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nsg106 > yoost chapter 35 medication administartion > Flashcards

yoost chapter 35 medication administartion Flashcards

1
Q

Schedule I means

A

High potential for abuse

No currently accepted medical use in treatment in the United States

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2
Q

Schedule I examples

A

Heroin, lysergic acid diethylamide (LSD), and methaqualone

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3
Q

Schedule II means

A

High potential for abuse; may lead to severe psychological or physical dependence

Has a currently accepted medical use with severe restrictions

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4
Q

Schedule II examples

A

Morphine, cocaine, methadone, and methamphetamine

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5
Q

Schedule III means

A

Lower potential for abuse compared with the drugs in schedules I and II in regard to moderate dependence

Has a currently accepted medical use

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6
Q

schedule III examples

A

Anabolic steroids, narcotics such as codeine or hydrocodone with aspirin or acetaminophen, and some barbiturates

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7
Q

Schedule IV means

A

Lower potential for abuse relative to the drugs in schedule III; may lead to limited dependence
Has a currently accepted medical use

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8
Q

Schedule IV examples

A

Pentazocine, meprobamate, diazepam, and alprazolam

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9
Q

Schedule V mean

A

Low potential for abuse relative to the drugs in schedule IV
Has a currently accepted medical use in treatment in the United States

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10
Q

Schedule V examples

A

Over-the-counter (OTC) cough medicines with codeine

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11
Q

Pharmacokinetics is the study of

A

the journey of medication is in the body

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12
Q

therapeutic means

A

intended effect, is the desired result or action of a medication

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13
Q

Absorption is

A

the passage of a drug from the administration site into the bloodstream

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14
Q

what is the 5 categorize of food and drug for pregnant women least to most harmful

A

A
B
C
D
X

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15
Q

what is a drug half life

A

expected time it takes for the blood concentration to measure one-half of the original drug dose

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16
Q

what is onset of action

A

the time the body takes to respond to a drug after administration

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17
Q

peak plasma level indicates

A

highest serum (blood) concentration

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18
Q

what is the trough

A

lowest serum level of the medication

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19
Q

Side effects are

A

predictable but unwanted effects

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20
Q

adverse effects are

A

often unpredictable and unwanted effects

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21
Q

Toxic effects are

A

overdose or the buildup of medication in the blood due to impaired metabolism and excretion

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22
Q

Allergic reactions

A

unpredictable response from immune system

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23
Q

anaphylactic reaction is

A

severe allergic reaction

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24
Q

idiosyncratic reaction is

A

unpredictable patient response to medication

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25
Q

Medication interactions happen when

A

a certain food or herb or another medication is present in the patient body

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26
Q

synergistic effect is

A

combined effect is greater than the effect of either substance if taken alone

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27
Q

Antagonism is

A

when the drug effect is decreased by taking the drug with another substance, including herbs

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28
Q

drug incompatibility is

A

Mixing medications in a solution that causes precipitation or combining a drug with another drug that causes an adverse chemical reaction

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29
Q

Factors to consider when selecting an OTC medication

A
  1. understanding the desired effect and potential side and adverse effects of all ingredients in the medication

2.possible allergic reactions

3.potential interactions with other medications and herbs

4.warnings

5.directions and dosage

  1. features (such as safety caps)
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30
Q

dangers of using vitamin

A

excess can build up in the liver

They can have side effects

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31
Q

vitamin B3 (niacin) adverse effects

A

Flushing, redness of the skin, upset stomach

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32
Q

vitamin B6 (pyridoxine, pyridoxal, and pyridoxamine) adverse effects

A

Nerve damage to the limbs, which may cause numbness, trouble walking, and pain

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33
Q

vitamin C (ascorbic acid) adverse effects

A

Upset stomach, kidney stones, increased iron absorption

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34
Q

vitamin Folic acid (folate) adverse effects

A

At high levels, especially in older adults, may hide signs of B12 deficiency

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35
Q

vitamin A (retinol, retinal, retinoic acid) adverse effects

A

Nausea, vomiting, headache, dizziness, blurred vision, clumsiness, birth defects, liver problems, possible risk of osteoporosis

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36
Q

vitamin D (calciferol) adverse effects

A

Nausea, vomiting, poor appetite, constipation, weakness, weight loss, confusion, heart rhythm problems, deposits of calcium and phosphate in soft tissues

