Medical Administration Part 2
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| Teratogenic Effect | Causes development in an embryo.
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| Mutagenic Effect | Causes genetic mutation (changes DNA)
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| What types of substances can cause drug interactions? | Perscribed, OTC meds, herbs, alcohol, and food.
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| Contraindicated | cannot be given together
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| Predictable and often unavoidable secondary effects produced at a usual therapeutic dose. | Side effect
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| Unintended, undesireable, and often unpredictable severe responses to medication. | Adverse effects
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| Where does meds exit body? | Kidneys, liver, bowel, lungs, and exocrine glands.
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| What determines which organs will excrete med? | Chemical makeup of med.
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| Exocrine glands excrete __ meds. | lipid-soluble
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| Main organ of med excretion? | Kidneys
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| Uticaria | hives-raised skin eruptions
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| Pruritus | Itching of skin that accompanies most rashes.
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| Rhinitis | Inflammation of mucous membranes lining nose – runny nose.
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| Synergistic Effect | Occurs when combined effect of 2 meds is greater than either alone.
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| Antagonistic Effect | One drug diminishes or cancels effect of first drug.
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| Incompatibility | 2 drugs cannot be given together or adverse effect may occur.
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| Oral meds have a __ onset of action and more __ effect than parenteral meds. | slower, prolonged
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| Name a drug given by sublingual route. | nitroglycerin – under the tongue
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| Placing a solid med in the mouth against mucous membrane of cheek until it dissolves. | buccal route of administration
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| Name 3 ways of oral admin of med. | Swallow, sublingual, buccal
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| Name 4 parenteral admins of med. | ID, IM, IV, Sub-Q
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| IM | intramuscular
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| ID | intradermal
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| Name routes of med admin that are admined into body cavities. | epidural, intrathecal, intraosseous, intraperitoneal, intrapleural, and intraarterial.
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| Intrathecal | through catheter in subarachnoid space of brain ventricle
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| Intraosseous | in bone marrow
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| Intraperitoneal | administered into peritoneal cavity
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| Intrapleural | adminstered into a chest tube to go into pleural space
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| Intraarterial | adminstered into an artery
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| Intraocular | adminstered into eye
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| Kilo | 1000 times
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| Deci | 0.1, one thenth
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| Milli | 0.001, one thousandth
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| Micro | 0.000001, one millionth
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| mcg | microgram
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| L | liter
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| dL | deciliter
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| mL | milliliter
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| 1g is equal to __mg. | 1000
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| 1000mcg is equal to __mg. | 1
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| 1kg is equal to __g | 1000
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| 1mg is equal to __ mcg. | 1000
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| What is a cubic centimenter? | The amount of space that 1 mL of liquid occupies. It is abbreviated cc.
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| 1g is equal to __ grains (gr). | 15
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| 1 gr is equal to __ mg. | 60
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| 1 oz is equal to __ mL | 30
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| 1 tsp(t) is equal to __ mL | 5
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| 1 tbs(T) is equal to __mL | 15
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| 1 cup is equal to __ mL | 240 (8 oz)
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| 1 pt(pint) is equal to __ mL | 500 (16 oz)
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| 1 qt(quart) is equal to __ ml | 1000 (32 oz)
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| 1 kg is equal to __ lbs | 2.2
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| 6 rights of medical administration | Right drug, dose, time, route, client, documentation.
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| Name 2 insertion routes | vaginal and rectal – dissolve with body temp
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| Name 2 instillation routes | eye drops, ear drops
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| Percutaneous | applied to skin or membranes and then absorbed
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| Transdermal | applied to skin in a patch or disk so med goes into tissues
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| Range in mL of oral syringes | 3 mL to 60 mL
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| What part of syringe is calibrated? | barrel
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| What inch needle is good for IM? | 3 inch
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| 1 inch is equal to __ cm. | 2.5
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| 1 lb is equal to __ oz. | 16
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| 7 items a medication order must contain. | Client’s name, date/time, drug, dose, route, time/frequency, signature of dr.
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| Medication orders are written in what order? | name of drug, dosage, route, frequency
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| MAR | Medication Administration Record
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| Acute drug therapy | Used to treat a short-term or critical problem like shock or infection.
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| Maintenance drug therapy | Used to treat long-term chronic disease like hypertension, diabetes.
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| Suportive drug therapy | Giving hydration or anti-emetics, blood products
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| Supplemental drug therapy | Giving vitamins, herbals, or iron to boost immune system.
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| Types of things nurses monitor during drug therapy | Response, side effects, concentration levels, tolerance/dependence, and interactions.
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| Therapeutic index | drug concentration levels – ratio between therapeutic benefit and toxic effects.
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| INR | International Ratio – used to measure range
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| What shows drug dependence? | Withdrawl symptoms if drug is abruptly discontinued.
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| What 2 methods of identification can you use to confirm client ID? | ID band, name and DOB.
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| Always assess what before giving meds to a patient? | ID, order, vitals, allergies, and client’s condition.
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| What are the 3 checks for med admin? | Check MAR against orders, Check meds against MAR while preparing, Check meds against MAR in client room.
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| Medication Reconciliation | Get list of all client’s current meds, share with providers, and provide list of meds to client upon discharge.
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| Who are drug prescribers? | Physician, nurse practitioner, or physician’s assistant.
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| CPOE | Computerized physician order entry
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| Standing Order/Routine Order | Administered until dosage is changed or another med prescribed.
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| PRN | Given only when a client requires it.
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| STAT | Single dose given immediately in an emergency
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| Now Order | When medication needed and must be administered within 90 minutes.
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| Prescription | Medication to be taken outside of hospital.
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| Nurses role in med admin | Must understand drug action, dose, potential SE, monitor patient for effects.
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| Who is responsible for monitoring compliance with meds and determining their effectiveness in the patient? | The nurse
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| Polypharmacy | When client takes two or more meds to treat the same illness on accident.
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| What is the easiest and most desirable way to administer meds? | Oral – by mouth
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| What position should clients be in during oral admin? | 90 degrees, seated.
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| MDIs | Metered-dose inhalers
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| It is unusual to use a syringe larger than __ mL for an injection. | 5 mL
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| Needles vary in length from __. | 1/4 to 4 inches
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| Ampules are made of __. | glass
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| Distribution refers to the method by which | medication, after absorption, is moved within the body.
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| Pharmacokinetics is the study of how medications | enter the body, travel to the site of action, metabolize, and exit the body.
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| Absorption is the | passage of medication molecules into the blood from the site of administration.
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| Who has the ultimate responsibility for the medication that is being administered? | nurse doesn’t have sole responsibility but is accountable for knowing which medications are prescribed for the client, their therapeutic and nontherapeutic effects, the nursing implications, and the level of the client's knowledge.
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| Which site is no longer used for intramuscular injections? | The dorsogluteal is the not-so-safe traditional site.
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| Medication errors occur most often when the nurse fails to | follow the routine procedures that are in place to ensure client safety.
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