question

Allergic reaction

answer

acquired hyperresponse of body defenses to a foreign substance (allergen)

question

Anaphylaxis

answer

acute allergic response to an antigen that results in severe hypotension and may lead to life-threatening shock if untreated

question

Apothecary system

answer

older system of measurement that uses drams;rarely used

question

ASAP order

answer

as soon as possible order that should be available for administration to the patient within 30 minutes of the written order

question

Astringent effect

answer

drops or spray used to shrink swollen mucous membranes, or to loosen secretion and facilitate drainage

question

Buccal route

answer

administration of a table or capsule by placing it in the oral cavity between the gum and the cheek

question

Compliance

answer

taking a medication in the manner prescribed by the health care provider, or, in case of OTC drugs, following instructions on label

question

Enteral route

answer

administration of drugs orally, and through nasogastric or gastrostomy tubes

question

Enteric coated

answer

referring to tablets that have a hard, waxy coating designed to dissolve in the alkaline environment of the small intestine

question

Five rights of drug administration

answer

principles that offer simple and practical guidance for nurses to use during drug preparation, delivery and administration

question

Household system

answer

older system of measurement that uses teaspoons, tablespoons, and cupts

question

Intradermal (ID)

answer

medication administered into the dermis layer of the skin

question

Intramuscular (IM)

answer

delivery of medication into specific muscles

question

Intravenous (IV)

answer

administration of medications and fluids directly into the bloodstream

question

Metric system of measurement

answer

most common system of drug measurement that uses grams and liters

question

Parenteral route

answer

dispensation of medication via a needle into the skin layers

question

PRN order

answer

medication is administered as required by the patient's condition

question

Routine orders

answer

order not written as STAT, ASAP, NOW, or PRN

question

Single order

answer

medication that is to be given only once, and at a specific time, such as a preoperative order

question

Standing order

answer

order written in advance of a situation that is to be carried out under specific cirumstances

question

STAT order

answer

any medication that is need immediately and is to be given only once

question

Subcutaneous

answer

medication delivered beneath the skin

question

Sublingual route

answer

administration of medication by placing in under the tongue and allowing it to dissolve slowly

question

Sustained release

answer

tablets or capsules designed to dissolve slowly over an extended time

question

Three checks of drug administration

answer

in conjunction with the five rights, these ascertain patient safety and druf effectiveness

question

The ____ route means the nurse will administer the drug to the patient by mouth, under the tongue, or into the rectum.

answer

enteral

question

When the nurse places a drug directly onto the skin or associated membranes, this is referred to as the ______ route.

answer

topical

question

The traditional ______ _______ of drug delivery form the operational basis for the safe delivery of medications.

answer

five rights

question

Drugs swallowed or chewed or slowly dissolved in the mouth are referred to as _____ medications.

answer

oral

question

________ administration involved plaocing drugs under the tongue.

answer

sublingual

question

_______ and ________ are examples of rectal administration methods.

answer

suppositories, enemas

question

The most common method of drug delivery is the ____ route.

answer

oral

question

Drugs are injected directly into the muscle in the _________ route.

answer

intramuscular

question

One popular method for delivering drugs across the skin at a slow steady rate is the _______ patch.

answer

transdermal

question

________, ________ and ______ type drug delivery methods are useful in treating respiratory and reproductive ailments.

answer

...

question

enteral

answer

rectal, oral, sublingual

question

parenteral

answer

intravenous (IV), intramuscular (IM), subcutaneous (SC or SQ), intradermal

question

topical

answer

transmucosal, transdermal

question

define dissolution

answer

the process of dissolving solid drugs

question

What is a standard order?

answer

prn

question

What type of patient would be appropriate for rectal administration

answer

unconscious patient, patient with nausea or vomiting, infant who cannot swallow pills

question

What is a major advantage of IV drug administration?

answer

a precise concentration of drug can be administered into the blood stream

question

What is a disadvantage of subcutaneous drug administration?

answer

pain, swelling or infection may occur if proper precautions are not taken

question

It rapid onset is critical which route would the nurse choose?

answer

intravenous

question

What administration method would the nurse use for TB test with purified protein derivative (PPD)

answer

intradermal

question

Implants are generally administered by which drug administration method?

