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Nurse 177
Researching and Preparing Medicatiions
| Question | Answer |
|---|---|
| chemical name | the name of the exact ingredients of medication |
| generic name | assigned by the US Adopted Name Council; nonproprietary name |
| brand name | trade name; shorter and easier to remember; proprietary name |
| prescription medications | available with a written direction from a health-care provider with prescriptive authority |
| over-the-counter medications | are available without prescription; nonprescription medications |
| routes of medication | oral, sublingual, mucosal, topical, parenteral |
| oral route | taken through mouth; swallow or buccal |
| sublingual route | absorbed under tongue; ODT(orally disintegrating tablet) |
| mucosal route | absorbed through the mucosa; rectum, vagina, eye, ear, inhaled into lungs and bronchi |
| topical route | applied to skin; creams ointments, lotions, transdermal patches |
| parenteral route | given beneath skin; all injections, intradermal, subcutaneous, intramuscular, intravenous |
| Effects of Medication | pain relief; drug interaction; food, supplement, vitamin and herb interaction |
| desired effect | reason a medication is prescribed or the purpose for which it is given |
| Food Drug and Cosmetic Act of 1938 | Established a government agency to approve all new drugs and determine that the drug was safe for humans (US FDA) |
| Durham-Humphrey Amendment of 1952 | Specified the criteria for prescription medications and OTC medications |
| Kefauver-Harris Amendment of 1962 | Established the FDA as responsible for giving drugs official (generic) names and specified criteria for deeming a drug safe and effective before it s offered for sale |
| Comprehensive Drug Abuse and Control Act of 1970 | Established Schedules I through V, categorizing drugs according to their potential for abuse; set guidelines for the manufacture, distribution, and sale of controlled substances |
| Schedule I | These drugs are highly addictive and have no medical purpose; street drugs, heroin, LSD, peyote |
| Schedule II | Have high potential for abuse and do have accepted medical use; morphine, codeine, fentanyl, oxycodone |
| Schedule III | while having potential for abuse, are at less risk to be abused than those in Schedules I and II; lower dose barbiturates, acetaminophen with codeine, paregoric |
| Schedule IV | lower potential for abuse than I, II, III; chloral hydrate, diazepam, lorazepam |
| Schedule V | lowest potential for abuse; small trace codeine & antidiarrheal |
| side effect | unintended outcome takes place |
| Adverse effects | unintended but are more severe or harmful than side effects |
| severe adverse effects | life-threatening |
| allergic reactions | patient's body reacts to the medication as a foreign invader to be destroyed |
| anaphylactic reaction | more severe reaction, life-threatening |
| Anaphylactic reaction suspected, what do you do? | stop medication at once and follow facility procedure for responding to anaphylaxis |
| When are you to check chart for allergies? | before administering and medication |
| If a patient says they are allergic to a medication what do you do? | record it as an allergy along with documenting the patients description of the reaction when medication is taken |
| Possible Allergic Reaction Classifications | Antibiotics (penicillin, sulfa drugs), Iodine and dyes injected for certain procedures, vaccines, anticonvulsants (seizure medications) |
| therapeutic level | amount of meds in the blood needed to achieve desired effect on target |
| When and or why will a patient exhibit toxicity? | medications can accumulate in the body rather than being completely excreted |
| T/F: In many cases amount of medication requires for desired effect is far below amount that could cause toxic effects | TRUE |
| T/F: medications are not likely to cause a toxic effect unless they are taken in amounts greater than prescribed | TRUE |
| If blood levels are elevated what does prescriber do with medication? | Discontinues for a few days to allow medication to be removed from bloodstream and restart at lower dose |
| It is the responsibility of the ___________ to check the most recent blood levels of medications in the patient's chart and to hold any questionable dose until you speak to ___________ | Nurse, Prescriber |
| Examples of common medications that may cause toxicity | Digoxin (Lanoxin), Gentamicin (Garamycin), Imipramine (Tofranil), Vancomycin (Vancocin), Warfarin (coumadin) |
| T/F: You are NOT responsible for looking up medications before you give them and for being aware of any potential drug-drug, drug-food, or drug-supplement interaction | FALSE |
| Physician's Desk Reference (PDR) | book containing detailed information about large number of medications |
| What contains the same info as drug package inserts provided by pharmaceutical companies? | Physician's Desk Reference (PDR) |
| Nursing Drug guides | include generic drugs listed in alphabetical order with information about their classification and brand names, absorption, distribution, metabolism, and excretion |
| Includes indications for use; dosage, contraindications, cautions, and interactions, nursing interventions and patient teaching | nursing drug guide |
| What are four ways to research medications? | Physician's Desk Reference, Nursing Drug Guides, Pharmacology Textbooks, Internet Resources |
| Antianginals | Increase blood flow and oxygen supplied to the heart muscle by causing the coronary arteries to dilate, allowing for the relief of chest pain or chest tightness. |
