Fundamentals of Nursing - E-Book: Medication Administration Flashcards


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1

What ensures that all medications undergo vigorous testing before being sold?

The Food and Drug Administration

2

What conforms to federal legislation but also has additional control such as alcohol and tobacco?

State government

3

What defines the scope of a nurse's professional functions and responsibilities?

The Nurse Practice Act

4

What provides an exact description of a medication's composition and molecular structure?

The chemical name

5

What is created by the manufacturer who first develops a medication and becomes its official name?

The generic name

6

What is trademarked by the manufacturer to identify the particular version of the drug they have manufactured?

The trade name

7

What indicates the effect of a medication on the body system, the symptoms the medication relieves, or the medications desired effects?

Medication classification

8

What determines a medication's route of administration?

The form

9

What is the study of how medications enter the body, reach their site of action, metabolize, and exit the body?

Pharmacokinetics

10

What refers to the passage of medication molecules into the blood from the site of administration?

Absorption

11

Route of administration
Ability of the medication to dissolve
Blood flow to the site of administration
Body surface area
Lipid solubility

Factors that influence drug absorption

12

Circulation
Membrane permeability
Protein binding
Metabolism
Excretion

Factors that affect the rate and extent of medication distribution

13

After a medication reaches its site of action, it becomes ____________ into a less active or inactive form that is easier to excrete.

Metabolizes

14

When renal function declines, a patient is at risk for medication ___________.

Toxicity

15

The ________ are the primary organ for drug excretion.

Kidneys

16

____________ effects are the expected or predictable physiological response to a medication.

Therapeutic

17

_________ effects are predictable and often unavoidable secondary effects a medication will cause.

Side

18

___________ effects are unintended, undesirable, and often unpredictable severe responses to medication.

Adverse

19

__________ effects develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion.

Toxic

20

___________ reactions are unpredictable effects in which a patient overreacts or underreacts to a medication or has a reaction that is different from normal.

Idiosyncratic

21

____________ reactions are unpredictable responses to a medication.

Allergic

22

___________ reactions are allergic reactions that are life threatening and characterized by sudden constriction of bronchiolar muscles, edema of the pharynx and larynx, and severe wheezing and shortness of breath.

Anaphylactic

23

____________ occurs when one medication modifies the action of another medication; it may alter the way another medication is absorbed.

Medication interaction

24

A ___________ effect is when the combined effect of the two medications is greater than the effect of the medications when given separately.

Synergistic

25

The plasma level of medication below which the medication's effect will not occur is called the ________.

MEC (Minimum effective concentration)

26

What is highest serum level concentration of a medication called?

Peak concentration

27

What is the lowest serum level concentration of a medication called?

Trough concentration

28

The time it takes for the excretion process to lower the serum medication concentration by half is called what?

The biological half-life

29

Oral
Buccal
Sublingual

The 3 types of oral routes

30

Intradermal
Subcutaneous
Intramuscular
Intravenous

The 4 major sites for parenteral injections

31

What are administered in the epidural space via a catheter, and is usually used for postoperative analgesia?

Epidural injections

32

What type of medication is administered via a catheter that is in the subarachnoid space or one of the ventricles of the brain?

Intrathecal

33

What type of medication is administered directly into the bone marrow and is commonly used in infants and toddlers?

Intraosseous infusion

34

What type of medication, such a chemptherepeutic agents, insulin, and antibiotics, are administered into the peritoneal cavity?

Intraperitoneal medications

35

What type of medication, commonly chemotherpeutics, are administered directly into the pleural space?

Intrapleural medications

36

What type of medications are administered directly into the arteries?

Intraarterial medications

37

What type of medications are administered directly into cardiac tissue?

Intracardiac medications

38

What type of medications are injected into a joint?

Intraarticular medications

39

What is readily absorbed and work rapidly because of the rich vascular alveolar capillary network present in the pulmonary tissue?

Inhaled medications

40

What is a given mass of solid substances dissolved in a known volume of fluid or a given volume of liquid dissolved in a know volume of another fluid?

A solution

41

Metric
Apothecary
Household

3 measurements used in medication administration

42

What is the formula used to determine the correct dose when preparing solid or liquid forms of medications?

Dose ordered/Dose on hand x Amount on hand = Amount to administer

43

What kind of order is carried out until the prescriber cancels it by another order or until a prescribed number of days elapse?

Standing or routine order

44

What kind of order is a medication that is given only when a patient requires it?

PRN order

45

What kind of order is given only once at a specific time?

