Buscar
Estás en modo de exploración. debe iniciar sesión para usar MEMORY

   Inicia sesión para empezar

level: Level 1 of Lesson 9

Questions and Answers List

level questions: Level 1 of Lesson 9

QuestionAnswer
Pharmacological concepts: Medication names: Provides the exact description of medication's composition. Example: N-acetyl-para-aminophenolChemical
Pharmacological concepts: Medication names: The manufacturer who first develops the drug assigns the name, and it is then listed in the U.S. pharmacopoeia. acetaminophenGeneric
Pharmacological concepts: Medication names: Also known as brand or proprietary name. This is the name under which a manufacturer markets the medication. Tylenol, Panadol, TempraTrade
Pharmacological concepts: Classification:Effect of medication on body system Symptoms the medication relieves Medication's desired effect
Pharmacological concepts: Medication forms:solid, liquid, other oral forms; topical, parenteral; forms for instillation into body cavities.
Drug form: Liquid drugs:1 Solutions 2 Tinctures 3 Suspensions 4 Emulsions 5 Elixirs 6 syrups
Drug form: Liquid drugs: 1: Generally water based. May be oil based.Solutions
Drug form: Liquid drugs: 2: Prepared using an alcohol extraction process. Alcohol usually remains in the final drug preparation.Tinctures
Drug form: Liquid drugs: 3: Solid does not dissolve in the solventSuspensions
Drug form: Liquid drugs: 4: Suspensions with an oily in the solvent.Emulsions
Drug form: Liquid drugs: 5: Alcohol and water solvent. Often with an additive for flavorElixirs
Drug form: Liquid drugs: 6: Sugar, water, and drug solutionsSyrups
Drug form: Solid drugs:1 pills 2 Powders 3 Tablets 4 Suppositories 5 Capsules
Drug form: Solid drugs: 1: Shaped like a sphere and easy to swallowPills
Drug form: Solid drugs: 2:Powder
Drug form: Solid drugs: 3: Powders compressed into a disk like formTablets
Drug form: Solid drugs: 4: Drugs mixed with a wax that are designed to dissolve at body temperature. Used for vaginal and rectal absorption.Suppositories
Drug form: Solid drugs: 5: Gelatin capsules filled with powderCapsules
Common abbreviations: CDControlled-diffusion
Common abbreviations: CRContinuous/controlled-release
Common abbreviations: CRTControlled-release tablet
Common abbreviations: LALong acting
Common abbreviations: SASustained-action
Common abbreviations: SRSustained/slow release
Common abbreviations: TDTime-delay
Common abbreviations: TRTime-release
Common abbreviations: XLExtra-Long
Common abbreviations: XRExtended-release
Common abbreviations: MRMedium-release
Common abbreviations: FRFast Release
Pharmacokinetics as the basis of medication actions: The study of how medications:Enter the body Are absorbed and distributed into cells, tissues, or organs Reach their site of action Alter physiological functions Are metabolized Exit the body
Passage of medication molecules into the blood from the site of administration:Absorption
Factors that influence absorption: 1:Route of administration
Factors that influence absorption: 2:Ability of a medication to dissolve
Factors that influence absorption: 3Blood flow to the site of administration
Factors that influence absorption: 4Body surface area
Factors that influence absorption: 5Lipid solubility
Factors that influence absorption:1 2 3 4 5
After distribution, occurs within the body to tissues, organs, and specific sites of action.Distribution
Distribution depends on: 1:Physical and Chemical properties of the medication
Distribution depends on: 2: Circulation Membrane permeability Protein bindingPhysiology of the person taking it
Metabolism: Medications are metabolized into a?less-potent or an inactive form
Metabolism: occurs under the influence of enzymes that detoxify, break down, and remove active chemicalsBiotransformation
Metabolism: Most biotransformation occurs in the?liver
Metabolism: What play a role? (there are three organ or parts of organ)Kidneys, blood, intestines, and lungs
Medications exit the body through the:Kidney Liver Bowel Lungs Exocrine glands
Excretion: Determines the organ of excretionChemical makeup of medication
Types of medication Action: Expected or predicted physiological responseTherapeutic effect
Types of medication Action: Unintended, undesirable, often unpredicatbleAdverse effect
Types of medication Action: Adverse effect: Predictable, unavoidable secondary effectSide effect
Types of medication Action: Adverse effect: Accumulation of medication in the bloodstreamToxic effect
