wk 5 (CHA & Meds)

Question 1

highest plasma concentration of the drug, measured when absorption is complete.

Answer 1

Peak level

Question 2

when the drug is at its lowest concentration. rate of elimination. 30 mins before the next dose.

Answer 2

trough level

Question 3

the time when 50% serum concentration of a drug to be eliminated.

Answer 3

Half-Life

Question 4

current meds order, pt med record, prior prescriptions are all compared to one another

Answer 4

Medication Reconciliation

Question 5

the goal of collecting pts current med list, and informing and educating pt about the accurate med list to avoid interference.

Answer 5

NPSG Goal 3

Question 6

as needed

Answer 6

PRN order

Question 7

single order, and immediate

Answer 7

Stat order

Question 8

parts of Med order

Answer 8

1) Pts 2 identifiers
2) date and time order was written
3) Name of drug
4) dosage
5) Route
6) frequency
7) signature

Question 9

this method of timekeeping is used to diminish the chance of mistaken time telling

Answer 9

Military time

Question 10

commonly, administering a drug ____ mins before the exact time is acceptable. EXCEPTION: preoperative drug orders

Answer 10

30

Question 11

avoid using __ zeros

Answer 11

trailing. “3.0 mg” *leading zeros are recommended! “0.4 ml”

Question 12

nurses have the right to ___ administration of a drug they know to be harmful.

Answer 12

refuse

Question 13

dose on hand/quantity on hand=

Answer 13

dose desired / x(quantity desired)

Question 14

1) when the nurse reaches for the unit dose
2) after retrieval from the drawer
3) before hand to pt

Answer 14

3 checks

Question 15

11 rights

Answer 15

meds, dosage, pt, route, time, reason, assessment, documentation, response, education, to refuse

Question 16

if you must leave meds unattended, make sure to place drugs in a ___ area.

Answer 16

locked

Question 17

order for Narcotics require a record of __ (5) by federal law

Answer 17

name of pt, amount of substance, the hour given, name prescriber, name nurse who administered substance.

Question 18

__ witnesses are required when discarding a narcotic

Answer 18

2

Question 19

if multiple drugs are being administered at once, make sure to administer drugs

Answer 19

one by one, to keep record

Question 20

how often should you leave drugs beside pts bed for them to take when they wish

Answer 20

never

Question 21

6 rights

Answer 21

patient, time, route, assessment, education, to refuse

Question 22

these orally administered drugs are not meant to chewed or broken

Answer 22

enteric drugs, sustained release, extended release, controlled release, sustained action, and long acting

Question 23

if oral meds are refuse by pt due to taste

Answer 23

crush meds, allow pt to suck on ice, store oils in fridge, offer oral hygiene right after, give meds with plenty of water.

Question 24

nitroglycerin is administered

Answer 24

sublingually, or buccal

Question 25

determinents for size of needls and syringes

Answer 25

route of admin, viscosity, quantity, body size, type of meds

Question 26

most needle stick occur during __

Answer 26

recapping

Question 27

parenteral injections are a ___ process

Answer 27

sterile

Question 28

diazepam should not be ___ in the same syringe

Answer 28

mixed

Question 29

the 4 classes of insulin are

Answer 29

rapid, short, intermediate, long

Question 30

insulin that covers the basal metabolic needs

Answer 30

NPH, glargine, detemir

Question 31

insulin to be given prandial, or preprandial

Answer 31

lispro, aspart

Question 32

these 2 insulins cannot be mixed with other insulin

Answer 32

glargine, detemir

Question 33

the longest absorption time of all parenteral routes, where TB and allergy test are done

Answer 33

intradermal injections

Question 34

intradermal injections require a needle ____ administered at a ___ angle

Answer 34

1/4" to 1/2" and 25- to 27- gauge. 5-15 degree

Question 35

this parenteral route is administered to adipose tissue, allows for slow sustained absorption. Method used for insulin and heparin.

Answer 35

Subcutaneous

Question 36

for subcutaneous, the __ absorbs the quickest and the ___ absorbs the slowest

Answer 36

abdomen; dorsogluteal

Question 37

equipment for subcutaneous injections includes____, at an angel of ___ degrees

Answer 37

3/8"- 1", 25-30 gauge, 45-90. usually no more than 1 ml

Question 38

for subcutaneous injections, ensure that injections sites are a minimum of _inch away from eachother

Answer 38

1

Question 39

insulin needles are ___long, ___

Answer 39

5/16"-1/2", 28-30 gauge, 3/10ml-1ml

Question 40

leave __inches from the belly button for subcutaneous injections

Answer 40

2

Question 41

method used for antibiotics, hormones, and vaccines

Answer 41

Intramuscular

Question 42

common sites for Intramuscular injections are

Answer 42

deltiod, ventrogluteal, vastus lateralis (infants)

Question 43

Intramuscular injections requires a needle that is ___ long, ____, admin'd at an angel of ___

Answer 43

5/8"-1 1/2",(oil: 18-25 gauge), aqueou 20-25 gauge, 90 degrees

Question 44

This prevents the medication from leaking back along the needle track and into the subcutaneous tissue. It is recommended for older adults.

Answer 44

Z-track technique

Question 45

You should not ___ the site of an intramuscular injection bc it may cause irritation

Answer 45

massage

Question 46

this parenteral route delivers med directly into bloodstream, and has an immediate effect.