answer

subcutaneous

question

What intravenous drug administration might be used to instill adjunct medications, such as antibiotics and analgesics over a short period of time?

answer

intermittent infusion

question

How are IV infusions administered?

answer

by way of a syringe and needle

question

Whatis the deepest layer of the skin?

answer

dermis

question

What is the most common type of drug formulation for eye and ear medication?

answer

drops

question

Prior to administration of a medication through a gastrostomy tube, the nurse takes what action?

answer

aspirate feeding and check for residual volume

question

A client has an allergac reaction to a newly prescribed medication. The nurse places the highest priority on what action?

answer

communicate the allergic response to the physician and the pharmacist

question

The order reads "Lasix 40 mg IV STAT, what action should the nurse take?

answer

administer the medication within 5 minutes of the order

question

The nurse determine the client needs an antipyretic medication. The nurse should check in which area of the MAR for this order?

answer

PRN orders ( orders that are administrated on an as needed basis are found in the PRN)

question

A nasal spray is ordered for a client. The nurse knows that this medication contains an astringent effect, which will?

answer

shrink mucous membranes

question

Toxic Epidermal Necrolysis (TEN)

answer

severe and deadly drug-induced allergic reaction, skin sloughing, 30% or more, associated with some anticonvulsants, antibiotics and some OTC, ex. advil & motrin

question

Stevens-Johnson Syndrome (SJS)

answer

prompted by same drugs as TEN, begins within 1 to 14 days, signaled by nonspecific respiratory infection, chills, fever, malaise, blisterlike lesions follow in a few days, skin sloughing 10%

question

Name five rights of drug .

answer

right patient, right medication, right dose, right route of administration, right time of delivery

question

Name three checks of drug administration.

answer

1. checking drug with MAR or medication information system when removing it from drawer, refrigeration or controlled substance locker 2. checking the drug when preparing it, pouring it, taking it out of the unit-dose container, or connecting IV tubing to the bag 3. checking the drug before administering it to the patient

question

Compliance

answer

taking a medication in the manner prescribed by the health care provider

question

What is the primary role of a nurse in medication administration?

answer

ensure medications are administered and delivered in a safe manner

question

Before administering drugs by the enteral route, the nurse should evaluate which of the following?

answer

ability of the patient to swallow

question

What medications would not be administered through a nasogastric tube?

answer

entertic-coated tablets, sustained-release tablets, IV medications

question

ac

answer

before meals

question

ad lib

answer

as desired/as directed

question

bid

answer

twice per day

question

AM

answer

morning

question

cap

answer

capsule

question

gtt

answer

drop

question

h or hr

answer

hour

question

IM

answer

intramuscular

question

IV

answer

intravenous

question

no

answer

number

question

pc

answer

after meals;after eating

question

PO

answer

by mouth

question

PM

answer

afternoon

question

PRN

answer

when needed/necessary

question

qid

answer

four times per day

question

q2h

answer

every 2 hours(even or when first given)

question

q4h

answer

every 4 hours (even)

question

q6h

answer

every 6 hours (even)

question

q8h

answer

every 8 hours (even)

question

q12h

answer

every 12 hours

question

Rx

answer

take

question

STAT

answer

immediately;at once

question

tab

answer

tablet

question

tid

answer

three times per day

question

1mL (metric) convert to apothecary & household

answer

15-16 minims (apothecary) 15-16 drops (household)

question

4-5 mL (metric) convert to apothecary & household

answer

1 fluid dram (apothecary) 1 teaspoon or 60 drops (household)

question

15-16 mL (metric) convert to apothecary & household

answer

4 fluid drams (apothecary) 1 tablespoon or 3-4 teaspoons (household)

question

30-32mL (metric) convert to apothecary & household

answer

8 fluid drams or 1 fluid ounce (apothecary) 2 tablespoons (household)

question

240-250 mL (metric) convert to apothecary & household

answer

8 fluid ounces (1/2) pint (apothecary) 1 glass or cup (household)

question

500 mL (metric) convert to apothecary & household

answer

1 pint (apothecary) 2 glasses or 2 cups (household)