Types of medication Action: Adverse effect: Overreaction of underreaction or different reaction from normalidiosyncratic reaction
Types of Medication action: Unpredictable response to a medicationAllergic reaction
Types of Medication action: When one medication modifies the action of anotherMedication interactions
Administration Preparation: 1:Obtain patients medication record. Medication record may be a drug card, medication sheet, or drug kardex (medex), depending on the method of dispensing medications in your faculty
Administration Preparation: 2:Compare the medication record with the most recent physician order
Administration Preparation: 3:Wash your hands
Administration Preparation: 4:Gather necessary equipments
Administration Preparation: 5:Remove the medication from the drug box or tray or medication cart or cubicle
Administration Preparation: 6:Compare the label on the medication bottle or wrapper to the medication record
Administration Preparation: 7:Check that medication to be administered via the right method, right time or base on the 5 rights
Administration Preparation: 8:Calculate dosage if necessary
Administration Preparation: 9: Level of consciousness (LOC) Ability to cooperate Potential known allergiesDo your patients assessment
The route of administration (ROA) that is chosen may have a profound effect upon thespeed and efficiency with which the drug acts
Routes of administration: Oral routes: 1Sublingual administration
Routes of administration: Oral routes: 2Buccal administration
Routes of administration: 1Oral routes
Routes of administration: 2parenteral routes
Routes of administration: Parenteral routes: Four major sites of injection:Intradermal Subcutaneous Intramuscular Intravenous
Routes of administration: Parenteral routes: other routes:Epidural, intrathecal, intraosseous, intraperitoneal, intrapleural, and intraarterial
Routes of administration: Parenteral routes: Routes usually limited to physiciansIntracardiac and intraarticular
Types of Orders in Acute Care Agencies: Administered until the dosage is changed or another medication is prescribedStanding or routine
Types of Orders in Acute Care Agencies: Given one time only for a specific reasonSingle (one-time)
Types of Orders in Acute Care Agencies: Given when the patient requires itprn
Types of Orders in Acute Care Agencies: Given immediately in an emergencySTAT
Types of Orders in Acute Care Agencies: Medication to be taken outside of the hospitalPrescriptions
Types of Orders in Acute Care Agencies: When a medication is needed right away, but not STATNow
Some of the common Latin prescription abbreviations include: ac (ante cibum):means "before meals"
Some of the common Latin prescription abbreviations include: bis (bis in die)means "twice a day"
Some of the common Latin prescription abbreviations include: gt (gutta)means "drop"
Some of the common Latin prescription abbreviations include: hs (hora somni)means "at bedtime"
Some of the common Latin prescription abbreviations include: od (oculus dexter)means "right eye"
Some of the common Latin prescription abbreviations include: os (oculus sinister)means "left eye"
Some of the common Latin prescription abbreviations include: po (per os)means "by mouth"
Some of the common Latin prescription abbreviations include: pc (post cibum)means "after meals"
Some of the common Latin prescription abbreviations include: prn (pro re nata)means "as needed"
Some of the common Latin prescription abbreviations include: q3n (quaque 3 hora)means "every three hours"
Some of the common Latin prescription abbreviations include: qd (quaque die)means "every day"
Some of the common Latin prescription abbreviations include: qid (quater in die)means "four times a day"
Some of the common Latin prescription abbreviations include: sig (signa)means "write"
Some of the common Latin prescription abbreviations include: tid (ter in die)means "three times a day"
Health Care Provider's Role: Prescriber can be:physician, nurse practitioner, or physician's assistant
Health Care Provider's Role: Orders can be:written (hand or electronic), verbal, or given by telephone
Health Care Provider's Role: The use of abbreviations can cause?errors; use caution
Health Care Provider's Role: Prepares and distributes medicationPharmacist's role
