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96 Cards in this Set
- Front
- Back
Arrange the routes of medication administration in descending order of absorption |
1. intravenous 2. intramuscular 3. Subcutaneous 4. Oral |
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what precautions should the nurse take to prevent infection during injection administration? |
1. Cover the tip of the syringe with a cap 2. Clean the skin with an antiseptic swab 3. Avoid touching the needle with the contaminated area |
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The patient tells the nurse "it feels like the medication is stuck in my throat". What should the nurse tell the patient? |
1. drink fluids after swallowing 2. crush certain medications and put them in pudding 3. eat a small amount of food after swallowing |
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The nurse is administering medications to a 4 year old. The mother states "I don't remember my child ever having that medication" what should the nurse do next? |
Withheld medications and verify the prescription |
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The nurse has been assigned to give a medication in the dose of 10 mg/kg to a patient weighing 44 lbs. How many mg's should the nurse give? |
44/2.2 = 20 kg 20 x 10 = 200 mg |
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How should the nurse position the patient that has to undergo administration of a nasal spray? |
- tilt the head slightly back - Have the patient lay in the supine position with the head tilted slightly back |
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The various steps of vaginal suppository administration in order |
1. Lubricate the applicator or suppository using a water soluble gel 2. expose the vaginal orifice with non dominant hand 3. Fully insert the applicator, using a rolling motion inserting downward and backward. 4. instruct the patient to remain on her side for 5-10 minutes |
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IM injection site for a 6 month old? |
Vastus Lateralis |
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IM injection site for children and adults? |
deltoid |
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4 mg morphine sulfate ordered. Medication comes in an ampule reading 10 mg/1mL. How many mL's should be administered? |
(ordered dose/dose on hand) = 4/10 = 0.4 mL |
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Which instructions does the nurse give to a patient who is administering a transdermal patch? |
1. Mark the patch with the date and time before applying it. 2. Rotate placement site of the patches to prevent irritation 3. fold the old patch so that it sticks to itself before disposing of it. |
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The nurse administers an opioid analgesic to a patient. Which vital sign does the nurse delegate to the aid? |
Respiratory Rate |
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A medication has a minimum effective concentration of 25 mg/dL and the therapeutic range is 25-100 mg/dL. What is the plasma concentration above which the toxic effects of the drug may appear? |
100 mg/dL. The highest reading of a therapeutic range is the plasma concentration |
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If the half life of a drug is 4 hours, and the nurse administers 1g of the drug, how many hours does it take to reach 250 mg of the original dose? |
If a drug has a half-life of 4 hours, 50 percent of the drug is eliminated from the body after 4 hours. Therefore, 500 mg will be present after 4 hours. After 8 hours, 25 percent of the original dose will be present in the body. Therefore, 250 mg of the original dose will be present in the body after 8 hours. |
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An elderly obese patient has undergone total hip replacement surgery and has been prescribed low - molecular - weight - heparin (LMWH) enoxaparin. What should the nurse inform the patient about subcutaneous injections? |
1. The injection site should not be near any bony prominences 2. the medication is injected into the connective tissue below the dermis |
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drug |
any substance that positively or negatively alters the physiologic function |
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medication |
is a drug specifically administered for its therapeutic effects on physiologic function |
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Generic name |
the official name and is simpler than the chemical name |
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trade name |
or brand name that is assigned by the drug manufacturer |
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Chemical name |
describes the elements of the medications molecular structure |
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controlled substances |
have regulated manufacturing, prescribing, and dispensing requirements. |
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schedule 1 controlled substance |
high potential for abuse - no currently accepted medical use in treatment in the US. EX: Heroin, LSD, and methaqualone |
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Schedule II controlled substance |
high potential for abuse; may lead to severe psychological or physical dependence. Has a currently accepted medical use with severe restrictions. EX: morphine, cocaine, methadone, and methamphetamine |
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Schedule III controlled substance |
lower potential for abuse compared to the drugs in schedules I and II in regard to moderate dependence. Has a currently accepted medical use. EX: anabolic steroids, narcotics such as codeine or hydrocodone with aspirin or acetaminophen, and some barbiturates |
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Schedule IV |
lower potential for abuse relative to the drugs in schedule III; may lead to limited dependence. Has a currently accepted medical use EX: pentazocine, meprobamate, diazepam, and alprazolam |
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Schedule V |
low potential for abuse relative to the drugs in schedule iv. has a currently accepted medical use in treatment in the US. EX: over the counter cough medicines with codeine. |
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pharmacokinetics |
the study of how a medication enters the body, moves through the body, and ultimately, leaves the body. |
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pharmacodynamics |