question

1 L (metric) convert to apothecary & household

answer

32 fluid ounces or 1 quart (apothecary) 4 glasses or 4 cups or 1 quart (household)

question

1 mg (metric) convert to apothecary

answer

1/60 grain (apothecary)

question

60-64 mg (metric) convert to apothecary

answer

1 grain (apothecary)

question

300-325 mg (metric) convert to apothecary

answer

5 grains (apothecary)

question

1 g (metric) convert to apothecary

answer

15-16 grains (apothecary)

question

1 kg (metric) convert to household

answer

2.2 pounds (household)

question

administration guidelines for a tablet

answer

assess patient is alert, has ability to swallow place capsules in medication cup if liquid, shake bottle,measure into medication cup offer glass of water, milk or juice if not contrtraindicted remain with patient until swallowed

question

administration guidelines for sublingual

answer

assess that patient is alert and has ability to hold medication under tongue place under tongue instruct patient, do not chew, swallow or move tablet with tongue remain with patient until dissolved offer glass of water

question

administration guidelines for buccal

answer

assess that patient is alert and has ability to hold medication between gums and cheek place tablet instruct patient do not chew, allow to dissolve completely remain with patient until dissolved offer glass of water

question

administration guidelines for nasogastric and gastrostomy

answer

administer liquid forms when possible to avoid clogging tube if solid, crush finely into powder and mix thoroughly with at least 30 mL of warm water until dissolved assess and verify tube placement turn of feeding if applicable aspirate stomach contents and mesure residual volume, if greater than 100mL for adult, check agency policy return residual via gravity and flush with water pour medication into syring barrel and allow to flow into the tube by gravity, give each medication separately, flushing between with water keep head of bed elevated for 1 hour to prevent aspiration reestablish continual feeding, as scheduled, keep head of bed elevated 45 degree to prevent aspiration

question

nasogastric tube (NG)

answer

soft flexible tube inserted by way of the nasopharynx with the tip lying in the stomach

question

gastrostomy tube (G)

answer

tube is surgically placed directly into the patient's stomach

question

What types of drug cannot be crushed and administered through NG or G tubes?

answer

sustained-release drugs

question

dermatologic preparations

answer

drugs applied to the skin, creams, lotions, gels, powders and sprays

question

instillation and irrigations

answer

drugs applied into body cavities or orifices, eyes ears, nose, urinary bladder, rectum and vagina

question

inhalations

answer

drugs applied to the respiratory tract by inhalers, nebulizers, or positive-pressure breathing apparatuses

question

transdermal drug administration

answer

read mfg. guidlines apply gloves cleanse area if using ointment apply amount on paper that accompanies medication tube press to clean dry, hairless skin rotate sites to prevent irritation label patch with date, time and initials

question

ophthalmic drug administration

answer

instuct patient to lie supine or sit with head slightly tilted back pull lower lid down gently to expose conjunctival sac, creating pocket ask patient to look upward hold eyedropper 1/4-1/8 inch above eye, do not hold dropper over eye (may cause blink) instill into eye, if applying ointment apply thin line along inner edge of lower lid margin, instruct patient to close eye gently, apply gentle pressure to the nasolacrimal duct for 1-2 minutes , wipe excess with tissue, replace dropper

question

otic drug administration

answer

instruct patient to lie on side or to sit with head tilted so that affected ear is facing up if necessary clean pinna of ear and meatus with a clean washcloth to prevent discharge from being washed into ear canal hold dropper 1/4" above ear canal, install drops into the side of ear canal, avoid placing drops directly on the tympanic membrane apply intermittent pressure to the tragus of the ear 3-4 times instruct patient to remain on side for 10 minutes, it cotton ball ordered, presoak with medication and insert into outermost part of ear canal wipe any solution that may have dripped

question

nasal drops administration

answer

ask patient to blow nose instruct patient to open and breath through mouth, measure correct volume into dropper, hold tip of dropper above nostril without touching the nose with dropper, direct solution toward the midline of the superior concha of the ethmoid bone- not the base of the nasal cavity, ask patient to stay in position for 5 minutes, discard any remaining solution that is in dropper

