Fundamentals of Nursing: Medications Chapter 29 Flashcards


Set Details Share
created 3 months ago by Jenniferduvall
16 views
updated 3 months ago by Jenniferduvall
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:
1

Pharmacist

licensed individual who prepares and dispenses medications

2

Drug

Substance that modifies body functions when taken into the body

3

Generic name for drug

assigned by the manufacturer that first develops the drug, identifies the drug's active ingredient

-usually in lower case

4

Chemical name for drug

A precise description of the drug's chemical composition

5

Trade name for drug

The brand name, selected by the pharmaceutical company that sells the drug and is protected by trademark

-is usually capitalized

6

Example of drug names using tylenol

Generic name: acetaminophen

Chemical name: tempra, licoprin

Trade name: Tylenol

7

What determines drug classification?

effect on body system, chemical composition, clinical indication of therapeutic action

8

Two primary classifications of drugs

Pharmaceutical

Therapeutic

9

Pharmaceutical class

refers to mechanism of action, the physiological effect and the chemical structure

10

Therapeutic class

this refers to clinical indication for the drug or its therapeutic action

-this would be like an anti-hypertensive drug or an antibiotic

11

Pharmacokinetics

The effect the body has on a drug once the drug enters the body, the movement of drug molecules in the body in relation to the drugs:

-absorption

-distribution

-metabolism

-excretion

12

Capsule

powder or gel form of an active drug enclosed in a gelatinous container; may also be called liquigel

13

Elixir

Medication in a clear liquid containing water, alcohol, sweeteners, and flavor

14

Enteric coated

A tablet or pill coated to prevent stomach irritation

15

Extended release (ER)

Preparation of a medication that allows for slow and continuous release over a predetermined period; may also be referred to as CR or CRT (controlled release), SR (sustained or slow release), SA (sustained action), LA (long acting), or TR (timed release)

16

Liniment

Medication mixed with alcohol, oil or soap, which is rubbed on the skin

17

Lotion

Drug particles in a solution for topical use

18

Lozenge

Small oval, round, or oblong preparation containing a drug in a flavored or sweetened base, which dissolves in the mouth and releases the medication; also called troche

19

Ointment

Semisolid preparation containing a drug to be applied externally; also called an unction

20

Pill

Mixture of a powdered drug with a cohesive material; may be round or oval

21

Powder

Single or mixture of finely ground drugs

22

Solution

A drug dissolved in another substance (e.g., in an aqueous solution)

23

Suppository

An easily melted medication preparation in a firm base such as gelatin that is inserted in to the body (rectum, vagina, urethra)

24

Suspension

Finely divided, undissolved particles in a liquid medium; should be shaken before use

25

Syrup

Medication combined in a water and sugar solution

26

Tablet

Small, solid dose of medication, compressed or molded; may be any color, size, or shape (e.g., caplets are elongated/oval in shape and are often coated) enteric-coated tablets are coated with a substance that is insoluble in gastric acids to reduce gastric irritation by the drug

27

Transdermal patch

Unit dose of medication applied directly to the skin for diffusion through skin and absorption into the bloodstream

28

What is absorption?

Movement of drug into the bloodstream

29

Factors that affect absorption -route of administration-oral

take the longest to absorb

30

factors that affect absorption- route of admin. - liquid

don't need to be dissolved, absorb faster

31

route of admin. - IM(intramuscular) or SubQ

absorb more easily than oral

32

route of admin. - IV (intravenously)

administered directly into the blood stream, so they take effect very quickly

33

route of admin. - transdermal, creams, lotions

primarily local effects, some have systemic absorption such as nicotine patches &transdermal patches

34

route of admin - mucous membrane

suppositories, absorbed locally and systemically

35

factors that affect absorption - drug solubility

lipid soluble are absorbed more easily because they pass through cell membranes

36

factors that affect absorption - pH/ionization

acidic drugs are well absorbed in the stomach

37

factors that affect absorption - blood flow

absorption is increased with good blood flow

38

factors that affect absorption - local conditions at site of administration

more extensive the absorbing surface the greater the absorption of the drug and the more rapid the effect