Health Care Provider's Role: Determining medications ordered are correct, assessing patient's ability to self-administer, determining whether patient should receive medications at a given time, administering medications correctly, and closely monitoring effects Cannot be delegated Includes patient teachingNurse's role
Medication Errors: 1:Report all medication errors
Medication Errors: 2: When an error occurs, what is top priority?Patient safety is top priority when an error occurs
Medication Errors: 3:Documentation is required
Medication Errors: 5: Nurses play an essential role in?medication reconciliation
Critical Thinking: Six rights: 1Right medication
Critical Thinking: Six rights: 2Right dose
Critical Thinking: Six rights: 3Right patient
Critical Thinking: Six rights: 4Right route
Critical Thinking: Six rights: 5Right time
Critical Thinking: Six rights: 6Right time
Critical Thinking: Six rights: 7right response
Critical Thinking: Six rights: 8right reason
Critical Thinking: Six rights: 9right assessment and evaluation
Critical Thinking: Six rights: 10right client education
Critical Thinking: Six rights: 11right to refuse medication
Critical Thinking: Six rights: 12right expiration date
Critical Thinking: Six rights:1 right medication 2 right dose 3 right patient 4 right route 5 right time 6 right documentation 7 right response 8 right reason 9 right assessment and evaluation 10 right client education 11 right tot refuse medication 12 right expiration date
Maintaining patient's rights: A patient has the right: 1To be informed about a medication
Maintaining patient's rights: A patient has the right: 2To refuse a medication
Maintaining patient's rights: A patient has the right: 3To have a medication history
Maintaining patient's rights: A patient has the right: 4To be properly advised about experimental nature of medication
Maintaining patient's rights: A patient has the right: 5To receive labeled medications safely
Maintaining patient's rights: A patient has the right: 6To not receive appropriate supportive therapy
Maintaining patient's rights: A patient has the right: 7To not receive unnecessary medications
Maintaining patient's rights: A patient has the right: 8To be informed if medications are part of a research study
Medication administration:oral topical inhalation irrigation parenteral injection
Caution: should or should we not? Leave medications in the patient's possession without a specific physician's order to do so.Do not leave medications in the patient's possession without a specific physician's order to do so.
Medication administration: Easiest and most desirable route Food sometimes affects absorption Aspiration precautions Enteral or small-bore feedings:Oral administration
Medication administration: oral administration: Enteral or small-bore feedings:Verify that the tube location is compatible with medication absorption. Use liquids when possible If medication is to be given on an empty stomach, allow at least 30 minutes before or after feeding. Risk of drug-drug interactions is higher
Warning: keme lang HAHAHAHHAHA DO NOT administer oral medications to patients with a decreased level of consciousness. Check with supervisor for instructions. NEVER directly touch oral medications. Some medications can be absorbed through the skin, also the medication will become contaminatedhehehe
How to give oral medication: Goal:To provide a safe effective method of giving drugs intended for absorption in stomach and small intestine
How to give oral medication: 1:Gather equipment. Check each medication order against original physicians order according to agency policy. Clarify any inconsistencies. Check patients chart for allergies
How to give oral medication: 2:Know actions, special nursing considerations, safe dose ranges, purpose of administration, and adverse effects of medications to be administered
How to give oral medication: 3:Perform hand hygiene
How to give oral medication: 4Move medication cart outside the patients room or prepare medication
How to give oral medication: 5Prepare the medicine
How to give oral medication: 6Place or pour the medicine on the medicine cup with the medicine card under it
How to give oral medication: 7Bring prepared medication at the patients room/bedside
How to give oral medication: 8identify the patient carefully
How to give oral medication: 9Assist the patient on the upright position, if possible
How to give oral medication: 10Check if the medicine is best to be swallowed whole, chewed, allowed to melt under the tongue to coat the pharyngeal area.