the process in which a medication interacts with the body's cells to produce a biologic response. |
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Therapeutic effect |
or intended effect, is the desired result of action of a medication. |
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absorption |
the passage of a drug from the administration route to the blood stream |
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Distribution |
the process of delivering the medication to tissues and organs and ultimately to the specific site of action |
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Metabolism |
the process by which a drug is altered to a less active form to prepare for excretion |
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metabolites |
products of metabolism |
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liver |
site of metabolism |
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elderly precautions |
impaired liver functioning causing slower metabolism of drugs |
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excretion |
process removed the less active drug or its metabolites |
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half life |
the expected time it takes for the blood concentration to measure one half of the original drug dose due to drug elimination. |
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onset of action |
the time the body takes to respond to a drug after administration |
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peak plasma level |
indicates the highest serum (blood) concentration |
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trough |
lowest serum level of the medication |
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side effects |
are predictable but unwanted and sometimes unavoidable reactions to medication |
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adverse effects |
are severe, unintended, unwanted, and often unpredictable drug reactions. |
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Toxic effects |
result from a medication overdose or the buildup of medication in the blood due to impaired metabolism and excretion |
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Allergic reactions |
unpredictable immune responses to medications. |
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anaphylactic reaction |
a true medical emergency. Can occur after treatment and can be fatal |
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idiosyncratic reaction |
unpredictable patient response to medication |
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medication interactions |
occur when the drug action is modified by the presence of a certain food or herb or another medication |
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synergistic effect |
occurs when he combined effect is greater than the effect of either substance if taken alone |
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antagonism |
occurs when the drug effect is decreased by taking the drug with another substance, including herbs |
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drug incompatibility |
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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Echinacea |
uses: Stimulates the immune system; facilitates wound healing; fights flu and cold side effects and drug interactions: possible liver inflammation and damage if used with anabolic steroids or methotrexate |
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feverfew |
uses: alleviates and helps prevent migraines' relieves pain of arthritis side effects and drug interactions: increased bleeding; potentiates action of anticoagulants |
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Garlic |
uses: lowers blood pressure and cholesterol and triglyceride levels side effects and drug interactions: increased bleeding; potentiates action of anticoagulants |
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Ginkgo biloba |
improves memory and mental alertness side effects: increased bleeding and potentiates action of anticoagulants |
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Ginseng |
increases physical stamina and mental concentration side effects: can increase heart rate and blood pressure; decreases effectiveness of anticoagulants |
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Saw palmetto |
helps with enlarged prostate and urinary inflammation side effects: interacts with other hormones |
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St. John's Wort |
alleviates mild to moderate depression, anxiety and sleep disorders side effects: interacts with antidepressants, birth control pills, cyclosporin, digoxin, and human immunodeficiency virus, and cancer medications |
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prescription |
medications that are dispensed by a pharmacist on receipt of written directions |
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Components for medication administration |
1. patient's name 2. date and time the order is written 3. name of drug to be administered 4. Dosage of drug 5. Route of drug administration 6. frequency of drug administration 7. signature of the person writing the prescription |
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oral route |
by mouth |
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buccal |
against the cheek |
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sublingual |
under the tongue |
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parenteral |
by injection or infusion |
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topical |
on skin or mucous membranes |
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inhalation |
Medications that are taken into the body through the respiratory tract. ex: MDI's and nebulizer |
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medical tube |
nasogastric tube or percutaneous endoscopic gastrostomy |
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PO |
by mouth. It is the safest, most convenient and least expensive route for medication administration |
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Topical medications |
applied to a specific skin surface or mucous membrane of body cavity. |
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Transdermal patch |
topical preparation designed to deliver medications slowly for systemic effects. |
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parenteral medications |
