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Pharm test 10/2/13
Test Mod A
| Term | Definition |
|---|---|
| MAR | Medication Administration Record |
| PRN | when needed/as needed |
| Safe Administration | 1. Wash hands 2. Check MAR 3. New Order 4. Check allergies 5. One patient at a time 6. Check SEVEN rights |
| Seven Rights of Medication Administration | Drug, Dose, Document, Route, Reason, Patient, Time |
| Enteral Medications | oral, sublingual, buccal, NG, G-tube, rectal |
| Parenteral Medications | IV, subcut, IM, intradermal |
| Topical Medications | eye, ear, nose, inhaled, meds to skin, vaginal |
| Considerations when administering a medication | -proper timing -proper administration: with/without food -NPO or testing -LOC/swallowing ability -current health status -storage considerations -troubleshooting -right to refuse |
| NPO | nothing by mouth |
| Intravenous | directly into the blood stream |
| Intramuscular | directly into the muscle tissue |
| High Alert Medications | medications & classifications that pose significant risk in the acute clinical setting |
| Consent form | grants permission to the health care facility and provider to provide treatment |
| Order form | all procedures & treatments ordered by a physician. Includes: general care, tests, results, etc. |
| Graphic record | the manual recording of temperature, pulse, respiration, blood pressure and pain |
| Kardex Records | large index type card that is usually kept in a flip file/separate folder that contains pertinent information (e.g.: name, dx, allergies, history, and nursing care plan) |
| Narcotic control systems | policy that controlled substances are issued in a single-unit package and kept in a lock cabinet |
| Unit-dose | use single-unit packages of drugs that are dispensed to fill each dose requirement as it is ordered |
| Prescription must contain | -patient's full name -date -drug name -route of administration -dose -duration of order -signature of provider |
| Stat Order | drug used on emergency level, be administered A.S.A.P. but only once |
| Single Order | administration at a certain time, but only once |
| Standing Order | a medication is to be given for a specified number of doses (e.g.: cefazolin 1q q6h x 4 doses) |
| Medication Errors | the failure of a planned action to be completed as intended or the use of a wrong plan to achieve a goal |
| Adverse Drug Events | serious complications from medication errors |
| Percutaneous Administration | refers to the application of medications to the skin or mucous membrane |
| Parts of a syringe | -Tip -Barrel -Plunger |
| Parts of a needle | -Hub -Shaft -Bevel -Needle cover |
| Drug Routes | IM - intramuscular IV - intravenous PO - by mouth SC - subcutaneous (subcut) |
| Nursing Responsibilites | -know expected therapeutic effect -know nursing implications -educate patient: REPORTABLE signs and symptoms -7 rights (and allergies) -3 label check |
| Buccal (dissolvable) | between the cheek and lower molar teeth: rapid absorption (no swallowing, chewing or water) |
| Sublingual (dissolvable) | under the tongue: rapid absorption (no swallowing, chewing or water) |
| Ophthalmic | medications for use in the EYES only |
| Otic | medications for use in the EARS only |
| Nasal Solutions | nose drops or sprays |
| Aerosols | flow of air or oxygen under pressure to disperse the drug throughout the respiratory tract |
| Intravaginally | administration of medications into the vagina |
| Douches | irrigation fluid to wash the vagina |
| 3 routes of drug administration | Enteral Parenteral Percutaneous |
| Capsules | small, cylindrical, gelatin containers that hold dry powder or liquid medicinal agents |
| Time-released capsules | (sustained) provide a gradual, but continuous release of a drug because the granules in the capsule dissolve at different rates |
| Pills | capsules/tablets |
| Tablets | dried powdered drugs that have been compressed into small disks |
| Caplet | tablet shaped in the form of a capsule |
| Orally disintegrating tablet | tablet that rapidly dissolves, under tongue, buccal, or on top of the tongue |
| Elixirs | clear liquids that are comprised of drugs that have been dissolved in alcohol and water |
| Emulsions | dispersions of small droplets of water-in-oil or oil-in-water (gelatin) |
| Suspensions | liquid dose forms that contain solid, insoluble drug particles dispersed in a liquid base |
| Syrups | contain medical agents that have been dissolved in a concentrated solution of sugar |