How to give oral medication: 11Provide a glass of water
How to give oral medication: 12Give the drug
How to give oral medication: 13Remain with the patient until each medication is swallowed
How to give oral medication: 14Document
Skin applications Follow directions for each type of medication Transdermal patchesTopical medication applications
Topical Medication Applications: Skin applications:use gloves and applicators; clean skin first use sterile technique if the patient has an open wound
Topical Medication Applications: Transdermal patches:Remove old patch before applying new Document the location of the new patch Ask about patches during the medication history Apply a label to the patch if it is difficult to see Document removal of the patch as well
Nasal Instillation:Spray Drops tampons
Eye Instillation:Avoid the cornea Avoid the eyelids with droppers or tubes to decrease the risk of infection Use only on the affected eye Never share medications
Intraocular instillation:Disk resembles a contact lens Teach patients how to insert and remove the disk Teach about adverse effects
Ear instillation:Instill eardrops at room temperature. Use sterile solutions Check for eardrum rupture if patient has ear drainage Never occlude the ear canal
Administering Medications by Inhalation:Pressurized metered-dose inhalers (pMDIs) Breath-actuated metered-dose inhalers (BAIs) Dry powder inhalers (DPIs)
Parenteral Administration of Medications: Equipment: syringes:Luer-Lok Non-Luer-Lok
Syringe tip selection: secure screw type connectionLuer Lok Tip
Syringe tip selection: Slip or push-on connectionSlip tip
Syringe tip selection: Off center tip used for surface veins or artery injections.Eccentric tip
Syringe tip selection: Longer and tapered slip design used for irrigation or with tubingCatheter tip
Parts of Luer-Lok Syringe:barrel fl*nge
Parts of Luer-Lok Syringe:Barrel
Parts of Luer-Lok Syringe:Luer lock
Parts of Luer-Lok Syringe:Plunger fl*nge
Parts of Luer-Lok Syringe:Plunger
Parts of Luer-Lok Syringe:Seal
Parenteral Administration of Medications: Needles:Hub Shaft Bevel (Gauge number)
Parenteral Administration of Medications: Preparing an injection from an ampule:Snap off ampule neck Aspirate medication into syringe using filter needle Replace filter needle with an appropriate size needle or needless device Administer injection
Parenteral Administration of Medications: Preparing an injection from a vial:if dry, use solvent or diluent as needed Inject air into vial Label multidose vials after mixing Refrigerate remaining doses if needed
Mixing medications: Mixing medications from a vial and an ampule:Prepare medication from the vial first Use the same syringe and filter needle to withdraw medication from the ampule
Parenteral Administration of Medications: Mixing medications from two vials:Do not contaminate one medication with another Ensure that the final dose is accurate Maintain aseptic technique
Parenteral preparation: Insulin preparation:Insulin is the hormone used to treat diabetes It is administered by injection because the GI tract breaks down and destroys an oral form of insulin. Use the correct syringe: 100-unit insulin syringe or an insulin pen to prepare U-100 insulin Insulin is classified by rate of action: rapid, short, intermediate, and long-acting Know the onset, peak, and duration for each of your patient's ordered insulin doses
Parenteral Administration of Medications: Mixing Insulins:patients whose blood glucose levels are well controlled on a mixed-insulin dose need to maintain their individual routine when preparing and administering their insulin. Do not mix insulin with any other medications or diluents unless approved by the health care provider Never mix insulin glargine (lantus) or insulin detemir (Levemir) with other types of insulin. Inject rapid-acting insulins mixed with NPH (neutral protamine Hagedorn) insulin within 15 minutes before a meal. Verify insulin doses with another nurse while preparing the injection.
