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Dosage Calc Mid-Term

When do you round decimals? Calculate one decimal place passed desired position; if 4 or less no adjustment; if 5 or more, round up
Do you round up decimal positions when administering oral medication or injections? NO. May cause overdose
Why do you always add a 0 before a decimal if the value is less than 1? Draws attention to the decimal and avoids two potentially critical errors: missing the decimal or mistaking it for a number “1.”
Divisor Number you are dividing by
Dividend Number being divided
Percent (%) means.. Per hundred
What is a Ratio? Comparison of two quantities
Two ways to express a Ratio As a fraction With a colon
How does the Ratio 2 : 3 read? 2 to 3
What is a Proportion? A statement that shows the relationship between two different ratios
Adverse Drug Event (ADE) A medication-related occurrence that causes harm to a patient
Drug Concentration (strength) The ratio of medication amount to a specific amount of liquid or solid ( amount of drug, 50 milligrams) per tablet or metric-calibrated teaspoon, or the amount of drug in the total quantity or weight supplied ( 1 gram per 500-milliliter container)
Food and Drug Administration (FDA) The federal agency responsible for ensuring the safety, efficacy, and security of drugs, biological products such as vaccines, medical devices, and more. FDA approves medications for specific uses and sale in the United States.
Generic Drug Drug product that is comparable to a brand-name drug product in dosage form, strength, route of administration, quality and performance characteristics, and intended use.
High Alert Medication Medication identified by ISMP as capable of causing significant harm to patients if used in error. The red flag icon is placed next to high-alert medications in the text as a visual reminder to help the reader become familiar with some of these drugs.
Institute for Safe Medication Practices (ISMP) A nonprofit, voluntary agency dedicated to educating the health care community and consumers about safe medication practices
Patent A license giving the original manufacturer exclusive rights to manufacture the approved new product for a period of about 20 years from the time the patent was filed. When the patent expires, other companies may manufacture a generic copy of the product
Sentinel Event an unexpected occurrence involving death or serious physical or psychological injury or the risk thereof. Serious injury specifically includes the loss of limb or function.
Unit Dose Packaging Non-reusable packaged and labeled single serving of drug dose ordered for the patient; usually used in health care institutions. May contain more than one unit of the drug, depending on the order (e.g., 2 tablets per serving).
The Joint Commission A national nonprofit, independent agency that provides accreditation and certification to health care organizations, with an emphasis on high standards and patient safety, including medication administration safety
Usual Dose The average dose ordered for the desired therapeutic effect for the target population (e.g., usual dose for children age 5 to 12 years: 1 teaspoon at bedtime for itching). Seen on manufacturers’ prepared labels
Seven Patient Rights Right Patient Right Drug Right Dose Right Time Right Route Right Documentation Right to Refuse
Minimum number of patient identifiers to be used when determining Right Patient Minimum of TWO patient identifiers
Name some patient identifiers Patients name Assigned ID number (wristband) Telephone Number Other person specific identifiers
What can not be used as patient identifiers? Bed number Room Number
What do you do when a patient refuses medication of is unable to tolerate the route ordered? Document patients reason and include an assessment of patients mental status Contact prescriber
Accurate and timely reporting and documentation in the patient medication record, as well as other records, is _________ Essential for patient safety
The nurse who prepares and administers the medication offers the last step in administration _________ Safeguards to the patient.