| Unit-dose packaging | single-use package that provides a single dose of medication in one packet that is ready for dispensing |
| Souffle' Cup | small paper cup that is used to transport solid medication forms such as capsules and tablets to the patient to prevent contamination by handling |
| Medicine Cup | plastic container for measuring liquids |
| Medicine dropper | used to administer eye drops, ear drops, and occasionally pediatric medications |
| Teaspoon | liquid medications: use Tsp. as unit of measure; 1 tsp. is converted to 5 mL |
| Oral syringe | plastic syringe used to measure liquid medications accurately |
| Nipple | nipple w/ holes to administer oral medications to infants |
| Nasogastric tube | used to give patients who have impaired swallowing, are comatose, or esophagus disorders medications |
| Suppository | solid form of medication that is designed for introduction into a body orifice |
| 2 types of Syringe tips | -Luer-Slip -Luer-Lok |
| Luer-Slip | male tapered end |
| Luer-Lok | a threaded locking collar |
| 3 sizes of syringes | 1 mL - 3 mL - 5 mL |
| millimeter scale | represents the units whereby medications are routinely ordered |
| Tuberculin syringe | 1 mL; measures small volumes of medications |
| Insulin syringe | has a scale that has been specifically calibrated for the measurement of insulin |
| Insulin important facts | -only use insulin syringe for insulin -U-100 concentration = 100 unites of insulin -U-40 concentration = 40 units of insulin |
| Prefilled cartridges/syringes | already measured; time saver, diminishes contamination |
| Insulin Pen | prefilled syringe; patient carries discreetly; for diabetic patients |
| Epi-Pen | prefilled with epinephrine to use in an emergency for allergic reactions |
| Needle Gauge | the diameter of the hole through the needle |
| Subcut | 25-29 gauge; 3/8, 1/2, 5/8 in. |
| Adult IM | 20-23 gauge; 1-1/2 in. |
| Child IM | 21-25 gauge; based on patient |
| Intradermal (e.g. TB testing) | 26-28 gauge; 1/4-1/2 in. |
| Safety devices | sleeve that is stored around the syringe barrel while the syringe is being filled; then sleeve is pulled forward fully to lock the shield permanently in place to cover the needle |
| Ampules | glass containers that usually contain a single dose of medication; never put air into Ampule; always use a filter |
| Vials | glass/plastic containers that contain one or more doses of a sterile medication |
| Liquid syringe | always BROWN in color |
| Intradermal | injections that are made into the dermal layer of the skin just below the epidermis |
| Anergic Reaction | no reaction to the allergens, especially to the positive control |
| Subcutaneous | injections that are made into the loose connective tissue between the dermis and the muscular layer; slower absorption; longer drug action |
| Intramuscular | injections that are made by penetrating a needle through the epidermis, dermis and the subcut tissue into the muscle layer; rapid absorption; 90 degree angle for injecting |
| Deltoid Muscle | easy access to area when patient is standing, sitting, or prone position; 1 mL or less |
| Intravenous (IV) | the introduction of fluids directly into the venous blood stream; most rapid; most comfortable for patient |
| Intravascular | within the vascular system (arteries, veins, capillaries) |
| Intracellular | within the cells |
| Interstitial | within the spaces between the cells |
| Extracellular | composed of the intravascular and interstitial compartments and it contains about 1/3 of the total body water |
| IV Administration set | an apparatus that connects a large volume of parenteral solution w/ the IV access device in the patients vein |
| Macro-drip | 10, 15, or 20 drops/mL |
| Micro-drip | 60 drops/mL |
| Blood-drip | 10 drops/mL |
| Intravenous IV Solutions | consist of water that contains one or more types of dissolved particles |
| Phlebitis | inflammation of a vein |
| Thrombophlebitis | inflammation of a vein with the formation of a thrombus in the area of inflammation (redness, warmth, tenderness, swelling or burning) |
| Infiltration | the leakage of an IV solution into the tissue that surrounds the vein |
| Extravasation | the leakage of an irritant chemical (medication) into the tissue surrounding the vein |
| AIR BUBBLE IMPORTANCE | If air bubble is found in the tubing, clamp tubing immediately, swab injection site, insert needleless device below the bubble and withdraw the air pocket |
| Air Embolism | occurs as a result of an air bubble entering the cardiovascular system |
| Pulmonary Edema | caused by infusing fluid too rapidly or by giving to much fluid |
