Week 10 Content Flashcards
1
Q
what are OTC meds
A
over the counter medication
2
Q
four main things to NOT do when assisting with meds
A
- monitor outcome of any drug therapy
- purchase ANY meds (incl. OTC + herbal)
- fill pill boxes
- assist with meds not in care plan
3
Q
what are defining characteristics of elixirs
A
-dissolved in liquid
containing alcohol or water and flavouring
4
Q
what are defining characteristics of syrups
A
-dissolved in a concentrated sugar solution (liquid)
5
Q
drugs and other substances used to prevent or treat disease or illness.
A
medications
6
Q
administer vs assist
A
administer = to give assist = means to help
7
Q
true or false - a psw can never administer medication
A
False, medication can be administered by a PSW if:
- you have been formally trained, supervised, and monitored
- it is in your job description
8
Q
9 Roles of the PSW for medication
A
- remind
- check dosage
- bring to client
- loosen lid/container
- provide
- supervise
- assist
- observe
- report
9
Q
alternative remedies
A
herbal or natural products that do not require a prescription
10
Q
prescription medication
A
medication that requires a physician’s prescription and dispensed by a pharmacist
11
Q
small gelatin containers that hold solid medication
A
capsules
12
Q
flat discs containing medication in a flavoured base, to be dissolved slowly in mouth
A
lozenges
13
Q
dry, powdered medications that have been formed into hard discs or cylinders
A
tablets
14
Q
what is the only solid medication that can be cut in half
A
scored tablets
15
Q
solid medications placed under the tongue and dissolved or absorbed into the body
A
sublingual
16
Q
what are suspensions
A
medication suspended in a liquid that should be shaken or stirred before use
17
Q
semi-solid material containing medication that stay within area they are applied
A
ointments or creams
18
Q
medication on a small disc or patch that is applied to unbroken skin; absorbed into the bloodstream through the skin over a 24-hour period
A
transdermal discs or patches
19
Q
solid form of meds inserted into rectum or vagina; dissolves via body heat and released/absorbed by mucous membranes
A
suppositories
20
Q
liquid form of medication in a special container that allows one drop at a time to be administer (typically for eyes, ears, nose)
A
drops
21
Q
injections
A
liquid form of medication that is injected using a syringe
22
Q
device consisting of a plastic tube filled with medication, plunger, and a needle attached
A
syringe
23
Q
three types of injections
A
intramuscular (in muscle)
intravenous (in vein)
subcutaneous (under skin)
24
Q
medication particles suspended in air or gas that are inhaled into the lungs using a metered dose inhaler
A
aerosols
25
MDI + definition
metered dose inhaler - small cylinder combined with a special delivery system (aka puffer or inhaler)
26
unwanted response to a medication that occurs with the intended response
side effect
27
Why is it important to know your client’s normal behaviour?
You must know your client’s “normal” to recognize the “abnormal”.
Adverse drug reactions may go unnoticed in seniors because people think they are a “normal” part of aging.
28
drug synergism
combined effect of drugs amplifies effects
29
drug antagonism
combined effect of drugs counteracts effects
30
polypharmacy
taking more than prescribed dose or too many medications
31
generic name of drug
chemical name of drug (acetaminophen)
32
trade name of drug
trademarked, packaged name given by manufacturer (tylenol)
33
5 reasons why clients may not follow med directions
- complex medication dosage
- failing memory
- do not understand why they are taking the drugs
- afraid to ask questions
- poor eyesight – difficulty reading the medication labels
34
what are 3 changes in body composition that impacts drug effect
increase in body fat tissue
decrease in lean body tissue
decrease in water in body
35
holding chamber
device used with MDI that prevents medication from landing on user's tongue (typically used by young, elderly, frail)
36
dangerous or unwanted side effect
adverse effect
37
antigen
substance that is attacked or fought by the body via antibodies
38
severe sensitivity to antigen that occurs rapidly and causes life threatening response involving whole body
anaphylaxis
ana= without
phylaxis = protection
39
MAR
medication administration record
40
9 Rights of Assisting w/ Meds
- Right Medication
- Right Person
- Right Dose
- Right Route
- Right Time
- Right Day
- Right Reason
- Right Expiry Date
- Right Documentation
41
what are 3 ways changes in GI function impacts drug effects
- decrease in gastric acid – slower breakdown of drug
- decrease in GI mobility possibly due to less fluids, eating less fruits/fibre
- decrease in blood flow to the kidneys = decrease filtering capacity
42
true or false: psw's can teach client about medication
FALSE - nurse or pharmacist are the ones that teach client about medication, if the client does not understand their medication then notify your supervisor
43
5 Rights of Delegation
- Right Task
- Right Circumstances
- Right Person
- Right Directions & Communications
- Right Supervision & Evaluation
44
6 Roles of PSW in delegation
- Know your scope of practice
- Skills are not transferable to another client!
