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CRMA Random Info
Random CRMA Information
| Question | Answer |
|---|---|
| How many years is the CRMA certificate valid for? | 2 years |
| Can you administer medications outside of Maine? | No. The CRMA certification is only valid in Maine and in facilities covered under certain regulations |
| What are the staff roles that a CRMA may report to and/or work with? | Administrator Directors Care Staff Facility Staff Nurse Consultants Pharmacist |
| What is an Administrator? | Oversees a facility from a business point of view. Key responsibilities: -Decision Making -Approves changes in systems or procedures -Problem solving - incident reports, medication errors, medication refusals, safe practices Example - Danielle |
| What is a Director? | Coordinates day-to-day direct services, schedules staff, coordinates access to outside services (dentist, doctor, etc.), arranges transportation and services from other agencies, as well as assigns duties to staff members. Example - PMs/APMs |
| What are Care Staff? | These employees provide the majority of the daily interactions with the individuals receiving care. Key Responsibilities: -Teaching problem-solving skills -Motivating -Developing goal-directed supports Example - Residential Counselor |
| What are Facility Staff? | These individuals either manage the food service needs of the facility or the general facility maintenance needs. Example - Maintenance |
| What are Nurse Consultants? | These individuals are Registered Nurses who serve as on-call experts in an advisory capacity when necessary. Example - Linsey |
| Can CRMA's take telephone orders? | No only a registered or licensed nurse or pharmacist |
| What does each prescription need on the label? | -Prescription number -Resident's full name -Name, strength & dosage of the drug -Directions for use -Name of prescribing provider -Name & address of issuing pharmacy -Date of issue of latest refill -Expiration date -Any cautionary instructions |
| How many people are needed to destroy medications? | 2 CRMAs |
| Can CRMA's destroy Schedule II medications? | No. Only an authorized representative of the Department, a licensed pharmacist, a member of the Commission on Pharmacy or an authorized representative of the DEA |
| How often do we count Schedule II controlled substances? | At the beginning of your shift with the outgoing CRMA and at the end of your shift with the incoming CRMA |
| What is a bound book used for? | Records kept of the inventory of Schedule II controlled substances. |
| How are Schedule II controlled substances stored? | Double lock in a separate locked box or cabinet |
| What are people resources that are available for the CRMA? | -Administrator -Supervisor -Pharmacist -Licensed Nurses -Physician |
| What are non-people resources available for the CRMA? | -Physician Desk Reference (PDR) -The PDR Pocket Guide to Prescription Drugs -Drug Handbook -Poison Control Center -Pharmacy website -Drug Companies -Drug inserts from the Pharmacy |
| What are the 4 links in the infection chain? | -A germ -A place for the germ to live and multiply -A susceptible host -A way for the germ to enter the hose |
| What are the different routes a germ can enter the host? | -Direct contact -Indirect contact -Droplets -Other particles in the air |
| What are some ways to break the infection change? | -Good hand washing -Using protective barriers -Immunizations -Wash fruits and vegetables -Not sharing personal items |
| How often can you use hand sanitizer before washing your hands? | No more than 10 times before rewashing your hands with soap and water |
| What are the principles of standard precautions? | -All body fluids should be considered infected -All materials, instruments, and surfaces should be treated as if they're infected -The different methods to be used for safeguarding the staff and the resident |
| What are examples of body fluids? | -Blood -Semen -Vomit -Saliva -Feces -Urine |
| What are the methods to be used for safeguarding the staff and residents? | -Hand washing -Sharps containers -PPE |
| What are the different types of PPE? | -Single use gloves -Utility gloves -Gown/apron -Mask -Mouthpiece or plastic airway |
| What kinds of incidences can cause exposure to HIV and HBV? | -Deep tissue injury -Needle stick -Direct contact with blood |
| What is the procedure for needle stick? | -Report injury immediately to supervisor -Allow wound to bleed freely -Get seen by a Doctor -Complete facility incident report -You'll be offered a test for HIV or other infectious diseases |
| What are the 4 different vital signs? | -Temperature -Pulse -Respiration -Blood Pressure |