Single or one-time order

46

What kind of order describes a single dose of a medication to be given immediately and only once?

STAT order

47

How long does a nurse have to administer a medication that is ordered "now"?

90 minutes

48

What are the medication distribution systems?

Unit dose and Automated medication dispensing systems (AMDS)

49

Inaccurate prescribing
Administration of the wrong medication
Giving the medication using the wrong route or time interval
Administering extra doses
Failing to administer a medication

Common medication errors that can cause a patient harm

50

Verify
Clarify
Reconcile
Transmit

Process of medication reconciliation

51

Right medication
Right dose
Right patient
Right route
Right time
Right documentation

The 6 rights of medication administration

52

A patient may:
-be informed of a medication's name, purpose, action, and potential undesired effects
-refuse a medication regardless of the consequences
-have qualified nurses or physicians assess a medication history
-be properly advised of the experimental nature of medication therapy and give written consent
-receive labeled medications safely without discomfort
-receive appropriate supportive therapy
-not receive unnecessary medications
-be informed if medications are a part of a research study

Patient Care Partnership

53

History
History of allergies
Medication data
Diet history
Patient's perceptual coordination problems
Patient's current condition
Patient's attitude about medication use
Patient's knowledge and understanding of medication therapy
Patient's learning needs

Areas a nurse needs to assess to determine the need for and potential response to medication therapy

54

Anxiety
Ineffective Health Maintenance
Readiness for Enhanced Immunization Status
Deficient Knowledge
Noncompliance
Effective Therapeutic Regimen Management
Impaired Swollowing

7 potential nursing diagnoses used during the administration of medications

55

Will verbalize understanding of desired effects and adverse effects of medications
Will state signs, symptoms, and treatment of hypoglycemia
Will monitor blood sugar to determine if medication is appropriate to take
Will establish a daily routine that will coordinate timing of medications with meal times

Outcomes for a patient with newly diagnosed type 2 diabetes

56

Health beliefs
Personal motivations
Socioeconomic factors
Habits

Factors that can influence a patient's compliance with medications regimen.

57

1. Patient's full name
2. Date and time that order is written
3. Medication name
4. Dose
5. Route of administration
6. Time and frequency of administration
7. Signature of provider

Components of medication orders

58

1. The name of medication

What needs to be on the medication record

59

Patient responds to therapy
Patient has the ability to assume responsibility for self-care

The goals for safe and effective medication administration

60

1. Determine the patient's ability to swallow and cough and check for gag reflex
2. Prepare oral medications in the form that is easiest to swallow
3. Allow the patient to self-administer medications if possible
4. If the patient has unilateral weakness, place the medication in the stronger side of the mouth
5. Administer pills one at a time, ensuring that each medication is properly swallowed before the next one is introduced
6. Thicken regular liquids or offer fruit nectars if the patient cannot tolerate thin liquids
7. Avoid straws because they decrease the control the patient has over volume intake, which increases the risk of aspiration
8. Have the patient hold the cup and drink it if possible
9. Time medications to coincide with meal times or when the patient is well rested and awake if possible
10. Administer medications using a different route if risk of aspiration is severe

Precautions to take when administering any oral preparation to prevent aspiration

61

1. Document where the medication was placed in the MAR
2. Assess if patient has an existing patch before application
3. Apply a noticeable label to the patch
4. Document removal of medications on the MAR

Guidelines to ensure safe administration of transdermal or topical medications

62

Decongestant spray or drops is the most common form of __________ instillation.

Nasal

63

1. Avoid instilling any eye medication directly onto the cornea
2. Avoid touching the eyelids or other eye structures with the eye dropper or ointment tube
3. Use medication only for the patient's affected eye
4. Never allow a patient to use another patient's eye medication
3.

4 principles for administering eye instillations

64

Vertigo, dizziness, and nausea are symptoms a patient can experience ear drops are not instilled at _________ temperature.

Room

65

____________ medications come in suppositories, foam, jellies, and creams.

Vaginal

66

____________ suppositories are used to exert local effects (promoting defecation) or systemic effects (reducing nausea).

Rectal

67

What type of inhaler delivers a measured dose of medication with each push of a canister and is often used with a spacer?

Pressurized metered-dose inhaler (pMDIs)

68

What type of inhaler releases medication when a patient raises a level and then inhales?

Breath-actuated metered-dose inhaler (BAIs)

69

What type of inhaler holds dry, powdered medication and creates an aerosol when the patient inhales through a reservoir that contains the medication?