Answer 46

Intravenous injection

Question 47

these intravenous meds work slower

Answer 47

Solutions

Question 48

topical ointment that is rubbed into skin for absorption

Answer 48

inunction (cleaning site of application improves absorption)

Question 49

meds for eye should ___ be applied directly to the eyeball

Answer 49

almost never, instead applied to the lower conjunctival sac.

Question 50

ear drops should be administered to the ____ of the ear canal.

Answer 50

side

Question 51

pts with recent rectal or prostate sx, low platelet and WBC counts, thrombocytopenia, neutropenic, should not receive

Answer 51

recal suppositories

Question 52

Regarding meds ed, patients should be able to verbalize - __ and __ to administer meds - when to __ the health care provider - ___ effects and adverse reactions

Answer 52

how, when notify expected

Question 53

the 3rd med check occurs ___, after identifying pt and before administration

Answer 53

bedside

Question 54

coordination of CHA & conventional medicine =

Answer 54

Integrative health

Question 55

Allopathic medicine is AKA ___ and great for acute, and aggressive treatment, but not as helpful for chronic care.

Answer 55

conventional medicine

Question 56

___ is the philosophy which underlies CHA

Answer 56

holism

Question 57

Holistic nursing, incorporates CHA and aims at healing the __ person

Answer 57

whole

Question 58

the ___ role is to discuss CHA with pt and aid in making informed decisions.

Answer 58

Nurse's

Question 59

"does it all", "all-natural", "personal testimony" "quick fix" "miracle cure" "conspiracy" should be thought of as ____

Answer 59

Red Flags

Question 60

the 3 categories of CHA are:

Answer 60

Mind-Body, Natural Products, Other

Question 61

relaxation, yoga, biofeedback, body scanning, hypnosis, Feldenkrais, guided imagery constitute which category of CHA? (Musculoskeletal pain/ chronic pain)

Answer 61

Mind-Body

Question 62

Diet, omega 3 FA, ginger, turmeric, MSM constitute which category of CHA? (Abdominal pain/ Chronic pain)

Answer 62

Natural products

Question 63

Qi gong, acupuncture, acupressure, reiki constitute which category of CHA? (trauma/ anxiety/ depression)

Answer 63

Other

Question 64

``` yogas: Iyenger = Kipula= Ashtanga= Bikram= ```

Answer 64

proper alignment gentle breathing, fast-paced HOT

Question 65

echincea and Goldenseal can treat

Answer 65

respiratory infections

Question 66

ginkgo and Biloba can

Answer 66

increase memory, decrease mental confusion

Question 67

"like cures like", minimal doses preferred, "little evidence", German

Answer 67

Homeopathy

Question 68

the ___ name is the monograph, used in the USP-NE 2018, Ex. "acetaminophen". it includes name of active ingredients.

Answer 68

official/Generic

Question 69

the ____ name is the trademarked name, most useful to communicating with pts. Ex: "Tylenol,Liquiprin" (same drug)

Answer 69

Trade

Question 70

these types of drugs should be shaken

Answer 70

suspensions

Question 71

refers to the therapeutic use and effects of a drug, answering "why" questions. (clinical indications)

Answer 71

Pharmacotherapeutics

Question 72

refers to the effects the body has on the drug once the drug enters the body. Absorption, Distribution, Metabolism, Excretion

Answer 72

Pharmcokinetics

Question 73

refers to portion of drug that acts on cell

Answer 73

Bioavailability

Question 74

basic drugs taken orally reach the ___ ____

Answer 74

small intestine

Question 75

decreased blood flow = ___ absorption

Answer 75

decreased

Question 76

sustained release / enteric coated are absorbed in the ___ ____

Answer 76

large intestine

Question 77

refers to after drug is absorbed into blood stream, and transported throughout body. based on adequate of blood circulation, protein binding, and selective permeability of blood-brain barrier.

Answer 77

Distribution

Question 78

refers to biotransformation, breakdown, "liver's work"

Answer 78

Metabolism

Question 79

removing drug from body, "kidney's work" via urine, elderly may have trouble

Answer 79

Excretion

Question 80

refers to drugs action on target cells, cellular reaction

Answer 80

Pharmacodynamics

Question 81

constipation and decrease blood pressure are ADR's of

Answer 81

morphine (opiod agonists)

Question 82

rashes, fever, diarrhea, anaphylaxis that occurs mins, hours, days after an event is a

Answer 82

Allergic reaction

Question 83

the body becomes accustomed to effects of a drug, requiring higher dosage

Answer 83

drug tolerance

Question 84

2 doses of different drugs in one pts body is a

Answer 84

cummulative toxic effect

Question 85

increases overall effect of a drug

Answer 85

additve

Question 86

different MOA, but potentiates (alcohol & barbiturates)

Answer 86

synergistic

Question 87

decreases overall effect of drug

Answer 87

antagonist

Question 88

toxicity

Answer 88

interference

Question 89

these still can interact with drugs, although they are not drugs

Answer 89

herbal supplements

Question 90

development (pregnant), weight, Biological sex, genetics/culture, Psychological factors, time of administration environment, pathology

Answer 90

factors affecting drug action

Question 91

the concentration of a drug in the blood serum that produces the desired effect without causing toxicity

Answer 91

Therapeutic Range