| What are the different ways to take a temperature and what's the normal temperature? | -Otic (ear) - 99.5 degrees F -Oral - 98.6 degrees F -Axillary (armpit) - 97.6 degrees F -Rectal - 99.5 degrees F -Skin/Transdermal - 94 degrees F |
| What is the most accurate way to take a temperature? | Rectal |
| What are the different factors that can affect body temperatures? | -Age -Time of Day -Gender -Emotions -Exercise -Infection -Food, fluid, smoking |
| What are the different ways to take a pulse? | -Radial -Brachial -Carotid -Apical |
| What is the normal pulse rate for adults? | 60-100 per minute |
| What is 1 full respiration? | One rise and fall of the consumer's chest |
| What is the normal rate for respiration? | 12-20 per minute |
| What is the systolic pressure? | The top number in a blood pressure. It measures the amount of pressure in your arteries during the contraction of the heart muscle |
| What is the diastolic pressure? | The lower number in a blood pressure. It measures the blood pressure when your heart muscle is between beats |
| What is the normal blood pressure for an adult? | 120/80 |
| What does the oxygen saturations measure and what's the normal levels? | It measures the level of oxygen in the blood stream. The normal O2 levels are 98-100% |
| What are the 3 things we measure? | -Weight -Volume -Length |
| What are the 3 systems of measurement? | -Household -Apothecary -Metric |
| What is the Household System of measurement? | It's used in cooking. We measure foods in pounds, cups, ounces, teaspoons. These measurements are fine for cooking but they're not precise enough for dealing with medications. The ones we typically use in medicine is teaspoon, tablespoon, ounce |
| What is the Apothecary System of measurement? | Used by pharmacists to measure medications until the metric system was developed. The unit for weight is grain. Ounces and drams are used to weight solids. Homeopathic medicine practitioners will use these forms of measurement |
| What is the Metric System of measurement? | The international system of measurement. It's commonly used for medication measurement. The unit of weight is gram. The unit of length is meter & the unit of volume is liter. There are prefixes that are added to these units to make them larger or smaller |
| What are the prefixes used in the Metric System? | -Kilo-one thousand -Hecto-one hundred -Deka-ten -Milli-one thousandth -Centi-one hundredth -Deci-one tenth |
| What are the 5 categories of drug sources? | -Plants -Animals & humans -Minerals or mineral products -Microorganisms -Man-made or synthesized |
| What are the 4 types of medication names? | -Chemical -Generic -Trade or Brand -Official |
| What is the Chemical Name? | The precise description of the drug's chemical composition and molecular structure |
| What is the Generic Name? | It's much simpler than the chemical name and assures us that we're getting the drug we want without any pharmaceutical company modifications |
| What is the Trade of Brand Name? | The company that has developed its own variations for the drug usually copyrights this name |
| What is the Official Name? | The official name is followed by the United States Pharmacopoeia (USP) of National Formulary (NF) denoting its listing in one of the official publications. It's often the same as the generic name with USP added to the end of it. |
| What are the 2 major medication categories? | Prescription and Non-prescription |
| What are Prescription medications? | They require us to have an order from a duly authorized licensed practitioner before we can purchase the medication from the pharmacy |
| What are Non-Prescription medications? | Also known as over-the-counter because they can be purchased at the counter of several types of stores. In the facility ALL drugs must have a written order. There's usually an over-the-counter form that we utilize |
| What are the sub-categories of prescription drugs? | Controlled Medications (Schedule II thru V) and Non-controlled |
| What are the different classes of controlled substance drugs? | Schedule I Substances Schedule II Substances Schedule III Substances Schedule IV Substances Schedule V Substances |
| What are Schedule I Substances? | Have a high potential for abuse and are NOT currently accepted as medical use. Examples-LSD, Heroin, Marijuana (considered a Schedule I federally but a Schedule II within States), and Mescaline |
| What are Schedule II Substances? | Have a high potential for abuse, but are currently accepted for medical use. Examples-oxycodone, fentanyl, Morphine, etc. |
| What are Schedule III Substances? | Have a lower abuse potential than Schedule II, but may produce low to moderate physical dependence Examples-Vicodin, Oxycodone mixed with Tylenol, etc. |