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37
Q

Herb uses: Echinacea

A

Stimulates the immune system; facilitates wound healing; fights flu and colds

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38
Q

Herb uses: Garlic

A

Lowers blood pressure and cholesterol and triglyceride levels

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39
Q

Herb uses: Ginkgo biloba

A

Improves memory and mental alertness

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40
Q

Herb uses: Ginseng

A

Increases physical stamina and mental concentration

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41
Q

Herb uses: Saw palmetto

A

Helps with enlarged prostate and urinary inflammation

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42
Q

Herb uses: St. John’s wort

A

Alleviates mild to moderate depression, anxiety, and sleep disorders

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43
Q

herb side effects and drug interations: Echinacea

A

Possible liver inflammation and damage if used with anabolic steroids or methotrexate

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44
Q

herb side effects and drug interations: Garlic

A

Increased bleeding; potentiates action of anticoagulants

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45
Q

herb side effects and drug interations: Ginkgo biloba

A

Increased bleeding; potentiates action of anticoagulants

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46
Q

herb side effects and drug interations: Ginseng

A

Can increase heart rate and blood pressure; decreases effectiveness of anticoagulants; may cause hypoglycemia in patients taking oral hypoglycemics or insulin

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47
Q

herb side effects and drug interations: Saw palmetto

A

Interacts with other hormones

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48
Q

herb side effects and drug interations: St. John’s wort

A

Interacts with anti-anxiety medications, antidepressants, anticoagulants, birth control pills, cyclosporine, digoxin, statins, and human immunodeficiency virus (HIV) and cancer medications

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49
Q

legally valid medication prescription include

A
  • Patient’s name
  • Date and time the order is written
  • Name of drug to be administered
  • Dosage of the drug
  • Route of drug administration
  • Frequency of drug administration
  • Signature of the person writing the order
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50
Q

Types of Medication Orders: Routine order

A

Administered until the health care provider discontinues the order or until a prescribed number of doses or days have occurred.

51
Q

Types of Medication Orders: PRN order

A

Given only when the patient requires it. Use determined by objective and subjective assessment and clinical judgment of the nurse.

52
Q

Types of Medication Orders: One-time or on-call order

A

Given only once at a specified time, often before a diagnostic or surgical procedure.

53
Q

Types of Medication Orders: Stat order

A

Given immediately and only once in a single dose; frequently given for emergency situations.

54
Q

Types of Medication Orders: Now order

A

Used when a medication is needed quickly but not as immediately as a stat medication; given one time.

55
Q

7 routes of administration are

A

oral (by mouth)
buccal (against the cheek)
sublingual (under the tongue)
parenteral (by injection or infusion)
topical (on skin or mucous membranes)
inhalation
medical tube

56
Q

what does PO mean

A

by mouth

57
Q

Common Forms of Medication: Tablets

A

Medication is compressed with binding substances and disintegrating agents; may have flavoring added to improve taste; used for oral, sublingual, and buccal routes.

Enteric-coated tablets have a special outer covering that delays absorption as it dissolves in the intestines.

58
Q

Common Forms of Medication: Capsules

A

Medications are enclosed in cylindrical gelatin coatings.

Time-release capsules have medication particles encased in smaller casings that deliver medication over an extended period.

59
Q

Common Forms of Medication: Powders

A

Ultrafine drug particles in a dry form; depending on the medication, may be inhaled, mixed with food, or dissolved in liquids immediately before administration.

60
Q

Common Forms of Medication:Troches or lozenges

A

Medications prepared to dissolve in the mouth

61
Q

Common Forms of Medication: Solutions

A

Medications already dissolved in liquid.
Syrups are mixed with sugar and water.
Suspensions are finely crushed medications in liquid.
Elixirs are medications dissolved in alcohol and water with glycerin or other sweeteners.
Drops are a sterile solution or suspension administered sublingually or directly into the eye, outer ear canal, or nose.
Injectable solutions are sterile suspensions supplied in ampules, vials, prefilled syringes, bags, or bottles.

62
Q

Common Forms of Medication: Inhalants or sprays

A

Medications inhaled or sprayed into the mouth or nose; may have local or systemic effects.
Some are delivered in fixed doses.

63
Q

Common Forms of Medication: Skin preparations

A

Ointments (spreadable, greasy preparations), creams (not greasy but used on skin only), and lotions (solutions or suspensions used on skin and not as sticky as creams or ointments).
Transdermal patches contain medication absorbed through the skin over an extended period.

64
Q

Common Forms of Medication: Suppositories

A

Bullet-shaped gelatin tablets commonly administered rectally or vaginally depending on the medication. Urethral preparations are used for erectile dysfunction.