- As a PSW you should be able to demonstrate knowledge of theory and practice
- Written authorization should be given for the specific act for a specific client
- If you refuse a task you must have a good reason, never ignore a request to do provide care
- Know your agency’s/facility’s policies & procedures
45
Examples of delegated tasks
```
Injections
Catheter insertion
Bowel routine
ROM
Tube feedings
Trachea suctioning
Oxygen therapy
Dressing changes
```
46
true/false: delegated tasks from one client can be transferred to another client
false, each delegated task is specific to that client with written authorization for each client.
47
6 DO's of assisting meds
- Review the care plan and follow employer policies
- Bring the right containers to the client
- Know the correct dose
- Give a glass of water with oral meds
- Listen to the client
- Report and record any changes or questions (especially if the client refuses their medication)
48
6 DON'Ts of assisting meds
- Leave medications at the bedside for client to take later
- Remove labels from the containers
- Use medications in containers where labels cannot be easily read
- Use discoloured or expired medications
- Give or purchase over the counter medications for clients
- Allow medications to run out before telling someone
49
Four things the MAR contains
- Client’s name
- Name/dose/administration instructions for each medication
- A place to sign after giving the medication
- Any allergies, expected side effects, special instructions
50
pr
per rectum
51
qd
every day
52
pc
after meals
53
ac
before meals
54
sl
sublingual
55
prn
when necesarry
56
hs
hour of sleep (at bedtime)
57
hob
head of bed
58
LOC
level of consciousness
59
mcg
microgram
60
mg
milligram
61
mL
millilitre
62
MRSA
methiciline resistant staphylococus aureus
63
N+V
nausea + vomiting
64
NKDA
no known drug allergies
65
NPO
nothing by mouth
66
VS
vital signs
67
Tx
treatment
68
Sx
symptoms
69
ung
ointment
70
gtt.
drops
71
S+S
signs symptoms
72
H+P
history and physical
73
Hx
history
74
Fx
fracture
75
SOBOE
shortness of breath on exertion
76
c
with
77
s
without
78
CBR
complete bed rest
79
BRP
bathroom privileges
80
BM
bowel movement
81
O2
oxygen
82
d/c
discontinue
83
r/t
related to
84
8 things on prescription label
1. Pharmacy name
2. File number or prescription number (for reordering medication)
3. Client exact name
4. Drug name (Brand & Generic) and dosage of medication
5. Refills
6. Physician’s Name
7. Expiry Date
8. Date Filled
85
6 Roles of PSW and Medication Labels
- Read the label on all medication bottles before the client takes the medication
- Make sure the label is legible and has not been changed
- Make sure the medication is in the original container
- Make sure you understand the special instructions
- Read the printed information from the pharmacy
- Ask your supervisor for assistance if you do not understand what you are reading
86
warning labels (for prescription meds)
Special instructions usually listed on the side of the container in a coloured label.