| What are Schedule IV Substances? | Have lower abuse potential than Schedule II, but may produce low to moderate physical dependence Examples-Ativan, Xanax, etc. |
| What are Schedule V Substances? | Have low potential for abuse and limited physical or psychological dependence Examples-Robitussin AC, Robitussin DAC, etc. |
| What are the different forms of liquid medications? | Syrup, Elixir, Suspensions, Tinctures, Unit Dose Ampoules |
| What is a syrup? | A concentrated solution of medication and sugar in water or aqueous liquid. It's typically used for kids |
| What is an elixir? | A clear sweetened liquid of water and alcohol containing flavorings and medications. Examples are adult cough syrup |
| What are suspensions? | An often thick, milky preparation of an insoluble drug suspended. Must be shaken well before dispensing -Ophthalmic - for the eyes only -Otic-for the ears |
| What are tinctures? | Preparations of liquid medications designed for "external use" ONLY. They are not intended for internal use or consumption |
| What are unit dose ampoules? | Sealed containers of liquid medication |
| What are the different forms of solid medications? | Capsule, Enteric Coated Capsules, Sustained Release, Tablets, Capseal, Troches/Lozenges |
| What are capsules? | Usually made of gelatin that serves as a container for powdered medications. They are NOT to be crushed, but some can be opened-you need an order for that |
| What are enteric coated capsules? | Capsules coated with a substance designed to resist the action of gastric juices so the release will not occur until the medication reaches the alkaline secretions of the intestines. These capsules are NOT to be crushed or opened. |
| What are sustained release? | A capsule that has individual portions of the medication that are coated with materials that dissolve at different times. Some particles may be released & absorbed immediately while others may not dissolve for an hour and still others in 4, 6, or 8 hours |
| What are tablets? | A powdered medication that is compressed or formed into a tablet. The same medication can be prepared in different doses, tablet shapes, colors, and labels. They may have an indented line across the face of the tablet (scored) that can be cut or crushed |
| What is a score mark? | It's an indented line across the face of the tablet to assist in cutting or breaking the tablet in 2. If it has a score mark it may/can be crushed (with it in the order). If it doesn't have a score, then CRMA's can not break it |
| What is a capseal? | A capsule that cannot be opened. It's been sealed during the manufacturing process example-Tylenol liquid gel |
| What are troches/lozenges? | Preparations come in various shapes, but are usually flat. They're held in the mouth until dissolved, releasing the medication as it dissolves. Chewing or swallowing are not recommended and may cause unwanted effects. |
| What is a spansule? | A medicinal capsule containing many tiny beads of medicine that dissolve at spaced intervals for long-acting medication |
| What is a powder? | Finely divided solid particles of medication or mixtures of medications for either internal or external use |
| What are vials? | Glass containers of powdered or liquid medication usually containing multiple doses. May have a rubber stopper or a cover device that allows for multiple doses to be given easily. This is important to know if you can use it multiple times or single use |
| What are lotions? | Liquid suspensions intended for external topical applications |
| What are Ointments? | Bases are often petroleum and lanolin. They do not wash off readily and are often used to protect sensitive areas, for soothing or for the bacteriostatic effect depending on the medication contained. |
| What are ophthalmic ointments? | Sterile ointment specifically prepared for the eyes |
| What are suppositories? | Medications prepared in a form appropriate for insertion into a body cavity. The molded form dissolves at body temperature in secretions allowing the medication to be absorbed for either local or systemic effect. |
| What are transdermal medications? | These medications are absorbed through the skin into the bloodstream. These may come in the form of a patch, gel, ointment or cream. |
| What are the 3 effects that CRMA's monitor? | -Desired effects -Adverse effects -No apparent effects |
| What are desired effects? | Medications are prescribed to cause this. There are many different reasons why. Some examples are to: -prevent or eliminate a disease (vaccines) -alter a person's behavior or mood (antidepressants) -assist the body (antibiotics) |