65
Q

Medication Administration Routes advantages/ disadvantages: oral

A

advantages:Certain oral tablets formulated to dissolve on contact with the tongue

disadvantage: Inappropriate for patients with nausea or vomiting

contraindicated for patients with swallowing difficulty

Can irritate the gastrointestinal lining, have an unpleasant taste, or discolor teeth

Patient must be alert and oriented to safely administer

Cannot be used with simultaneous gastric suctioning or before various diagnostic or surgical procedures
Possible irregular or slow absorption

66
Q

Medication Administration Routes advantages/ disadvantages: sublingual or buccal

A

advantages: As above plus more potent because the drug bypasses the liver and enters the bloodstream directly

disadvantages: May be inactivated by gastric juices if swallowed

67
Q

Medication Administration Routes advantages/ disadvantages: Topical

A

advantages: Local effect with few side effects

disadvantages: Absorption may be irregular if skin breaks are present, and it may be slow

68
Q

Medication Administration Routes advantages/ disadvantages: Transdermal

A

advantages: Prolonged systemic effects without gastrointestinal absorption problems

disadvantages: May leave residue on clothes or skin. May cause localized skin irritation.

69
Q

Medication Administration Routes advantages/ disadvantages: Mucous membranes (eyes, ears, nose, vagina, rectum, ostomy)

A

advantages: Local effects to involved sites with systemic effects possible; readily absorbed; may be used if the oral route is contraindicated

disadvantages: Mucous membranes are highly sensitive to concentrated medications
Dose absorption may be unpredictable
Procedure may be messy

70
Q

Medication Administration Routes advantages/ disadvantages: Inhalation

A

advantages: Rapid localized effect; may be administered to unconscious patients

disadvantages:May cause serious systemic effects; can be administered only through the respiratory system

71
Q

Medication Administration Routes advantages/ disadvantages: Parenteral (intradermal, subcutaneous, IM, IV)

A

advantages: Can be used if the oral route is contraindicated; more rapid response than the oral or topical route; can be used for critically ill patients or for long-term therapy
IV route can decrease discomfort and can better control absorption if peripheral perfusion is compromised

disadvantages: Sterile technique must be used, as the skin barrier is compromised
More costly to formulate and administer; useful for small volumes only, except by IV route; affected by circulatory status; can produce patient anxiety

72
Q

Intradermal

A

Shallow injection into the dermal layer just under the epidermis

73
Q

Subcutaneous

A

Injection into the subcutaneous tissue just below the skin

74
Q

Intramuscular (IM)

A

Injection into a muscle of adequate size to accommodate the amount and type of medication

75
Q

Intravenous (IV)

A

Injection or infusion directly into the bloodstream via a vein

76
Q

Proper needle length depends on

A

age and size of the patient and the route of administration

77
Q

Syringe and Needle Sizes: Subcutaneous

A

Syringe Selection:1⁄2–3mL
Insulin syringe: U-100, U-50, or U-30

Needle Selection: 25–31 gauge, 3⁄8–5⁄8 inch (up to 1 inch for an obese patient)
Preattached to Insulin syringe: 29–33 gauge, 1⁄8–5⁄16 inch (4–8 mm)

Site Selection:Abdomen, lateral aspects of the upper arm and thigh, scapular area of the back, and upper ventrodorsal gluteal area

78
Q

Syringe and Needle Sizes: Intradermal

A

Syringe Selection:1-mL tuberculin syringe

Needle Selection: Preattached 25–27 gauge, 1⁄4–5⁄8 inch

Site Selection: Inner forearm, upper arm, and across the scapula

79
Q

Syringe and Needle Sizes: Intramuscular (IM)

A

Syringe Selection: Adults: 1–5mL
massInfants, small children: 0.5–1 mL

Needle Selection: 19–25 gauge, 1–3 inch (adult)
22–25 gauge, 5⁄8–1 inch (pediatric)
Oil-based solutions: 18–20 gauge

Site Selection: Infant: Vastus lateralis
Children: Vastus lateralis or deltoid
Adult: Ventrogluteal or deltoid

80
Q

Syringe and Needle Sizes: Infant: Vastus lateralis
Children: Vastus lateralis or deltoid
Adult: Ventrogluteal or deltoid

A

Syringe Selection: Depends on amount of medication to be infused

Needle Selection: Typically, a large-gauge, 1-inch needle; needleless, blunt-tip cannula or Luer-Lok used with associated IV ports. (Do not use needles in a needleless system to access IV ports.)