87
Pre-Procedure: 9 ‘Rights’
| for Oral Meds
- Identify the person
- Explain the procedure to the client
- Wash yours and assist client to wash hands
- Collect the med, measuring device, water to take med with
- Provide privacy
88
Pre-Procedure: 9 ‘Rights’
| for Ear drops
- Identify the person, explain procedure
- Wash yours and assist client to wash hands
- Collect the med and provide privacy
- Person should lie down on side
- Pull ear lobe down– do not let dropper touch ear
- Do not wipe inside ear with tissue
- Wash hands, report/record
89
Pre-Procedure: 9 ‘Rights’
| for Nose drops
- Blow nose
- Block one nostril
- Assist person to place correct amount of drops in nose
- Do not blow nose after application
- Wash hands
- Report and Record meds taken
90
Pre-Procedure for EYE ointment
- Identify the person, explain procedure
- Wash yours, assist client to wash hands
- Collect the med and provide privacy
- Guide person to grasp lower eye lid and look upwards
- Place drop in lower lid –do not let dropper touch eye
- Assist person to place correct amount of ointment on lower lid of eye from inner to outer corner
- Close eye to help ‘melt’ ointment and distribute med
- Wash hands
- Report and Record meds taken
91
Pre-Procedure for EYE drops
- Identify the person, explain procedure
- Wash yours, assist client to wash hands
- Collect the med and provide privacy
- Guide person to grasp lower eye lid and look upwards
- Place drop in lower lid –do not let dropper touch eye
- Close eye - do not wipe eye with tissue
- Wash hands, report/record
92
assisting with transdermal discs
- Standard Precautions- put on gloves
- Remove old disc
- Select new site
- Assist to apply new disc- do not touch medicated surface of disc with bare hands
- Report & Record what you do
93
ways you can assist for oral med
- Check container label
- Loosen cap for client if necessary
- Place container within reach of client
- Assist person to pour out correct amount of medication
- Assist as to swallowed or sublingual med
- Close containers/return to storage area
94
what angle should subcutaneous injection
45 or 90 degrees
95
most common med given by subcutaneous
insulin
96
normal blood sugar level
4-6 mmol/L
97
symptoms of hyperglycemia
```
No insulin = hyperglycemia (elevated blood glucose)
Increased thirst
Increased urination (polyuria)
Weight loss
Increased heart rate
Abdominal pain
Difficulty breathing
```
98
4 types of insulin
rapid acting (15 min b4 meals, 15 min onset)
short acting (30 min b4 meals, 30 min onset)
intermediate acting (30 min b4 meals, 1-3 hr onset)
long acting (30 min b4 meals, 3-4 hrs onset)
99
Pre-mixed Insulin
Give 15 minutes before meals, 70% intermediate acting and 30% short acting. Once short acting Insulin has been absorbed, intermediate acting insulin takes over the action of maintenance of blood glucose levels. Example: InsulinlPen
100
5 considerations of storing insulin
- New vials to be refrigerated until expiry date
- Opened vials stable in fridge up to one month
- Vials stable at room temperature up to 14 days
- Before drawing up Insulin, remove vial from fridge 30 minutes ahead of time to settle at room temperature
- Do not freeze Insulin
101
subcutaneous injection sites
abdomen, arms, thighs, buttocks
102
right expiry date for insulin
Date on the label of vial has been checked, does not exceed 14 days at room temperature, opened vial has not been in fridge longer than one month. Insulin has not been frozen.
103
if insulin is refrigerated, after checking the vial is useable and correct, what should you do to assist client to use it?
remove from fridge 30 minutes before administration, roll vial between palms of hands, avoid shaking vial
104
symptoms of hypoglycemia
- Nervousness, feeling of hunger, weakness
- Drowsiness, dizziness, faintness
- Increased perspiration, confusion
- Adverse Effects:
Seizures, shock, death
105
Lipohypertrophy
soft, grape-like lump under skin as a result of many injections, therefore, need to rotate sites
106
observations for PSW to report when assisting insulin
- Client’s status and blood glucose level prior to administration of Insulin
- Status of the skin at site of injection
- If lipohypertrophy noted at other areas of skin
- Client’s tolerance to injection
- Client’s ability to assist
- Client’s knowledge re: need for Insulin
107
antibiotics
meds that kill bacteria
108
mro's
multi resistant organisms (MRSA, VRE) aka super bugs
109
vre
vancomycin-resistant enterococcus
110
systemic infection effects
whole body
111
local infection effect
one part of body
112
6 modes of infection transmission
- direct contact
- indirect contact
- droplet
- airborne
- vehicle
- vector-based
113
Vector transmission
occurs when a living organism carries an infectious agent on its body (mechanical) or as an infection host itself (biological), to a new host.