| Pulmonary Embolism | occurs as a result of foreign materials being injected into the vein or from a blood clot that breaks loose and travels to the lungs, where it lodges in the arterioles |
| Speed Shock | occurs as a systemic reaction to a foreign substance that is given to rapidly into the bloodstream (rapid IV) |
| Medication Administration | -time frame -check label 3 times -unwrap dose at bedside -correct route -contraindications: antacids -check ID and 2 other identifiers |
| Patient Assessment before medication | if blood pressure medication - what is the blood pressure |
| Patient Education | what does the patient need to know? allow for questions; maintain dignity/provide privacy/is pt. comfortable |
| Remember after administration | -did patient swallow meds? -did you document? -reassess: did you see the desired effect? -document your reassessment |
| Do you administer another medication for another nurse????? | NO NO and NO!!!!!!! "Do it yourself HOMIE!!!!! Not going to be my ASS!!!!" |
| Written orders | order by a physician, dentist, nurse practitioner, or other designated health professional for a medication to be dispensed by a pharmacy for administration to a patient |
| Verbal Orders | orders given verbally by a health care provider, must sign within 24 hours; risk for med error; in an emergency situation only |
| Phone Orders | medication orders taken from a licensed health care provider over the phone, must sign within 24 hours; always repeat orders back to the physician for confirmation; risk for error |
| Liquid Medications | shake, if required, remove cap and place upside down on clean surface, label against palm, hold med cup at eye level, check meniscus, pour excess in drain, wipe rim before replacing cap |
| Crushed medications | -when and why? -pill crusher -mix in small amount of soft food after crushing -clean the equipment! -DO NOT crush enteric coated tabs or time release tabs -may open capsules and mix with soft food |
| Splitting/Cutting Tablets | -ONLY split scored tablets -DO NOT split enteric-coated or timed released tablets -use a cutting device -line up score with blade cutter -DON'T touch med -discard the extra portion properly |
| Sublingual Meds | -place med under patient's tongue -instruct patient not to chew or swallow -med should dissolve completely |
| Powdered Meds | mix with appropriate amount of appropriate liquid at the bedside |
| Enteral Tube Administration | must be liquid or suspension form; pills must be crushed into a fine powder |
| Parenteral Meds | -7 rights -needle and syringe selection -prepare injection -change needle, if indicated -select site -inject |
| Ampules | -medication should be in body of ampule -place an alcohol wipe in unopened package around neck -snap neck away from you -use filter needle to draw up med -may invert, but don't touch rim of ampule -aspirate med, remove air bubbles -recap and change |
| Vials | -unused vial; remove cap -previously used vial; cleanse rubber seal w/ alcohol wipe; dry -draw up air equal to amount of med to be withdrawn and inject into vial -invert vial, aspirate correct amount of med -dislodge bubbles and eject from vial -remo |
| Viscosity of a medication | very "thick" meds may be better tolerated in a larger muscle, or in smaller divided doses |
| Z-Track injections | -used to prevent irritating or staining meds from leaking to skin or subcut tissues -apply downward pressure to skin -inject as usual; wait 10 seconds -when ready to withdraw needle, withdraw then release traction on skin |
| Electrolytes | solutes that dissolve in water and dissociate into ion particles; because the ions give water the ability to conduct electricity |
| Isotonic Solution | IV solution and the blood have approximately the same osmolatity; 270 - 310 mOsm/L; acute blood loss due to trauma |
| Hypotonic Solution | solution that have fewer dissolved particles than the blood ˄310 mOsm/L (cellular dehydration) |
| Hypertonic Solution | solution that have a higher concentration of dissolved particles ˅270 mOsm/L (severe low sodium) |
| Normal Saline | 0.9% solution of sodium chloride; isotonic solution with an osmolality of 308 mOsm/L |
| Tandem, Piggyback, or IV rider | intermittent infusion; secondary to a primary set-up; small volume of fluid infused over 20-60 minutes |
| Solutes for IV Solutions | -sodium chloride -dextrose -potassium chloride |
| Comma placing for units | no commas unless it has at least 5 numbers NO - 1,000 YES - 1000 YES - 15,000 |
| Milliequivalent | mEq |
| 1 part drug to 1000 parts solution | 1:100 |