Medication form can affect _________. Rate of absorption Route of administration Distribution through body
Medication forms Solids Liquids Inhalants Suppositories Skin Patched Others
Compress powder drugs Plain tablet
Tablet with a dividing line Scored tablet
What is the ONLY kind of tablet that can be cut? Scored tablet
Oval shaped tablets Caplet
Tablets with coating to permit them to dissolve in the small intestine instead of the stomach, where it might cause gastric irritation Enteric Coated tablet
Soluble case—usually gelatin—that holds liquid or dry particles of the drug; can be hard or soft (softgels), in one piece or two pieces Capsule
Forms of Delayed Release (DR) ER - Extended Release SR - Slow Release CR - Controlled Release LA - Long Acting EL - Extra Long Acting CD - Controlled Dose
DS Double Strength
ES Extra Strength
Loose or molded drug substance usually to be dissolved in liquid or nonessential food Powders/granules
Never crush or cut Delayed Release or Enteric Coated medications It will accelerate their release into the body
Solid particles suspended in liquid that must be mixed well before administration Aqueous Suspension
Sweetened alcohol and water solutions Elixir
Fats or oils suspended in a solution by an emulsifier Emulsion
Syrups or derived form of active drugs Extract
Concentrated alcoholic liquid extracts of plants or vegetables Fluid Extract
Mixture in solids are fully dissolved Solution
How to measure a liquid using a metric-calibrated cup? On level surface at eye level
Routes of Medication Administration Parenteral (Injectable) Nonparenteral (All other routes that are not injectable)
Parenteral routes Intradermal (ID) - between dermis and epidermis Intramuscular (IM) - into muscle Intravenous (IV) - into vein Subcutaneous (Subcut) - injected in hypodermis Epidural - into the space between vertebral wall/dura mater Intrathecal - into spinal fluid
Nonparenteral routes Oral (PO) - swallowed by mouth Sublingual (SL) - dissolved under tongue Buccal (bucc) - dissolved in cheek Topical (top) - applied to skin Transdermal (skin) - for systemic effects (skin patches) Nasogastric (NG) - nose to stomach Inhalants Others
Most medications are ordered for which routes? Oral (PO) Intravenous (IV) Intramuscular (IM) Subcutaneous (Subcut)
When patient is discharged from the hospital, you should? Teach correct use and/or application of drug
Copies of original brand name drugs after their patent has expired Generic drugs
What are the only differences permitted by the FDA between original and generic drug? Inactive ingredients Size Shape Color
What is included on drug labels? Brand/Trade name (may have) Generic name (must have) National Drug Code Manufacturer name Drug concentration (dose) Form (tablet,etc) Bar Code Total quantity Administration route Expiration Date Lot number Directions/Warning Special storage
Medication order can be: Handwritten Faxed Entered in computer Verbal?
Medication orders must have: Date/Time Patient name Medication name Dosage Form Route Frequency (dose schedule) Prescribers signature
A report that is confidential regarding a medication related incident Medication Incident Report
Medication Reconciliation A measure to reduce the high rate of medication errors upon transfers, admissions, and discharges
How many times should drug dose, label, and drug order be checked prior to administration? 3
How many times difference is between a (g) and mg; mg and mcg? 1000 times
5 mL 1 teaspoon
15 mL 1 Tablespoon
30 mL 1 ounce
240 mL 1 measuring cup (1 glass)
1 L 1.06 qt
Pupil size: 1-2mm; possible strong reaction to light or opioid use Pinpoint pupil
Dilated pupil 10 mm
1 kg 2.2 lb
10 cm 2.5 in
1 m 39 in
1 pint 16 oz 540 mL
1 gallon 4 quarts
1 quart 960 mL
Milliequivalent (mEq) The number of grams of solute dissolved in 1 mL of solution. Typically, electrolytes are measured in mEq (potassium, sodium, chlorides)
Milliequivalent per 1 L 1/1000 of gram of substance dissolved in 1 L
Milliequivalent per 1 mL 1/1000 of a gram of substance dissolved in 1 mL
Controlled Drug Schedules Schedule I Schedule II Schedule III Schedule IV Schedule V
Highest potential for abuse and no medical use (heroin) Schedule I
High potential for abuse and have medical use with severe restrictions; potential for severe dependence (morphine, hydrocodone, amphetamines) Schedule II
Potential for abuse and moderate dependence (codeine products, testosterone) Schedule III
Lower potential for abuse than schedule I, II, III; limited dependence lower than schedule III (Valium, Ambien) Schedule IV
Lower potential for abuse than schedule IV; Limited dependence relative to schedule IV (cough syrups with codeine) Schedule V
A set of graduations on a scale to indicate values Calibration
Viscosity fluid resistance
“under the skin,” a “hypodermic” is an injection that delivers medication under the skin to the intradermal, subcutaneous, muscular, and intravenous layers. Hypodermic
A standardized means of measure used to quantify selected products with biological activity such as vitamins, vaccines, blood products, and hormones, including insulin. Units
Syringe selection depends on: Volume of medication to be administered Calibrations on syringe Route to be administered Viscosity of medication (thicker the med, larger the syringe barrel needed)
Syringe parts: Plunger Rubber stopper Barrel Tip (Hub)
Needle parts: Hub Shaft Bevel
Needle selection criteria: Patient size Location to be administered Skin condition Muscle development Type and viscosity of medication Equipment available
How should the patient be when giving injections? Seated or lying down to prevent injury
Created by: crazybafireguy