question

medication rights. 8- 10 rights

answer

right: drug, patient, dose, route, time, reason, assessment data, documentation, response, education, refuse

question

Three Checks

answer

Label should be read: 1. when the nurse reaches for the unit dose package 2. after retrieval from the drawer and compared with the MAR immediately before pouring from a multi dose container 3. Before giving it to the patient or when replacing the container in the drawer or shelf

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oral meds

answer

Intended for absorption in stomach and small intestines. Drug action has slower onset and more prolonged, but less potent, effect.

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enteric coated meds

answer

impede absorption in the stomach and absorbed in small intestines. Good for meds that call stomach upset. Do not chew or crush.

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SR

answer

sustained release Do not chew or crush.

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XL

answer

extended release Do not chew or crush.

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CR or CRT

answer

controlled release Do not chew or crush.

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SA

answer

sustained action Do not chew or crush.

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LA

answer

long acting Do not chew or crush.

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Liquid meds admin with syringe

answer

place syringe between pt's gums and cheek and give slowly.

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admin of drugs that can damage teeth enamel or discolor teeth

answer

mix well with H2O/some form of liquid and have patient take med via a straw and encourage pt to drink water after med admin.

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admin of drug that pr finds distasteful

answer

crush if appropriate and add to food or drink. If med cannot be crush allow pt to suck on piece of ice for a few minutes before taking med.

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Oily meds

answer

store in fridge--cold oil is less aromatic

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parenteral

answer

admin of drug outside of intestines or alimentary tract

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Intradermal injection

answer

5 to 15 degrees. Admin in dermis, just below epidermis. Longest absorption time. Used for sensitivity test due to long absorption time. TB, allergen, and lovely anesthetics. 1/4" to 1/2", 25- or 27- gauge needle. Forearm or back under the scapula.

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Subcutaneous injections

answer

Admin in adipose tissue. 90 - 45 degrees. Admin here is slow, sustained rate of absorption. Insulin and heparin. Sites: lateral upper arm- slower absorption then ABD, ABD-most rapid absorption (costal margarine to iliac crest), anterior aspects of thigh-slower then arms, upper back, upper central or dorsogluteal area- slowest absorption. Use a 25- to 40-gauge needle. 3/8" (90 degrees)to 1" (45 degrees) Usually around 1 ml given.

question

Intramuscular injections

answer

Faster onset and action. ABTs, hormones, vaccines. Sites: ventrogluteal site, vastus lateralis, and deltoid muscle. Meds in aqueous solutions or biological agents should be admin with 20- to 25- gauge. Meds in oil based solutions should be admin with 17- to 25- gauge. Generally 1-4 ml can be admin. 72 to 90 degrees. Always use z-track technique with admin.

question

ventrogluteal site

answer

Intramuscular site. Place palm over greater trochanter with fingers facing patients head. Place index finger on anterosuperior iliac spine and extend middle finger dorsally. Forming a triangle to injection is given in the triangle. 1 1/2" needle.

question

Vastus lateralis site

answer

Intramuscular site. Divide thighs into thirds horizontally and vertically and admin injection in the outer middle third. 5/8" to 1" needle

question

Deltoid muscle

answer

Intramuscular injection. Only 1ml can be given at this site. Not developed enough in infants under 1 to absorb meds correctly. Damage to radial nerve and artery are a risk. Locate by palpating the lower edge of the acrimonious process and a triangle is formed at the midpoint in line with the Scilla or the lateral aspect of the arm. Should definitely give hepatitis b here because it induces adequate levels of antibodies. Adults: 5/8" to 1 1/2". Child: 5/8" to 1 1/4" needle.

question

Intravenous route.

answer

Most dangerous route. Immediate onset and action. PCA pumps. Aseptic technique.

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Med admin via intravenous solutions

answer

Patient receives it slowly and over a long period of time. Monitor for adverse reactions at least every hour.

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Ned admin via intravenous bolts or push

answer

Sing or injection of a concentrated solution into IV line. Admin drug slowly over at least 1 minute.

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Ned admin via intermittent IV infusion

answer

Drug mixed with small amount of IV solution such as 50-100ml and admin over short period of time. Usually with IV pump

question

Topical application

answer

Direct action at a particular site.

question

Skin application

answer

Also called an inunction. Drug absorbed through sebaceous glands. Clean skin thoroughly then apply med.

question

Transdermal

answer

Patches or discs. Hormones, narcotic analgesics, cardiac meds, nicotine. Do not apply estrogen transdermal to breast skin. Slow onset of action. Maintain consistent serum drug levels.

question

Eye drops.

answer

Instillation for local effects. Pupil dilation or construction. Treat an infection, control IOP in patients with glaucoma.

question

Eye Ointment instillation

answer

Used for local infection or irritation. Placed on exposed lower conjunctival sac after cleansing eyelids and eyelashes. About 1/2". Inner to outer then close eyes and move eyes whilst closed. Do n it rub. May blurt vision temporarily.

