Nursing – Medication Administration Skill Check off – Flashcards
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Generic name for "Colace."
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ducosate sodium
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Therapeutic classification of colace
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Laxative
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Pharmacological classification of colace
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Stool softener
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Indications for colace
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To treat and prevent constipation
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What is the client's medication order for colace?
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100 mg PO QD at 1000
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What is the usual oral dosage for colace?
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50-400 mg PO in 1-4 divided doses
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What is the action of colace?
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promotes the incorporation of water into the stool, resulting in a softer fecal mass
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What is the therapeutic effect of colace?
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softening and passage of stool
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What are adverse reactions of colace?
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severe diarrhea, severe cramping
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What are the side effects of colace?
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mild cramping, throat irritation, rash
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What are the contraindications of colace?
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Severe nausea or vomiting, hypersensitivity, abdominal pain (especially with fever)
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What are the major nursing interventions/implications involved with administering colace?
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1. Complete abdominal assessment, especially look for distention and presence of bowel sounds. 2. Ask about last bowel movement
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What is the evaluation of treatment with colace?
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A soft, formed bowel movement within 24-48 hours.
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What is the generic name for Coumadin?
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Warfarin
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What is the client's medication order for Coumadin?
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5 mg PO QD at 1000
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What is the therapeutic classification of coumadin?
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anticoagulant
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What is the pharmacological classification of coumadin?
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coumarins
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What are the indications of coumadin?
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Prophylaxis / treatment of venous thrombosis, pulmonary embolism and atrial fibrillation with embolization.
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What is the action of coumadin?
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interferes with hepatic synthesis of vitamin k-dependent clotting factors
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What is the therapeutic effect of Coumadin?
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prevention of throembolic events
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An adverse reaction of coumadin would be?
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Bleeding, skin/tissue necrosis
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What are the side effects of coumadin?
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cramps, nausea, fever
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The contraindications of coumadin are ___
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Uncontrolled bleeding, open wounds, stomach ulcers, recent brain/spinal, or eye surgery, uncontrolled liver or kidney disease, hypertension & pregnancy
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The nursing assessment and interventions of coumadin are?
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1. assess for signs of bleeding and hemorrhage, monitor PT/INR and CBC, hepatic function. 2. Same brand should be given each administration. 3. Second practitioner should sign off on administration. 4. Drug interactions should be assessed before administration and everytime a new drug is added (RX, OTC or herbal)
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How would you detect bleeding in a client?
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Bleeding from any orifice, bruising, petechia, fecal occult, hematuria, drop in BP, drop in hematocrit, bloody NG aspirate
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What is the evaluation of Coumadin?
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no evidence or episodes of thromboembolic events
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What is the normal oral adult dosage for coumadin?
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2-5 mg PO QD
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What is the generic name for Prilosec?
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omeoprazole
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What is my patient's medication order for Prilosec?
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20 mg PO QD at 1000
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What is the normal oral adult dosage for Prilosec?
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20 mg PO QD for GERD/esophagitis; sometimes up to 40-120 mg for some gastric conditions
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What is the therapeutic class of Prilosec?
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antiulcer agent
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What is the pharmacological classification of Prilosec?
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proton-pump inhibitor
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What are the indications for Prilosec?
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GERD, maintenance or healing in erosive esophagitis, GI ulcers (stomach/duodenum). Hypersecretory conditions (Zollinger-Ellison syndrome), reduction of risk of GI bleeding for critically ill & chronic heartburn
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What is the action of Prilosec?
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Binds to an enzyme on gastric parietal cells in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen
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What is the therapeutic effect of Prilosec?
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Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux. Healing of duodenal ulcers.
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What are the adverse reactions of Prilosec?
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pseudomembranous colitis, abdominal pain, bone fracture hypomagnesemia, acid regurgitation, chest pain.
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What are some side effects of Prilosec?
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dizziness, drowsiness, fatigue, headache, weakness, constipation, diarrhea, flatulence, nausea, vomiting, rash, itching.
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What are the contraindications of Prilosec?
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hypersensitivity and lactation
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The nursing assessments and interventions for Prilosec are?
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1. Routine assessment for epigastric or abdominal pain with frank and occult blood testing of GI excretions. 2. Periodic monitoring of CBC w/ differential, liver functions, PT/INR (in patients on anti-coagulants) and magnesium levels. 3. Administer before meals, preferably in the morning. 4. Do not crush or chew. Capsules can be opened and contents mixed in applesauce or water (for NG tube) and administered immediately.
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The evaluation of Prilosec would be __?