administered through a needle by a route other than topical or through the gastrointestinal or respiratory tract. |
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4 major sites for injection |
1. intradermal 2. Subcutaneous 3. Intramuscular 4. Intravenous |
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intradermal injection |
ID. Shallow injection into the dermal layer just under the epidermis |
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Subcutaneous injection |
Sub - Q, subQ; injection into the subcutaneous tissue just below the skin |
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Intramuscular injection |
IM; injected into a muscle of adequate size to accommodate the amount and type of medication |
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Intravenous injection |
IV; injected into a vein |
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Syringe and needle size for subQ |
syringe selection: 1-3 mL; insulin syringe: 0.5-1 mL with reattached needle Needle selection: 27-25 gauge, ⅜ -⅝ inch. insulin syringe: 26-31 gauge, 5/16 - ½ inch site selection: abdomen, lateral aspects of the upper arm and thigh, scapular areas of the back, and upper ventrodorsal gluteal area |
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Syringe and needle size for Intradermal |
Syringe selection: 1-mL tuberculin syringe needle: reattached 25-27 gauge, ¼ - ⅝ inch Site selection: inner forearm, upper arm and across the scapula |
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Syringe and needle size for intramuscular |
Syringe: adults - up to 3 mL depending on the site; infants/small child - 0.5 - 1 mL needle: 20-25 gauge, 1-3 inch/ oil based solutions: 18-20 gauge Site: Ventrogluteal, vastus lateralis, and deltoid. age of patient and corresponding site: adult - ventogluteal or deltoid child - vastus lateralis or deltoid infant: vastus lateralis |
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Syringe and needle size for intravenous |
Syringe: depends on the 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 intravenous ports. (do not use needles in a needleless system to access iv ports) site: vein |
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safe medication administration |
before administering a medication, the nurse should check the patient's MAR or the health care providers prescription, review diet and fluid orders, review relevant laboratory values, and perform a brief physical assessment. |
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To decrease medication errors: |
the nurse should follow only written orders. in an emergency setting, a verbal order may be taken but must be put in writing as soon as possible. |
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medication error |
any preventable event that may cause or lead to inappropriate medication use or patient harm while they medication is in the control of the health care professional; patient or consumer. |
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types of medication errors: |
some cause harm to the patient directly (excessive dose), others fail to treat the patient's illness (not enough of a dose), giving the wrong drug, giving a med to the wrong patient, or using the wrong route. |
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if a med error occurs: |
determine the effect on the patient and intervene to offset any adverse effects of the error. Actions include immediate and ongoing assessment, notification of the prescribing physician, initiation of interventions as prescribed to offset any adverse effects, and documentation relating to the event. |
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Six rights of medication administration |
right drug right dose right time right route right patient right documentation |
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three checks |
1. verifying that the med matches the MAR, calculating the dosage, checking the expiration date of the drug 2. preparing the medication and again checking the med label to the MAR 3. recheck of the label again before returning the med to storage place or re checking of the label a final time against the MAR before opening the package at the bedside. |
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preventing med errors |
following hospital policy for patient identifiers, giving med prepared by the person giving them, double checking doses, verifying high risk drug doses with a second nurse, addressing patient questions about the meds, and understanding why the patient is being given a certain medication. |
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Patient rights |
- The right to be informed of the name, purpose, and potential side effects of medications - The right to refuse medication - The right to have an accurate medication history taken by a qualified person - the right to receive medications in accordance with the 6 rights of med admin. |
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Assessment: |
Information about the patient's allergies to drugs and food and the patient's pregnancy or breastfeeding status is especially critical. |
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Important Data to be collected: |
patient's medical history, allergy information, medication history, including any prescription, over the counter, or alternative therapies; physical examination results, with a focus on medication effects of the body; and relevant lab results. |
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Common Labs used to monitor medication responses: |
electrolytes, serum glucose, complete blood count (CBC), white blood cell count (WBC), bleeding time, blood urea nitrogen (BUN), creatinine, and serum levels of specific medications |
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Respiratory assessment is performed before administration of a ___________________. |
bronchodilator treatment for a patient having an asthma attack |
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Respiratory assessment: |
Respiratory rate, Auscultation of lung sounds, use of accessory muscles, and o2 saturation levels |
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________ is obtained for 1 minute before digoxin is given |
apical pulse digoxin is a medication that slows the heart rate. |
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________ is evaluated before administration of a antihypertensive |
blood pressure |
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________________ is evaluated before an antipyretic is administered |
temperature |