question

Ear instillation.

answer

Instilled in auditory canal for local affect. Soften wax, relieve pain, local anesthetic, destroy insect or organisms lodge in there. Adults: pull up and back. School sheds Kids: straight back. Kids 3 and under: down and back.

question

Nasal instillation

answer

Treat allergies, sinus infections, nasal congestion. Have patient blow nose before instilling nasal drops.

question

Rectal instillations

answer

Do not give if had recent rectal or prostate surgery. Antipyretic, laxatives, softeners. Patients who have thrombocytopenic or neutropenic should not receive or cardiac arrhythmias.

question

Piggyback delivery system

answer

Requires intermittent or additive solution to be place higher then the primary solution container via an extension hook. Port on primary IV has a back check valve that automatically stops the primary and allows the piggyback or secondary to flow. Check manufacturers recommendations for use.

question

metric system/international system

answer

The decimal measuring system based on the meter, liter, and gram as units of length, capacity, and weight or mass.

question

1 kilgram equals how many grams

answer

1000 grams WEIGHT

question

1 gram equals how many milligrams

answer

1000 milligrams WEIGHT

question

1 milligram equals how many micrograms

answer

1000 micrograms WEIGHT

question

1 liter equals how many milliliters or cubic centimeters

answer

1000 milliliters or cubic centimeters VOLUME`

question

pediatric med calculations

answer

based on weight. Recommended dosage is usually expressed as the amount to be given over 25 hour period. (mg/kg/day) or single does (mg/kg/dose) Weigh child and convert to kilograms.Then multiple weight in kg by prescribed dose. Example: 2mg/5kg/day. Child weighs 10 pounds. 10/2.2= 4.55 then 4.55 x 5 =22.7mg/day

question

apothecary

answer

a health professional trained in the art of preparing and dispensing drugs

question

The nurse is preparing supplies for a TB screening. The nurse should choose which of the following syringes and needles? A. 10ml syringe; 3", 18 gauge B. 1ml syringe, 1/2", 26 gauge C.5 ml syringe, 2", 20 gauge D. Insuline syringe, 1", 16 gauge

answer

B. 1ml syringe, 1/2", 26 gauge

question

A nurse needs to admin a subQ injection to a client. For which of the following clients can she admin the subQ at a 90 degree angle? A. infant client B. obese client C. thin client D children

answer

B. obese client

question

A client is ordered a shot IM. The nurse chose the ventrogluteal site based on which reason? A. the area is free of major vessels and fat B. the site is in close proximity to the sciatic nerve C. there is high possibility of injecting into subQ fat D. the site lies close to the radial nerve

answer

A. the area is free of major vessels and fat

question

What is the common maximum volume of a subQ shot? A. 0.05ml B. 3ml C. 1ml D. 0.01ml

answer

C. 1ml

question

A nurse needs to use a moisturizer for an older clients. Why is the onset of the med action atypical in older clients? A. decreased appetite B. decreased body temp C. diminished mobility D. diminished subQ fat

answer

D. diminished subQ fat reasoning:results in quicker absorption

question

A nurse brings a client meds and finds that the client is not in their room. What should the nurse do? A. return meds to cart or med room B. leave meds at pt's bedside C. inform physician about the pt's absence D. inform headdress about the pt's absence

answer

A. return meds to cart or med room

question

A nurse is admin'ing meds through a med lock. How often should the nurse flush the med lock to maintain patency? A.every 8-12 hours B. every 72-96 hours C. every 1 to 2 hours D. every 36 to 48 hours

answer

A.every 8-12 hours

question

A nurse needs to admin in sho to a toodler. Which of the following sites is most suitable? A. vastus lateralis site B. deltoid site C. ventrogluteal site D. dorsegluteal site

answer

A. vastus lateralis site

question

drug chemical name

answer

identifies the meds atomic and molecular structure

question

generic name

answer

identifies the drugs active ingredient and is assigned by manufacturers when first developing the drug

question

official med name

answer

the name by which the drug is identified in the official publications--often the generic name

question

trade name

answer

also called the brand name or proprietary name, is selected by pharmaceutical company that sells drug and is protected by trademark.

question

med absorption

answer

process by which a drug is transferred from its site of entry to the blood stream. Influenced by route, lipid solubility, pH, blood flow, local conditions at site of admin, and drug dosage.

question

med that has a more lipid soluble can be absorbed more readily and pass more easily through cell membranes

answer

...

question

acidic drugs are absorbed best in stomach

answer

...

question

meds that are basic pH remain ionized of insoluble in an acid environment. Absorbed in small intestines

answer

...

question

impaired circulation can inhibit or make for slower drug absorption

answer

...

question

patient with burns would have poor absorption of an IM at the burn site

answer

...

question

food in stomach can delay absorption in some meds or speed up absorption is some meds

answer

...