question

vaginal drug administration

answer

instruct patient to assume a supine position with knees bent and separated place water soluble lubricant into medicine cup apply gloves, open suppository and lubricate rounded end expose vaginal orifice by separating labia insert about 8-10cm along the posterior wall of vagina or as far as it will pass if using cream, jelly or foam insert application 5cm along posterior wall of vaginal and slowly push the plunger remove applicator and place on a paper towel ask patient to lower legs and remain in supine or side lying position for 5-10 minutes

question

intradermal route administration

answer

prepare medication in a tuberculin or 1 mL syringe with preattached 26-27 guage 3/8 to 5/8 neede, apply gloves, cleanse injection site, with thumb and index finger spread skin taunt, insert needle with bevel facing upward at angle of 10-15 degrees, advance needle until entire bevel is under skin;do not aspirate, slowly inject medication to for small wheal or bleb, withdraw needle quickly and pat site with sterile 2 X 2 gauze, instruct patient not to rub or scratch area, draw circle around perimeter of injection site, read in 48 to 72 hours

question

subcutaneous route

answer

prepare medication in a 1 to 3 mL syringe using a 23 to 25 guage, 1/2 to 5/8 needle, for heparin use 3/8 needle and 25-26 guage, choose side, check previous rotation sites, apply gloves and cleanse injection site, allow to dry, bunch skin between thumb and index finger spead taunt, insert needle at 45 to 90 angle dependeing on body size, 90 degree if obese, 45 degree if average weight, if patient very thin gather skin and insert at 90 degree angle, for nonheparin injections, aspirate by pulling back on plunger, if blood appears, withdraw needle, discard syringe and prepare new injection. for heparing do not aspirate ( can cause damage surrounding tissues and cause bruising)

question

intramuscular route; ventrogluteal (different guidelines would apply to the dorsogluteal, vastus lateralis, and deltoid muscle sites)

answer

prepare medication, using a 20-23 gauge, 1 to 1.5" needle, apply gloves, cleanse ventrogluteal site, let dry,insert needle with smooth, dartlike movement, angle at 90 degree within V-shaped area, aspirate and observe for blood, if blood appears, discard syrings, inject slowly and with smooth even pressure, remove needle quickly, apply pressure with 2 X 2 gauze and massage vigourously to create warmth and promote absorption of the medication into the muscle

question

intravenous route of drug administration

answer

to add to IV fluid container- verify order and compatibility of drug with IV fluid prepare medication in a 5 to 20 mL syringe, using a 1 to 1.5", 19-21 gauge needle, apply gloves, assess injection site for signs and symptoms of inflammation or extravasation, locate medication port on IV fluid container and cleanse with antiseptic swab, carefully insert needle or access device into port and inject medication, withdraw needle and missolution by rotating container end to end, hand container and check infusion rate

question

When is deltoid site used for injections?

answer

well-developed teens and adults for volumes of medication not to exceed 1 mL, usually only used for small-volume vacines, ex; hepatitis B

question

When is dorsogluteal site used for injection?

answer

adults and for children who have been walking for at least 6 months, nurse must avoid puncture or irritation of the sciatic nerve and blood vessels

question

What is the vastus lateralis site used for injection?

answer

middle third of the muscle is the site of IM injections

question

large-volume infusion administration

answer

IV administration for fluid mainteance, replacement or supplmentation

question

intermittent infusion administration

answer

this is a small amount of IV solution that is arranged tandem with or piggybacked to the primary large-volume infusion, used to instill medications over a short period of time ex: antibiotics or analgesics

question

IV bolus (push) administration

answer

this is a concentrated dose delivered directly to the circulation via syringe to administer single-dose medications

question

What is the goal of studying pharmacology?

answer

to limit the number and severity of adverse drug events

question

What are most common causes of med errors?

answer

incomplete patient information unavailable drug information miscommunication of drug orders: illegible handwritten orders lack of appropriate labeling environmental factors: distractions during the preparation of administration of drugs

question

First-pass metabolism

answer

medication absorbed in the stomach and intestine first travel to the liver where they may be inactivated before they ever reach the target organs

question

Pharmacokinetics

answer

study of drug movement or motion throughout the body

question

Processes of Pharmacokinetics:

answer

absorption, distribution, metabolism, excretion

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