parenteral Administration of Medications: Subcutaneous injections:Medications placed into loose connective tissue under dermis
Parenteral Administration Medications: Intramuscular injections:Faster absorption than subcutaneous route Many risks, so verify the injection is justified Angle of administration: 90 degrees Body mass index (BMI) and adipose tissue influence needle size selection
Parenteral Administration Medications: Intramuscular injections: Amounts:Adults: 2 to 5 ml (4 to 5 ml unlikely to be absorbed properly) Children, older adults, thin patients: up to 2 mL Small children and older infants: up to 1 mL Smaller infants: up to 0.5mL
Parenteral Administration of Medications: Ventrogluteal:Gluteus medius Deep and away from major nerves and blood vessels Preferred and safest site for all adults, children, and infants Recommended for volumes greater than 2 mL Index finger, the middle finger, and the iliac crest form a V-shaped triangle Injection site is the center of the triangle
Parenteral Administration of Medications: Vastus lateralis:used for adults and children Use middle third of muscle for injection Often used for infants, toddlers, and children receiving biologicals
Parenteral Administration of Medications: use the Z-track method in intramuscular injections:Zigzag path seals needle track Medication cannot escape from the muscle tissue
Parenteral Administration of Medications: Intradermal injections:Used for skin testing (tuberculosis [TB], allergies) Slow absorption from dermis Skin testing requires the nurse to be able to clearly see the injection site for changes Use a tuberculin or small hypodermic syringe for skin testing Angle of insertion is 5 to 15 degrees with bevel up A small bleb will form
Safety in administering Medications by Injection: Needleless devices:Most needlestick injuries are preventable Needlestick safety and prevention act Safety syringes
Safety in administering Medications by Injection: Dispose of sharps in marked containers:Use puncture-and leak-proof containers Never force needles into receptacle Never place used needles into wastebaskets, your pockets, or patient's tray or bedside
Parenteral Administration of Medications: Intravenous Administration: Three methods:As mixtures within large volumes of IV fluids By injection of a bolus or small volume of medication through an existing IV infusion line or intermittent venous access (heparin or saline lock) By "piggyback" infusion of a solution containing the prescribed medication and a small volume of IV fluid through an existing IV line.
Parenteral Administration of Medications: Large-Volume Infusions:Safest and easiest method of IV administration. Large volumes (500 or 1000 mL) are used. If infused too rapidly, patient is at risk for overdose and fluid overload. Best practices: Standardized concentrations and dosages Standardized procedures for ordering, preparing ,and administering IV medications Ready-to-administer doses when possible
Parenteral Administration of Medications: Intravenous bolus:Introduces a concentrated dose of medication directly into the systemic circulation Advantageous when the amount of fluid that a patient can take is restricted The most dangerous method for medication administration because there is no time to correct errors Confirm placement of the IV line in a healthy site. Determine the rate of administration by the amount of medication that can be given each minute.
Parenteral Administration of Medications: Volume-Controlled infusionsUses small amounts (50 to 100 mL) of compatible fluids Three types of containers: volume-control administration sets, piggyback sets, and syringe pumps Advantages of volume-controlled infusion: Reduces the risk of rapid-dose infusion by IV push Allows for administration of medications that are stable for a limited time in solution Allows control of IV fluid intake
Parenteral Administration of Medications: A small (25 to 250 mL) IV bag or bottle connected to a short tubing line that connects to the upper Y-port of a primary infusion line or to an intermittent venous accessPiggyback
Parenteral Administration of Medications: Small (150-mL) containers that attach just below the primary infusion bag or bottleVolume-control administration
Parenteral Administration of Medications: Battery operated Allows medications to be given in very small amounts of fluid (5 to 60mL) within controlled infusion times using standard syringesSyringe pump
Drug calculations: The formula for this calculation can be applied to many situations: Note: Do basic conversion if necessarydose ordered/dose on hand x amount on hand = amount to administer Desired dose/Available dose x Volume = exact dosage