39

factors that affect absorption - drug dosage

when determining the dosage the Dr. should consider metabolism

40

Distribution

after the drug has been absorbed, drug molecules are transported to tissues and organs where the drug "takes action"

41

Factors that affect distribution

-Adequacy of blood circulation

-Protein-binding capacity

-Selectively permeable blood-brain barrier - protects CNS but can limit the passage of drugs intended to act on CNS

42

The _______ is the primary site for drug metabolism

liver

43

Biotransformation

the change of an active drug from its original form to an inactivated or new form

44

Factors affecting metabolism

-liver function

-health/disease status

-first-pass effect: Drugs given orally move from the intestinal lumen to the liver by way of the portal vein, results in a reduction of bioavailability

ex. nitroglycerin, can't give orally because it would be destroyed by the liver and there would be little to no drug left to work on the body. Given sublingual, transdermal or IV

45

Excretion

The process of removing the drug and its products of metabolism from the body

46

Factors affecting excretion

Organ function - especially kidney, liver and lungs. kidneys excrete most drugs through urine.

47

Adverse drug reaction

Harmful effects that lead to injury, can be severe and contribute to discontinuation of drug

48

Side effects (drug reaction)

Unintended, secondary effects that may be mild and predictable, may be tolerated as part of therapy

ex. opioids cause constipation due to decreased bowel mobility

49

Iatrogenic disorder (drug reaction)

can be caused unintentionally by drug therapy

ex. neutropenia can be cause by chemotherapy

50

FDA classifies a serious adverse drug event as

an action that is life threatening, requires intervention to prevent death or permanent impairment, and/or leads to death, hospitalization, disability, or congenital abnormality

51

black box warnings

placed on med. due to reporting and have a specific label, so very important to look for these

52

Allergic effect (drug reaction)

an immune system response that occurs when the body interprets the administered drug as a foreign substance and forms antibodies against the drug

-can range from mild to serious and can get worse each time the drug is taken

53

Anaphylactic Reaction

Most serious allergic effect, life threatening and results in respiratory distress, sudden severe bronchospasm, and cardiovascular collapse

**Requires medical intervention**

54

Drug Tolerance

Occurs when the body becomes accustomed to the effects of a particular drug over a period of time

-body will eventually need larger doses

55

Toxic Effects

Specific group of symptoms related to drug therapy that carry risk for permanent damage or death

56

Idiosyncratic Effects

Any unusual response to a drug that may manifest itself by overresponse, underresponse, or even the opposite of the intended response

-usually pt. specific, opposite of what was intended

57

Drug interactions

One drug is affected in some way by another drug, a food, or another substance taken at the same time; can be advantageous or not

58

Additive effect

Drugs with similar pharmacologic actions, result in an increase in overall effect, so you're adding to that effect

59

Synergistic effect

drugs with different sites, results in greater effects when taken together, one drug potentiates the other

60

Antagonistic effect

Combined drugs negate each other, results in effect less than that with each drug taken alone

61

Interference

one drug interferes with metabolism of another, this leads to the buildup of a medication that can't be metabolized and can result in toxicity

62

Displacement

When one drug binds to a protein binding site and forces another drug to be displaced, results in drug being inactive and can lead to the effect of the one bound drug

63

Factors affecting drug action

-Developmental considerations

- weight

- gender

-genetic and cultural factors, some meds are less effective in African Americans such as ACE inhibitors

-psychological factors, such as placebo effect

- pathology- diseases effect medications like liver disease

-environment

-Timing of administration - some need to be taken before they eat synthroid needs to be taken 1 hour before food

64

Therapeutic range

concentration of drug in the blood serum that produces the desired effect without causing toxicity

65

Trough level

the point when the drug is at its lowest concentration, indicating the rate of elimination

66

Half-life

amount of time it takes for 50% of blood concentration of a drug to be eliminated from the body

-when a drug is given at normal doses it takes about 4 or 5 half lives to achieve a steady concentration and develop balance between tissue and serum concentration.

