-Pass effect when considering dosage.
False:
Sublingual and Buccal ARE Enteral administration methods, but they are dissolved and absorbed into the blood stream in the mouth. Because of this they bypass the first-pass effect
True or False:
A Gastronomy Tube is for short-term food and drug administration into the GI tract. It is surgically placed directly into the patient’s stomach.
False:
Gastronomy tubes are for long-term food and drug administration.
What is the First-Pass effect?
An inactivation of a drug by being processed in the liver.
True or False: Installations and Irrigations are subcategories of the Topical route of drug administration
True:
Installations and Irrigations are a subcategory of the Topical route
If a Topical drug is labeled as being “Dermatologic”, where would you administer the drug?
On the skin
Where in the body are Irrigations and Installations placed?
They are placed into body cavities, Like the rectum, or vagina, or ear canal.
A drug that is applied to the mucosa of the respiratory tract is labeled as what subcategory of the Topical route?
An Inhalant/Inhalation
True or False:
Topicals are absorbed slowly, which leads to fewer side effects.
True:
Topicals are absorbed slowly
Do Transdermal patches bypass the First-Pass effect? Why or why not?
Yes, because they are absorbed into the dermis and circulate into the blood. They are not metabolized by the liver.
What does a Clonidine patch do?
A Clonidine patch lowers a patient’s blood pressure.
A patient has gotten into a car crash and is brought into the E.R. The Nurse notices that the patient has a Clonidine patch? How should the nurse handle the Clonidine patch?
Remove the patch.
Clonidine patches lower a patient’s blood pressure. The Patient was just in a car crash, and we don’t want their Bp getting any lower.
Where in the body is an Opthalmic administration given?
The eyes
When giving a single medication via the Opthalmic route, how long should you wait in-between eye drops?
What about for two separate medications?
-For single Medications: 2 min between drops
-For double: 5 min between drops of different meds
True or False:
Otic administration is through the Nasal ducts.
False:
Otic is into the ear.
The most common reason to use medicine via Nasal administration is to shrink what?
To shrink swollen mucous membranes inside of the nose
Following the primary reason for Nasal administration (shrink swollen mucous membranes), what is another reason one might administer a Nasal medication?
To facilitate drainage for people with allergies or a cold
Nasal administration of medicine is used for its Astringent effect. What is the Astringent effect?
The shrinking of swollen mucous membranes, and the start of nasal drainage.
For Vaginal administration, if a nurse needs to administer a foam, a jelly, or a suppository, what will the nurse use to administer these medications?
An Applicator Tool
Parenteral administration means that you are using what portal of entry?
The skin
There are 4 types of Parenteral administrations. What are they?
-Intradermal
-Subcutaneous
-Intramuscular
-Intravenous
What technique does the Parenteral administration route require use of?
The Aseptic Technique
True or False:
Subcutaneous Injections are absorbed more easily than Intradermal injections, because they bypass the enzymatic barriers in the dermis layer.
False:
Intradermal injections are absorbed more easily than subcutaneously.
What is the degree of the angle used to inject a drug Subcutaneously?
45 degrees.
What is the degree of the angle used to inject a drug Intradermally?
15 degrees.
What is the degree of the angle used to inject a drug Intramuscularly?
90 degrees.
IM (Intramuscular) injections have a much more rapid onset than which other Parenteral administrations?
Intradermal, and Subcutaneous
When choosing an injection site for an IM injection, you must be careful to avoid what 3 things?
Bone, Nerves, and Blood Vessels
The Ventrogluteal and the Dorsogluteal are injection sites for an IM injection. Where are these two sites located on the body?
-Ventrogluteal is on the hip. Make a “V” with one hand using your index and middle finger. place it on the patient’s hip and inject in the middle of the “V”.
-Dorsogluteal is in the upper, outer quadrant of a patient’s gluteus maximus, under the crest of the ilium.
The IM injection site known as the Vastus Lateralis is located where on the body?
The top middle of the quadriceps
What is the most common area for an IM injection?
The Deltoid
What parenteral method has the fastest onset effect, but is also the deadliest?
Intravenous (IV)
What are two reasons why Intravenous administration (IV) is the most dangerous form of parenteral administration?
-Possible contaminations
-Adverse reactions are very swift, giving nurses less time to react to possible life-threatening reactions.
There are 3 types of IV infusion: What are they?
-Large-Volume
-Intermittent
-Bolus
If a patient’s IV requirements call for Fluid maintenance, Supplementation, or Replacement, what type if IV infusion should be used?
a.) Bolus
b.) Intermittent
c.) Large-Volume
c.) Large-Volume IV should be used for maintenance, replacement, or supplementation of fluids.
A small amount of IV solution arranged tandem with or piggybacked to primary large volume infusion is known as a what?
Intermittent IV infusion
A physician needs a nurse to instill adjunct medications like antibiotics into a patient. What type of IV infusion would the nurse use?
a.) Large-Volume
b.) Intermittent
c.) Bolus
b.) Intermittent
“Adjunct” means to add to or supplement (Add-Junk). Adjunct antibiotics would mean that a small amount of IV solution would need to be added on to an existing IV solution.
A concentrated dose delivered directly to circulation via syringe to administer single-dose medications is known as what type of infusion?
Bolus infusion. (IV Push)
A Bolus infusion (IV Push) is:
a.) A concentrated dose of medication delivered directly into circulation.
b.) A small amount of IV solution used in tandem with a Large-Volume infusion.
c.) An injection used to Supplement, Replace, or Maintain bodily fluids
d.) An Injection into the muscle tissue to dilate the Bolus Arterioles.
a.) A Bolus Infusion is a concentrated dose of medication delivered directly into circulation by the use of a syringe.
During a Large-Volume infusion, what should the nurse be paying particular attention to?
The patient’s Intake & Output.
The patient should be putting out adequate amounts of urine.