question

distribution

answer

occurs after the drug has been absorbed into the bloodstream and the drug is distributed throughout the body. Depends on blood flow to the tissues, meds ability to leave the blood stream, and ability to enter cells.

question

when drug binds to plasma proteins it causes unequal distribution and prevents med from reaching intended site

answer

...

question

drugs readily move across the placenta but not the BBB

answer

....

question

first pass effect

answer

The elimination of drug that occurs before it reaches the systemic circulation and have a considerably higher oral dose than sublingual or parenteral dose. Term that describes drugs metabolizing in the liver before having systemic effects. ORAL meds. Coumadin, lidocaine

question

biotransformation

answer

3rd stage of the Pharmacokinetic process where metabolism of the drug most often occurs in the liver but other tissues may be involved

question

excretion

answer

occurs after med is broken down into an inactive form. kidneys excrete most of meds. lungs are primary excreter for gaseous substances. Through bile of GI tract. Sweat, salivary, and mammary glands.

question

meds to monitro in elderly fro med excretion do to aging

answer

psychotropic, NSAIDs, oral hypoglycemics, anticoagulants, certain broad spectrum ABTs, cardiac meds.

question

therapeutic effect

answer

The desired or intended effect of a particular medication.

question

adverse drug effect/side effect

answer

an undesirable and potentially harmful action caused by the administration of medication. Can develop an iatrogenic disorder. Ex: neutropenia. Some are expected and may be tolerated as part of therapy. EX; morphine-pain management outweighs constipation. Monitor and report as per policy as well as to MedWatch

question

iatrogenic

answer

a disease produced secondary to the treatment of the patient; often it is the result of side effects of the drug therapy chosen by the physician

question

toxic effect

answer

specific group of symptoms related to drug therapy that carry risk for permanent damage or death. Can occur from a cumulative effect. Toxicities named from the system they affect. Ex: hepatoxicity.

question

cumulative effect

answer

occurs when body cannot metabolize one dose of a med before another dose of the same med is administered.

question

allergic reaction

answer

immune response that occurs when the body interprets the drug as foreign and forms antibodies against it. Ranges from minor to serious. S/S: rash, urticaria, fever, diarrhea, nausea and vomiting.

question

anaphylaxis

answer

a severe response to an allergen in which the symptoms develop quickly, and without help, the patient can die within a few minutes. Sudden rest. distress-sudden severe bronchospasm and cardiovascular collapse. Treated with vasopressors, bronchodilators, corticosteroids, O2 therapy, IV fluids, antihistamines

question

idiosyncratic effects/paradoxical effect

answer

any unusual or peculiar responce to a drug that may manifest itself by over response, , under response, or even the opposite of the expected response. R/t patients unique response to meds and thought to be due to genetic enzyme deficiencies.

question

synergistic response

answer

when the effect of two or more combined drugs is greater than the sum of their individual effects Ex: alcohol and barbiturates cause CNS depression but taken together they cause even greater CNS depression

question

BSA

answer

body surface area. Area of external surface of the body. most accurate way to calculate drudges for infants, children and older adults, pt's receiving oncologic meds, with low body weight. Expressed in square meters m2

question

due to differences in men and women fat composition and fluid composition meds have different, weaker, or stronger effects on certain genders.

answer

....

question

christian scientist view on meds

answer

place their faith in spiritual healing, therefore they do not take meds.

question

certain ethnic groups have more genetic variations which affects med therepy

answer

...

question

some ACE inhibitors have been found to be less effective in the african american pop.

answer

...

question

BMR

answer

basal metabolic rate.

question

lowered protein levels in body means less med bounds to plasma leading to a higher concentration of free med in the body. puts pt at risk for adverse effects due to high concentration of med.

answer

....

question

peak level

answer

or highest plasma concentration of the drug should be measure when absorption is complete. Ensures therapeutic levels can be maintained without causing toxicity.`

question

trough level

answer

the point when the drug is at its lowest concentration, indicating the rate of elimination. Ensures therapeutic levels can be maintained without causing toxicity.

question

half life

answer

is the amount of time it takes for 50% of the blood concentration a drug to be eliminated from the body. Ensures therapeutic levels can be maintained without causing toxicity.

question

minimum effective concentration/MEC

answer

Amount of drug required to produce a therapeutic effect.

question

minimum toxic concentration/MTC

answer

level at which toxic effects begin

question

agonist medication

answer

chemical entity extrinsic to endogenously produced substances that acts on a receptor and is capable of producing the maximal effect that can be produced by stimulating that receptor. Full ________ opioids activate the opioid receptors in the brain fully resulting in the full opioid effect. Examples are heroin, oxycodone, methadone, hydrocodone, morphine, opium and others.

question

antagonistic medication

answer

blocks opioids by attaching to the opioid receptors without activating them and cause no opioid effect and block full agonist opioids. Examples are naltrexone and naloxone. Naloxone is sometimes used to reverse a heroin overdose.

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