| What are adverse effects? | Anything but the desired effects. Sometimes these may be expected or predictable, but they can be unexpected, unpredictable, extremely serious and possibly even life threatening. They do not always occur in every person with every drug. |
| What are no apparent effects? | When the medication appears to have no effect on the resident. Some reasons for this might be: -The resident's body chemistry may not be affected by the med -There may not be an adequate dose to have an effect -There may not have been enough time |
| What are other variables that impact medication effects? | -Gender -Body weight -Metabolic rate -Physical status -Psychological aspects -Age |
| What are the 8 rights? | 1. The right resident 2. The right medication 3. The right dose 4. The right time 5. The right route 6. The right to know 7. The right to refuse 8. The right documentation |
| What are required elements in a medication order? | -Residents name and DOB -Name of med -Dosage -Time to be administered -Date order was written -Route -Any special instructions -Practitioner's signature |
| What do prescription orders require? | Same as a medication order along with -Authorized provider's name -Address -Phone number -DEA number -How much medication to fill |
| What do psychotropic PRN orders require? | Resident's name, Med name, Route, Time to be administered, Directions for administration, Specific indications for use, Exact dosage, Exact time frames between doses, Max dose in 24-hrs, When the provider wants to be notified, Signature, date of the order |
| What do individual's that are being admitted need? | Valid orders that are given to the program 24 hours prior |
| How long are psychotropic med orders valid for? | 3 months or 90 days |
| How long are Controlled II meds valid for? | 30 days |
| How long are OTC/standing orders valid for? | One year |
| When a resident is admitted to another facility (hospitals, etc.) are their medication orders still valid? | No |
| When a resident is discharged back to the program, how long do you have to get the medication orders signed by the Provider? | 24 hours |
| What is the least amount of medications that we can have on hand? | 5 day supply |
| When will should you reorder liquid meds; meds in tubes, creams, ointments, etc.? | When there is a quarter of the container left |
| When do you check the MAR against valid orders? | -At the time orders are transcribed -When the order is double-checked by staff -At the beginning and end of each month by a CRMA. |
| What happens if there are missing initials on the MAR? | The CRMA that finds it should notify the person responsible for the missing documentation. They have 24 hrs. to sign it. |
| What is the med window for medications? | 1 hour before and 1 hour after the scheduled time. |
| When can you administer medications outside of the window? | If there is a document from the provider stating that the resident has an extended med window |
| What do you do when you open non-prescription medications? | Must be dated when they're opened, the expiration should be circled, and resident's initials. |
| How long does insulin last after it's been opened? | 28 days |
| How long can nitroglycerin tablets be used once they're opened? | 90 days after the bottle is opened |
| Can we accept a medication with no expiration date? | No. We need to have an expiration date that hasn't passed the current date. |
| What are the different types of errors? | -Documentation -Omission -Commission -Refusal -Transcription -Wrong dosage -Wrong medication -Wrong person -Wrong time |
| What happens when a medication is contaminated? | If medications show some evidence of tampering, deterioration, or damage, notify the prescribing pharmacy. If a medication is dropped on the floor it must be destroyed and documented on the MAR with a witness present |
| What do you do if the medication label is improperly labeled, the label doesn't match the order or is illegible? | You need to contact the prescribing pharmacy for proper labeling within 2 working days. |
| What are the different route of administrating medications? | oral, rectal, vaginal, topical, eye drops, eardrops, nose drops and inhalants. |
| What medications cannot be crushed? | -Sublingual tablets -Delayed-release or time-released -Coated tablets |
| When should you not give a medication? | -No physician's order -No MAR -The pharmacy label is not legible -Resident exhibits a dramatic change in status |
| How do you measure liquid medications? | Do not estimate liquid dose. Measure at eye level on a flat surface. Use a syringe for odd amounts |
Created by:
ebilodeau