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Lack of heartburn and dyspepsia associated with GERD.
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A patient taking Prilosec who begins to experience diarrhea, abdominal cramping, fever and bloody stools while taking the medicine or up to a couple of weeks after discontinuing it, may be experiencing ___.
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peudomembranous colitis
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The generic name for Percocet is?
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Oxycodone w/ Acetaminophen
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What is this patient's medical order for Percocet?
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5 mg PO PRN Q6 for pain
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What is the normal adult oral dosage for Percocet?
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2.5-10 mg q4h
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What is the therapeutic classification of Percocet?
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opioid analgesic
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What is the pharmacological classification of Percocet?
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opioid agonist/nonopioid analgesic combination
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What is the action of Percocet?
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Binds to opiate receptors in the CNS. Alters perception of and response to painful stimuli, while producing generalized CNS depression
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What are the adverse affects of Percocet?
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respiratory depression, hallucinations, severe constipation, choking, drug dependance/tolerance, urinary retention, bowel obstruction
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What are the side effects of Percocet?
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confusion, sedation, dizziness, GI upsets, flushing/sweating, floating feeling and unusual dreams
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What are the contraindications of Percocet?
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Hypersensitivity, respiratory depression, lactation, paralytic ileus, acute or severe bronchial asthma
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What are the nursing assessments and interventions associated with administering Percocet?
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1. Assess vitals routinely before and periodically following administration 2. Abdominal assessment for constipation. Laxatives may be needed. 3. All orders need to be verified and checked off by second practitioner. 4. Administer before pain becomes severe. 5. Do not crush, break or chew
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What is the evaluation of Percocet?
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Patient will consistently demonstrate a pain level less than 3 on a scale of 0-10 before discharge
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What is the medication order on this patient for Ampicillin?
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250 mg IM q6h beginning at 12 MN
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What are the dosage times of Ampicillin for this client?
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12 MN, 600, 12 Noon, 1800
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How many mL of Ampicillin contains 250 mg?
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1 mL contains 250 mg Ampicillin
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What type of syringe would be used for Ampicillin?
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1" or 1.5" inch 20-25 gauge
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What is the normal adult IM dosage for Ampicillin?
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500 mg to 3 g q6h; do not exceed 14 days
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What is the therapeutic class for Ampicillin?
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anti-infectives
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What is the pharmacological class for Ampicillin?
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aminopenicillins
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What are the indications of Ampicillin?
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Treatment of skin and soft tissue infections, Otitis media, sinusitis, respiratory infections, genitourinary infections, meningitis, septicemia and endocarditis prophylaxis
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What is the action of Ampicillin?
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binds to bacterial cell wall, resulting in cell death
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What is the therapeutic effect of Ampicillin?
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Bactericidal action; broader spectrum than penicillin.
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What are the adverse reactions of Ampicillin?
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Anaphylaxis, serum sickness, seizures, pseudomembranous colitis, diarrhea, rash, superinfection
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What are the side effects of Ampicillin?
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nausea, vomiting, diarrhea, rash, hives
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What are the contraindications of Ampicillin?
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Hypersensitivity to penicillin,allergic to cephalosporins, severe renal insufficiency, infectious mononucleosis, acute lymphocytic leukemia, CMV
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Nursing assessments/interventions for Ampicillin are __
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1. Monitor for signs of an anaphylactic response 2. Assess patient for history of hypersentivity or allergic reaction to penicillin before administration. 3. Monitor bowel function to rule out pseudomembranous colitis. 4. Patient should be assessed for signs of infection before beginning and throughout the administration of therapy. 5. IM route is for moderate to severe infection. Change to PO as soon as possible.
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What is the evaluation for Ampicillin?
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Patient will show no signs of an active infection by the time of discharge and/or at the completion of antibiotic therapy.
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6 Rights of Medication Administration:
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1. right patient, 2. right medication, 3. right dose, 4. right route, 5. right time, 6. right documentation
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Describe the first check of medication administration
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scan patient wrist band if applicable) Look to see if there are any allergies. Read the MAR and remove the medications from the client's drawer. Compare the label of the medication to the MAR. Determine if you need to do a math calculation if the dosage doesn't match the MAR. Check the expiration date of the medication.
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Describe the second check of medication administration
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While preparing the medication, i.e. drawing up, pouring, or placing unopened package in a medication cup, look at the medication label and check against the MAR.
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Describe the third check of medication administration
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Recheck the label on the container before returning the bottle or box to its storage place. or Check the label on the medication to the MAR before opening the package at the bedside. (Do not open the package before going to the bedside). What if the patient refuses the medication???
