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ch 35

Administering Medicine

This can be accomplished by addressing the pt. by his or her name. The right patient
Always compare the physician's written order with the medication label when you: 1. take the medication from the storage area. 2. Dispense the medication from the container, and 3. Replace the container to storage or before discarding the used container The Right drug
If the ordered dose doesn't match the dose according to the drug label, perform pharmacology math to determine the accurate dose. If in doubt, have your calculations checked. The Right drug
Check the physician's order to determine the route of administration. (oral, via the mucous membrane, or parenteral) The Right Route
Most medications are ordered stat in the ambulatory setting. Refer back to the notes to clarify instructions on home administration. The Right Time
The M.A. must be familiar with all techniques of administering medication. The Right Technique
Immediately document the medication (strength, dose0, route, time and date. Also record any reactions the patient has to the medication. The Right Documentation
Never substitute a ___ or its ____. Drug or Strength
Prepare medications in a quiet, ___ ___ area. Well lit
Store medications according to the ____. label
The person who administers the drugs is responsible for any ___ ____. Drug errors.
Routinely check _______ dates and discard _____ as needed. Expirations and medications
Discard medications with _____ labels to avoid errors by inaccurately reading labels. damaged
Always ask the patient about ____ _____, as these can change over time Drug allergies
What physician-prescribed medication are you taking? Include names, doses/ strengths, and routes of administration
Do you take any OTC drugs on a regular basis? Record the purpose, amount, and frequency, and time/date of last dose.
Where do you store your medication? Review any special storage procedures.
Can you tell me why you are taking the prescribed medication? This is to ensure the patients are well informed about their drug therapy.
Do you use the same pharmacy to fill all your prescriptions? To avoid medications contraindication, suggest that the patient uses only one pharmacy.
Gels/Magmas Consist of minerals suspended in water. Minerals settle so products must be shaken before use.
Pre-filled syringe may use? cartridge injections, ex. Tubex/Carpuject
Gauges range from 14 (____) to 31 (____) Largest to Smallest
Gauges 27/28 are used for _____? (ID) Intradermal Injections
Gauges 25/26 are used for ______? (SC) Subcutaneous Injections
Gauges 20-23 are used for ____? (IM) Intramuscular Injections
Needles larger than 20-gauge are used for _____? Venipuncture, blood donations, and blood transfusions
(1 mL) (3/8 in long needle) used for (ID)
(2mL) used for (SC)
(2-5mL0 used for (IM)
Needle length ranges from _/_ inch to _ inches 3/8 and 4
ID injections use the _____ in size 3/8
SC injections use the ___ - ___ in 1/2 to 5/8
IM injections use _inch or longer 1
A typical syringe holds up to _ ml 3 mL
Hypotension from systemic vasodilation Hives/urticarial Difficulty breathing (dyspnea) form bronchoconstriction Difficulty swallowing due to edema Vomiting/ diarrhea Signs/symptoms of Anaphylactic shock
Injections should not be given near? Bones, blood vessels, scarred skin, discolored skin, or near excess tissue growth (ex mole)
Intradermal Injections are given ? Within the skin layers
Intradermal Injections are used for? Allergy and tuberculin testing
swelling/induration appears after? 48 hours
A ____ should be raised on the skin when ID injection is given correctly Wheal
The angle of insertion is ? 15 degrees
Upper back, chest frequently used for ? allergy testing
Subcutaneous Injections are given between the ? Epidermis and muscle (adipose tissue)
for Subcutaneous Injections no more than ___ given 2mL
for subcutaneous injections the angel of insertion is? 45 degrees
Heparin/insulin are exceptions, administered at a? 90 degree angels when using a micro needle or with an obese patient
SC injection sites? Posterior upper arm, abdomen, anterior thighs, upper back
Site must be rotated when? Frequent injections are required
Intramuscular injections are used if? the drug is irritating, rapid absorption is needed, or a large amount of medication is needed.