67

Drug legislation

-drug listings, directories, and references

-legal considerations (national standards for drug quality)

-extensive testing of new drugs

- systems for storing and distributing medications

68

Components of the medication order

  • clients full name and second identifier (usually D.O.B or MRN)
  • date and time the order is written
  • name of medication
  • dosage size, frequency, number of doses
  • route of administration
  • printed name and signature of prescriber, including relevant credentials
  • orders can be routine (standing), PRN, STAT, one-time order)
69

As a nurse what are you responsible for when preparing to administer a medication?

checking med order, checking med and it's expiration, checking pt. allergies, making sure order was transcribed accurately, make sure order in computer matches written order, double check dosage and appropriateness of medication.

70

When should the nurse check the orders for medication?

when you open pyxis, when you retrieve a medicine check package and container, compare to MAR or order, before you give med to the pt. and complete electronic scanning

71

Why is it important to double check the medication orders?

The nurse is legally responsible for the drugs they administer!

72

What should you do if you're unfamiliar with a drug?

take time to look it up!

73

3 checks and the rights of medication administration

-the label should be read

  1. when the nurse reaches for the unit dose package or container
  2. after retrieval from the drawer and compared with eMAR/MAR immediately before pouring from a multidose container
  3. before giving the unit dose medication to the patient, or when replacing the multidose container in the drawer or shelf
74

Rights of Medication administration

  • right medication/drug- has the patient been given this medication before?
  • right client - make sure you're giving it to the right person verifying 2 forms of identification
  • right dose - make sure the labeling is legible and clearly understood
  • right time- check to see when the medication was last administered
  • right route - check the original orders to verify the route of administration
  • right reason - determine if the patient has a condition the medication is used for
  • right documentation - complete documentation according to facility policy immediately after administering any medication
  • right response - monitor patient to make sure the medication is working
  • right assessment data - collect appropriate assessment data
  • right to know - educate pt. about medication if necessary
  • right to refuse - ask why? notify provider, document refusal and that you educated pt. regarding medication
75

Identifying the patient

  • check ID bracelet
  • validate patients name (have them say it)
  • validate patients ID number, medical record number, or date of birth
  • compare with MAR
  • don't always rely on the barcode scanner, make sure the bracelet is correct
76

Enteral route

administering a drug through an enteral tube (nasogastric tube)

77

Sublingual route

under the tongue

78

Buccal route

between the cheek and the gum

79

Parenteral medications (outside the intestines or alimentary canal)

intradermal

transdermal

subcutaneous

intramuscular

intravenous

80

Equipment for parenteral medications

needle/syringe (different sizes, lengths, gauges)

choose your syringe based on route of administration, viscosity of the solution, quantity to be administered, patients body size, type of medication

do not recap needles! After use place needles and syringes in puncture resistant containers

**Beware of the right site of administration

81

What does the gauge of a needle refer to and whats largest?

gauge is the size of the needle

the smaller the number the larger the needle size

82

Controlled substances

  • should always be locked up
  • federal laws must be observed for administration of this medication
  • do not leave unattended
  • when all the medication is not used, the remainder must be discarded by 2 nurses and documented
  • Counts for these medications are done per facility policy
83

What should I do if I commit a medication error?

  • ASSESS THE PATIENT!! V/S, INTERVIEW, AND PHYSICAL STATUS
  • Report findings to the primary care provider
  • notify the nurse manager of your unit and report the actions surrounding the event
  • check with your institution for agency-specific policies regarding incident reporting

**reporting allows things to be tracked so the same errors aren't made again