114
Vehicle transmission
occurs when a substance, such as soil, water, or air, carries an infectious agent to a new host.
115
direct transmission
occurs when there is physical contact between an infected person and a susceptible person
116
indirect transmission
occurs when there is no direct human-to-human physical contact
117
what should you ask the client if they checked before taking insulin
did you check your blood sugar? what are the levels?
118
if a clients glucose is less than 4, what should the psw do
"lets wait, have you eaten?" offer sugar and carbs (natural) and call supervisor how to proceed
119
nosocomial infection
acquired at health care facility
120
how does cold impact the blood
causes blood vessels to constrict
121
how does heat impact the blood
causes blood vessels to dilate
122
heat increases ...?
circulation
123
cold decreases...?
swelling, pain, bruising, itching
124
heat can help
with arthritis, muscle cramps, promote healing, stiffness of joints
125
how long should heat or cold be applied, and how often should it be checked?
no more than 15 minutes, checked every 5
126
reasons to remove heat application
- redness of skin
- extreme redness of face
- blisters
- client complains of pain or burning
- changes in clients behaviour
- skin irritation: rash, itching, burning
127
serious complications from heat application
burns, death of tissue, and circulatory shock
128
reasons to remove cold application
- pale, white, or grey skin
- blue skin (cyanosis)
- shivering
- numbness, pain, burning
- change in clients behaviour
- skin irritation: rash, burning, itching, redness
129
cyanosis
blue skin
130
serious complications from cold application
frostbite, tissue death, circulatory shock
131
clients at risk for complications for heat/cold application
- white people, infant, children, older adults
- delicate and fragile skin
- those with reduced sensation
- medications
- spinal cord injuries
- diabetes
- stroke
- aging
- loss of consciousness
- pacemakers
- joint replacements/metal in body
132
role of PSW for heat/cold application
- check care plan
- be aware of agency policy
- know equipment to use, apply to specific time and length to be applied
- measure temp according to agency policies (not above 41.1C)
- cloth to cover dry heat or cold
- provide privacy, wear gloves in you or client has broken skin
- observe for complications
133
when is proper storage of meds the psw responsibility
when medication assistance is your responsibilty
134
where should be meds are stored
where cognitively aware client wants them
135
7 storage considerations for meds
- cool, dry place
- refrigerator (if not contraindicated)
- out of reach children
- out of sight of cognitively impaired
- away from light, heat
- medicine cabinet, not ideal - bathroom warm/moist
- not in car (too hot)
136
examples of medication misuse
- forgetting
- too much
- incorrect timing
- double or decrease dosage
- not disclosing of other meds
- skipping
- sharing med
- expired med use
- not following spec. instructions
- not finishing prescription
137
why could med misuse be unintentional
- uncomfortable asking questions
- effects not felt immediately
- unpleasant side effects
- did not really think they needed it
- complicated med schedule
- limited financial resources
138
hypoxia
deficiency of oxygen in cells
139
role of PSW with oxygen
- monitor client for signs of SOB
- report low tank levels
- maintain safe environment
- give fluids if allowed
- provide nasal care with WATER based gel
- keep tubing free of kinks
- clean masks and cannula as required
140
cannula
thin tube used to administer meds
141
sources of oxygen
- oxygen tank
- oxygen concentrator
- liquid oxygen
- wall outlet
142
LOC x3
oriented to person, place and time
143
LOC x4
oriented to person, place, time, situation
144
psw main role around safety
to create and maintain a safe environment at ALL times
145
REACT upon discovery of fire
Remove person in immediate danger if possible
Ensure the door(s) is closed to confine fire and smoke
Activate fire alarm system using the nearest pull station
Call fire department/notify switchboard
Try to extinguish fire or concentrate further evac
146
3 components of fire
oxygen, fuel, heat
147
RACE
Rescue
Alarm
Confine
Extinguish
148
PSW role in fire
- follow fire policy/plan
- remove those in immediate danger
- keep all exits
- know how to use fire extinguishers - paper/wood, oil/gas and electrical fires
- never use elecators
- know where extinguishes are
- regular practice of escapes
149
5 ways to prevent suffocation in adults
- cut food well, feed slow
- fit dentures properly
- position in bed correctly
- use bedrails as ordered
- report any gas odors
150
preventing suffocation in children
- supervise when eating, near water
- remove tie cords/drawstrings
- check floor for small objects
- never leave unattended in car
- do not prop bottles
- dispose of all plastic wrapping
151
WHMIS
work place hazardous materials information system, national system to provide workers with safety information regarding hazardous materials
152
OHSA
occupational health & safety act, sets out the rights and duties of all parties in the workplace, as well as the procedures for dealing with workplace hazards and for enforcement as needed.