| 1 part drug in 5 parts solution | 1:5 |
| IM | intramuscular |
| IV | intravenous |
| PO | by mouth |
| SC | subcutaneous (also SQ, subq) under the skin |
| AC | before meals |
| PC | after meals |
| Ad lib | as desired |
| Bid | twice daily |
| h | hour |
| HS | hours of sleep |
| qd | every day |
| qh | every hour |
| qid | 4 times a day |
| qod | every other day |
| STAT | at once |
| tid | three times a day |
| mL/hr ordered 500 mL in 6 hours | 500mL _______ = 83.3 or 83 mL/hr 6 |
| mL/24 hrs ordered 125 mL/hr | 125 x 24 = 3000 mL in 24 hr |
| 750 mL of saline to infuse over 8 hours. how many drops/min? (15 tubing) | 750mL x 20 11,250 ____________ = _______ = 23.4 or 23 gtt/min 8 x 60 480 |
| 1000 mL to L | 1 L (move decimal point 3 places to the right) |
| 1 L to mL | 1000 mL (move decimal point 3 places to the left) |
| five hundred milliliters | 500 mL |
| two-tenths of a milligram | 0.2 mg |
| two and five tenths kilograms | 2.5 kg |
| sixty milliequivalents | 60 mEq |
| tablets: ordered 50 mg available 25 mg | 50/25 = 2 tabs |
| tablets: ordered 37.5 mg available 75 mg | 37.5/75 = 0.5 tabs |
| tablets ordered 300 mg available 100 mg | 300/100 = 3 tabs |
| tablets ordered 62.5 mcg available 0.25 mg (convert) | 62.5/250 = 0.25 NO, cannot give a quarter of tablet, must call pharmacy!!!!!!!!!!! |
| IM ordered 15 mg available 2%, 20 mg/mL 2 mL vial | 15mg/20mg = 0.75 mL or 0.8 mL remember to round to the tenths for tablets and IV's |
| IV 1000 mL saline in 6 hours and 1 L bag on hand, tubing 10, how many drops/min. | 1000 mL x 10 10,000 ______________ = _______ = 27.7 gtt/min or 28 gtt/min 6 x 60 360 remember to circle or box your final answer!!!!!!! |
| IV 1000 mL saline in 6 hours and 1 L bag on hand, tubing 10, how many drops per hour? | 1000 mL / 6 = 166.6 mL/hr or 167 mL/hr remember to circle or box your final answer!!!!!!! |
| FOR CALCULATIONS!!!!!!!!!!!!! | REMEMBER TO SHOW YOUR WORK AND CIRCLE OR BOX YOUR ANSWERS!!!!!!!!!!!!!!!!!!!!!!!!! |
| WHO'S GROUP KICKS ASS?????????????? | THAT'S RIGHT!!!! THE LPN'S KICK ASS!!!!!!!!! |
| 3 teaspoons | 1 tablespoon |
| 2 tablespoons | 1 ounce |
| 8 ounces | 1 glass |
| 1000 mL | 1 liter |
| 1000 micrograms | 1 milligram |
| 1000 milligrams | 1 gram |
| 1000 grams | 1 kilogram |
| 5 mL | 1 teaspoon |
| 30 mL | 1 ounce |
| 2 tablespoons | 1 ounce |
| 1 quart | 1 liter |
| 2.2 lb | 1 kg |
| 2.54 cm | 1 inch |
| tab | tablet |
| syp | syrup |
| NS (N/S) | normal saline |
| Pharmacokinetics | the study of four major processes; medication absorption, distribution, metabolism, and excretion |
| Absorption | passage of medication molecules from the site of administration into the blood |
| Therapeutic Effect | the intended or desired physiological response of a medication |
| Toxic Effects | capable of causing injury/death; excess amounts of medication within the body |
| Idiosyncratic Reactions | individual sensitivity to effects of a drug caused by inherited or other bodily constitution factions |
| Allergic Reactions | unfavorable physiological response to an allergen to which a person has previously been exposed and to which the person has developed antibodies |
| Synergist effect | their combined effect is greater than their effects when given separately |
| Half-life | the time it takes for the body to lower the amount of unchanged medication by half (ex: 12-6-3) |
| Peak | concentration is the highest plasma level |
| Trough | concentration is the lowest plasma level |
| Transdermal disk/patch | disk/patch firmly holds the medicated ointment to the skin (ex: nicotine patch) |
| Solution | a given mass of solid substance dissolved in a known volume of fluid or a given volume of fluid dissolved in a known volume of another fluid |
| NOW orders | must be given within 60 minutes |
| Polypharmacy | a patient uses two or more medications to treat the same illness, takes two or more medications from the same chemical class |
| Anaphylactic Reactions | hypersensitive condition induced by contact with certain antigens |
| Apothecary System | System of measurement. |
| Biotransformation | the chemical changes that a substance undergoes in the body, such as by the action of enzymes |
| Medication Interaction | the response when one drug modifies the action of another drug |
| ASAP | as soon as possible |
| gm | gram |
| gtt | drop |
| kg | kilogram |
| oz | ounce |
| q6h | every 6 hours |
| Infusion | slow and/or prolonged intravenous delivery of a drug or fluids |
Created by:
Smccunn
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