Site Selection: Vein

81
Q

Common Abbreviations Related to Medication Administration: ac

A

Before meals

82
Q

Common Abbreviations Related to Medication Administration: pc

A

After meals

83
Q

Common Abbreviations Related to Medication Administration: h or hr

A

hour

84
Q

Common Abbreviations Related to Medication Administration: bid

A

Two times per day

85
Q

Common Abbreviations Related to Medication Administration: tid

A

Three times per day

86
Q

Common Abbreviations Related to Medication Administration: qid

A

Four times per day

87
Q

Common Abbreviations Related to Medication Administration: q

A

every

88
Q

Common Abbreviations Related to Medication Administration: g or gm

A

gram

89
Q

Common Abbreviations Related to Medication Administration: mcg

A

Microgram

90
Q

Common Abbreviations Related to Medication Administration: mg

A

Milligram

91
Q

Common Abbreviations Related to Medication Administration: mL

A

Milliliter

92
Q

Common Abbreviations Related to Medication Administration: IM

A

Intramuscular

93
Q

Common Abbreviations Related to Medication Administration: IV

A

Intravenous

94
Q

Common Abbreviations Related to Medication Administration: PO or po

A

By mouth, orally

95
Q

Common Abbreviations Related to Medication Administration: NPO or npo

A

Nothing by mouth

96
Q

Common Abbreviations Related to Medication Administration: PRN or prn

A

As needed

97
Q

Common Abbreviations Related to Medication Administration: SL

A

Sublingual

98
Q

Common Abbreviations Related to Medication Administration: STAT

A

Immediately

99
Q

Six Rights of Medication Administration:

A
  • The right drug
  • The right dose
  • The right time
  • The right route
  • The right patient
  • The right documentation
100
Q

Additional checks before medication administration

A
  • Check prescriber order.
  • Check patient allergies.
  • Check medication expiration date.
101
Q

Complete an assessment and verify the observations:

A
  • The appropriate vital signs are taken before and after administration.
  • The patient has no allergies to the drug.
  • The appropriate laboratory data are obtained.
  • The appropriate physical assessment data are collected.
  • The patient’s pain levels are known.
102
Q

patient rights

A
  • If the patient questions or refuses the medication, stop the administration, verify the information, and proceed accordingly.
  • The patient has the right to refuse medications.
  • The nurse investigates the patient’s reasons for refusing the medication and provides, reinforces, or clarifies information to ensure that the patient understands the risks of refusing the medication.
  • The prescriber needs to be notified of the patient’s refusal of the ordered medication.
  • Documentation of refusal of medication should include the patient’s concern, the information provided by the nurse, and the name of the prescriber who was notified of the patient’s refusal.
103
Q

Do not document administration of the medication until?

A

it is given to the patient.

104
Q

Nursing Intervention Classification (NIC)

A

Teaching: Prescribed Medication
Instruct patient on possible adverse side effects of each medication.

105
Q

Nursing Outcome Classification (NOC)

A

Knowledge: Medication
Medication adverse effects

106
Q

types of topical medications

A

Creams or oils (for lubrication)
* Lotions (to protect and soothe)
* Powders (for drying surface moisture and decreasing friction)
* Ointments (to provide prolonged contact with the medication and to soften)
* Transdermal patches or disks (for continuous medication administration for several hours to several days)

107
Q

Parenteral Medications are

A

Parenteral medications are administered by injection into tissue, muscle, or a vein.

108
Q

Ampules are

A

a small glass container that holds a single liquid dose of medication

109
Q

A vial is

A

glass or plastic container holding one or more doses of a solution or medication

110
Q

intramuscular are giving in what degree angle

A

90

111
Q

subcutaneous are giving in what degree angle

A

45 and 90

112
Q

intradermal is giving in what degree angle

A

15

113
Q

The EpiPen and Adrenaclick are specialized devices that look like a large pen and consist of a needle and a syringe; both contain one dose of

A

epinephrine

114
Q

Patient education regarding medications is an important responsibility for the

A

nurse

115
Q

the nurse administers an opioid analgesic to postoperative patient who reports pain at a level of 9 out of 10. which vital sign does the nurse delegate to the unlicensed assistive personnel for frequent monitoring

A

respiration

116
Q

Types of ophthalmic medication

A
  • Eyedrops (for treatment of eye diseases or irritations)
  • Ointments (for infections or irritations)
  • Irrigations (to remove secretions or foreign bodies or to cleanse and sooth the eye)
  • Disks (for continuous medication administration up to a week), which are similar to a contact lens, usually placed in the eye at night because they may cause blurriness of vision, and may stay in place for a week
117
Q

which form of medication is most rapidly absorbed

A

inhalers

118
Q

the nurse works in the postoperative unit. which type of primary care provider order warrants an assessment by nurse to determine if the patient requires medication

A

PRN order

119
Q

Types of rectal suppositories

A

antipyretics, antiemetics, and laxatives

120
Q

what position is required to administer a requtal suppository to patient

A

lateral recumbent position

121
Q

who determine the route for administering medication

A

the prescriber

122
Q

nurse observe paitent has a rash, itchy skin, inflammation, and swelling of nasal passages, and raised skin eruptions after iv drug, what drug effect is the patient experincing

A

allergic effect

123
Q

which route of administation is suitable for administering a suppoitory

A

rectal

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