153
MSDS
material safety data sheets
154
order of easiest to evacuate
- ambulatory
- wheelchair
- non-ambulatory
- resistive
155
horizontal evacuation
move people beyond smoke barrier doors, does not involve stairs
156
vertical evacuation
evacuate down to a story below the fire floor or to the exterior of building
157
common areas for adults to fall
bathroom + stairs
158
ways to prevent fall
- no sock feet
- check clients shoes and clothing fit
- use handrails
- non skid mat
- good lighting
- observe client for unsteadiness, dizziness
- check ambulation equipment
- remove clutter from pathways
- clean spills immediately
- assist client during care as required
- safety over independence
159
heat exhaustion
illness resulting from being exposed to high temperatures and inadequate fluids for an extended period of time
160
people vulnerable to hear exhaustion
- hypertension
- elderly
- those working + exercising outdoors in hot weather
161
warning signs of heat exhaustion
- increased perspiration
- paleness
- muscle cramps
- weakness
- dizziness
- headache
- nausea, vomiting
- fainting
- VS weak and rapid
162
treatment for heat exhaustion
- resting out of sun, AC, fan
- cool non alcoholic bevarages
- cool shower/bath
- put in light weight clothing
- call 911 if condition worsens or does not get better (risk for heat stroke)
163
PSW role in home management
- light housekeeping task (ex: vacuum, dust, wash dishes, linens, laundry
- NOT heavy household tasks
- be motivated, organize priorities, consult with client
- client, family & supervisor will decide tasks to be completed by PSW
- listed on care plan, do only what is assigned unless supervisor agrees
164
9 principles of cleaning
- clear away clutter
- work higher to lower
- work far to near
- work dry to wet
- work from cleanest to dirtiest
- change water and cloths frequently
- use a damp cloth for dusting
- rinse and dry washed surfaces
- avoid soiling a clean area
165
Vitamin for grown, vision, hair, skin, mucous membranes, resistance to anxiety infection
Vitamin A
166
Vitamin for muscle tone, nerve function, digestion, appetite, normal elimination, carbohydrate metabolism
Vitamin B1 (thiamine)
167
Vitamin for Growth, vision, protein and carbohydrate metabolism, healthy skin, and mucous membranes
Vitamin B2 (riboflavin)
168
Vitamin for Protein, fat, and carbohydrate metabolism, nervous system function, appetite, digestive system function
Vitamin B3 (niacin)
169
Vitamin for Formation of red blood cells, protein metabolism, nervous system function
B12
170
Vitamin for Formation of red bloods cells, intestinal function, protein metabolism
Folic Acid
171
Vitamin for Formation of substances that hold tissues together, healthy blood vessels, skin, gums, bones, and teeth, wound healing, prevention of bleeding, resistance to infection
Vitamin C (ascorbic acid)
172
Vitamin for Absorption and metabolism of calcium and phosphorus, healthy bones
Vitamin D
173
Vitamin for Normal reproduction, formation of red blood cells, muscle function
Vitamin E
174
Vitamin for Blood clotting
vitamin K