Intramuscular injections angle of insertion is a 90 degree
Intramuscular site of injections are? vastus lateralis, deltoid, ventrogluteal, gluteus medius muscles
Intramuscular site of injections for children is/ the vastus lateralis
Deltoid region can hold up to 2mL
Vastus lateralis/ gluteal sites can hold up to 5 mL
Infants/children should receive no more than 2mL in the Vastus lateralis. ventrogluteal sites
Avoid IM sites near? large nerves, bones, blood vessels
Deltoid Site is the Muscular cap of the shoulder
Deltoid is the Triangular shaped muscle
Types of shot to go in the Deltoid muscles is ? Hepatitis B, flu vaccine, and vitamin B12
23 gauge, 1 inch needles are usually used on the Deltoid site
25 gauge, 5/8 inch maybe be use for smaller arms
Place the palm of your hand across the shoulder, and grasp the muscle before injection
the injection degree for the deltoid site is? 90 degree angel
Vastus Lateralis (thigh) site is one of the? largest muscles
The Vastus Lateralis is the safest IM site for? Infants
Located one hand with above the? Patella (knee cap)
Dorsolateral site (Gluteus Medius) is used for? Deep IM injections
Dorsolateral site are used for? adults only
Ventrogluteal site (Gluteus Medius) is? infrequently used
The Ventrogluteal site is free of? major nerves and blood vessels
The Ventrogluteal site is safest for? Adult and Children
Z track intramuscular injection displaces the? upper tissue laterally before insertion
For z track IM injection the skin is? pushed to one side and held during injection
The z track IM prevents? A direct pathway for the medication to return to the surface
z-tracks injections sites should not be? messaged after aministration
3 basic types of fluid used for IV therapy is? Isotonic Solutions, Hypertonic Solutions and Hypotonic Solutions
Isotonic Solution EX.9%sodum chloride (NaCl, normal saline) Contains the same amount of salt as normal body fluids Used for patients who need replacement of lost body fluids Provide electrolytes including sodium, potassium, calcium and chloride
Hypertonic solution Contains more NaCl than those in body fluid causes extracellular fluid to shift from cells into bloodstream May be used in patients with extensive peripheral edema to dilute the concentrated plasma May lead to increase blood pressure in the blood vesse
Hypotonic Solution D10W 10% dextrose in water, 5% dextrose in .3% sodium chloride Contains less salt than body fluid Promotes cellular hydration by shifting fluid from body vessels in the interstitial spaces around cells
unclean conditions may result in? infection/systemic infection
Inflammation may occur at the? IV site
Contaminated bandage over the IV site may cause Inflammation
Veins may become inflamed when the patient moves the? IV site, the medication is irritating or the IV solution is irritating
Possible phlebitis is immediately reported to the physician because? it may lead to thrombus formation or systemic infection
indications of phlebitis are? inflammation, edema, warmth, tenderness at site, veins that feel hard/ropelike
Infiltration occurs when the IV/catheter becomes? dislodged from the vein. Close the roller clamp on the IV tubing and notify the physician STAT
Fluid overload is caused by? administering the fluid too quickly. Complications may occur in those with hypertension, heart disease, or congestive heart failure.
Medication errors can occur and can be fatal. It is very important to ensure the correct medication is being given because? it will be circulated throughout the body in one minute
all IV infusion equipment is individually ____ and ____ packed and disposable
IV equipment includes? skin-cleaning solution, needle or catheter, tubing with spike to insert into IV bag, sterile dressing, IV fluids
Usually packaged together in a? sterile IV infusion kit
Always check the _____ date and check for _____ in the package expiration and tears
Additional supplies are? Tourniquet, disposable gloves, biohazard container, and IV pole
For IV the Gauges are? 25-17, .5-1 inch in length needles
The macro drip delivers 8-20 gtt/mL for Adult fluid replacement
Micro drip dispenses 50-60 drips/mL is used for? children/patients who require slow administration
Drop are regulated by? compressing the roller clamp
Be alert for indication of? phlebitis or infiltration
watch for too quick? infusion
Created by: chass