Dry powder inhaler (DPI)

70

1. Draw medication from ampule quickly; do not allow it to stand open
2. Avoid letting the needle touch contaminated surface
3. Avoid touching the length of the plunger or inner part of the barrel
4. Prepare the skin, use friction and a circular motion while cleaning with an antiseptic swab, and start from the center and move outward

Aseptic techniques to prevent an infection during injection

71

Patient size and weight
Type of tissue into which the medication is to be injected

Factors to consider when selecting a needle for an injection

72

What contains a single dose of medication in a liquid?

Ampule

73

What is a single dose or multidose container with a rubber seal at the top (closed system)?

Vial

74

1. Do not contaminate one medication with another
2. Ensure that the final dose is accurate
3. Maintain aseptic technique

3 principles to follow when mixing medications from two vials

75

_______ is classified the rate of action (rapid, short, intermediate, and long acting); each has a different onset, peak, and duration of action.

Insulin

76

1. Maintain patient individual routine when preparing and administering their medication
2. Do not mix insulin with any other medication or dilutes
3. Never mix insulin glargine or insulin detemir with other types of insulin
4. Inject rapid-acting insulin mixed with NPH within 15 minutes of a meal
5. Verify insulin dosages with another nurse while preparing them

Principles to follow when mixing two types of insulin in the same syringe

77

1. Use a sharp beveled needle in the smallest suitable length and gauge
2. Position the patient as comfortably as possible to reduce muscle tension
3. Select the proper injection site
4. Apply a vapocoolant spray or topical anesthetic to the site if possible
5. Divert the patient's attention from the injection
6. Insert the needle quickly and smoothly
7. Hold the syringe while the needle remains in the tissue
8. Inject the medication slowly and steadily

Techniques used to minimize patient discomfort that is associated with injections

78

The outer posterior of the upper arm
The abdomen (below the costal margins to the iliac crest)
The anterior aspects of the thigh

Best sites for subcutaneous injections

79

What is the maximum amount of water-soluble medication given by the subcutaneous route?

0.5 to 1 mL

80

What angles should be used when administering a subcutaneous injection, and what needle should be used?

25-gauge, 5/8-inch needle inserted at a 45-degree angle, or a 1/2-inch needle inserted at a 90-degree angle

81

What is the angle of insertion for an intramuscular (IM) injection?

90 degrees

82

What is the maximum volume of medication for an IM injection for a well-developed adult?

2-5 mL

83

What is the maximum volume of medication for an IM injection for older children, older adults, and thin adults?

2 mL

84

What is the maximum volume of medication for an IM injection for older infants and small children?

1 mL

85

What site of administration of injections is deep and away from nerves and blood vessels and is the preferred site for large volumes for adults, children, and infants, viscous and irritating solutions?

Ventrogluteal

86

What site of administration of injections for adults and children due to well developed thick muscle; it is the lateral aspect of the thigh?

Vastus lateralis

87

What site of administration of injections is easily accessible, is used for small volumes, not used in infants or children, and has a potential for radial and ulnar nerve damage?

Deltoid

88

What type of injection minimizes local skin irritation by sealing the medication in muscle tissue?

Z-track method

89

___________ injections are used in skin testing and is injected into the dermal layer where the medication is absorbed slowly.

Intradermal

90

Mixtures within large volumes of IV fluids
Injection of a bolus or small volume of medication
Piggyback infusion

Methods of IV administration

91

Fast-acting medications must be administered quickly
It provides constant therapeutic blood levels
It can be used when medications are highly alkaline and irritating to the muscle and subcutaneous tissue

Advantages of IV administration of medication

92

It is the most dangerous method because there is no time to correct errors
A bolus may cause direct irritation to the lining of blood vessels
They reduce

Disadvantages of IV bolus medications

93

What reduces the risk of rapid infusion by IV pust, allow for administration of medications that are stable for a limited time in a solution, and allow for control of IV fluid intake?

Volume-control infusions

94

What is a small (35-250 mL) IV bag connected to short tubing lines that connects to the upper Y port of a primary infusion line?

Piggy-back set

95

What is a batter-operated machine that allows medications to be given in a very small amounts of fluid (5-60mL)?

A mini-infusion pump

96

What is a small (50-150 mL) container that attaches below the primary infusion bag?

A volume-control administration set

97

1. Cost saving
2. Convenience
3. Increased mobility
4. Safety
5. Patient comfort

5 advantages of using intermittent venous access devises

98

A nurse preparing an insulin injection in which both regular and NPH will be mixed, which vial should the nurse inject air into first?

Into the vial from the long-acting insulin