| Antiarrhythmics | Regulate an irregular heartbeat; act on the nerve impulses in the heart; often slow the heartbeat and decrease blood pressure; suppress cardiac arrhythmias. |
| Anticoagulants | Delay blood clotting; sometimes called blood thinners; prescribed to treat or prevent heart attack, stroke, and blood clot formation. |
| Antiplatelet agents | Also prevent blood clotting but work by making platelets less sticky so they are less likely to form clots |
| Antihyperlipidemic (lipid-lowering agents) | Prescribed to treat high cholesterol and triglycerides in the blood causing narrowing and restriction of blood flow; can contribute to heart attack, stroke, high blood pressure, and other conditions. |
| Antihypertensive | Prescribed to lower blood pressure; often more than one drug is prescribed because they work in different ways. |
| Cardiac glycosides | Prescribed to slow and strengthen the heartbeat; include all drugs that contain or are derived from digitalis. Used to treat heart failure and atrial arrhythmias, such as atrial fibrillation. |
| Diuretics | Prescribed to decrease edema and fluid retention; rid the body of excess fluid through the urine. Cause kidneys to increase salt and water output, which decreases excess fluid in the blood and lowers blood pressure |
| Vasodilators | Prescribed to widen blood vessels, lower blood pressure, and increase circulation |
| What are Cardiovascular Medications? | Antianginals, Antiarrhythmics, Anticoagulants, Antiplatelet agents, Antihyperlipidemic, Antihypertensive, Cardiac glycosides, Diuretics', Vasodilators |
| What are gastrointestinal medications? | Antacids, anticholinergics, antiemetics, gastroesophageal reflux disease medications, laxatives and stool softeners |
| What are endocrine medications? | Antidiabetics, steroids, reproductive hormones, thyroid replacement hormone |
| Antacids | Used to neutralize stomach acid; products contain aluminum, magnesium, calcium, or a combination of them. |
| Anticholinergics | Ordered to block the action of the parasympathetic nervous system; slow peristalsis and reduce stomach acid production; sometimes called antispasmodics; prescribed for irritable bowel syndrome, ulcers, Parkinson’s disease, and asthma. |
| Antiemetics | ordered to relieve nausea and vomiting |
| Gastroesophageal reflux disease medications | given to reduce or block amount of acid produced by the stomach |
| laxatives and stool softeners | Given to relieve constipation; stool softeners keep water in the feces of the large intestine; some laxatives increase peristalsis, and other laxatives, such as milk of magnesia, pull water into the intestine to prevent dry, hard feces |
| antidiabetics | Oral hypoglycemic stimulate the pancreas to produce more insulin when it is not making enough to meet the body’s needs |
| steroids | Ordered to relieve inflammation and to treat diseases such as asthma and bronchitis; may be ordered as skin cream to treat local inflammations, and as injections directly into inflamed joints or into muscle to decrease systemic inflammation. |
| reproductive hormones | Estrogen ordered to minimize symptoms of menopause and decrease osteoporosis; counteracts testosterone, so may be used to treat prostate cancer. Testosterone is ordered to increase strength and virility in males and block estrogen in females with cancer |
| thyroid replacement hormone | Ordered to replace thyroid hormone that is not being produced in sufficient amounts by the body. |
| What are immune system medications? | Antibiotics, antifungals, anti-inflammatories, antivirals |
| antibiotics | treat infections caused by bacteria by interfering with the way bacteria live and reproduce, allowing the immune system to more easily eliminate the infection; antibiotics must be taken regularly for the prescribed amount of time |
| antifungals | Used to treat fungal infections such as athlete’s foot, yeast infections, and systemic fungal infections. |
| anti-inflammatories | Prescribed to decrease the symptoms of inflammation and to relieve pain from muscle strain/sprain and arthritis; there are two types: steroids (see Endocrine Medications) and NSAIDs. |
| antivirals | prescribed to treat viral infections |
| What are nervous system medications? | analgesics, antianxiety medications, anticonvulsants, antidepressants, sedative and hypnotic medication |
| Analgesics | Prescribed to relieve pain, often called pain medicines; include narcotics and nonnarcotics.Narcotic analgesics act on the brain to relieve pain and are addictive; nonnarcotic analgesics include NSAIDs and acetaminophen |
| antianxiety medications | Antianxiety medications are prescribed to relieve anxiety and promote calm, rest, and sleep |
| anticonvulsants | Ordered to decrease seizure activity caused by epilepsy or other causes. |
| antidepressants | Prescribed to relieve depression and to treat certain types of pain, such as migraine headaches; selective serotonin reuptake inhibitors increase the function of neurotransmitters in the brain; older drugs, particularly monoamine oxidase inhibitors |
| sedative and hypnotic medication | Sedatives act on the brain to promote calm and sleep; hypnotics induce sleep and fall into two classes: benzodiazepines and nonbenzodiazepines. Benzodiazepines carry a higher risk for dependency, toxicity, and abuse |
| What are respiratory medications? | antihistamines, antitussives, bronchodilators, expectorants |
| antihistamines | Prescribed to block the action of histamine, which decreases allergy symptoms, including mild respiratory allergies such as hay fever and sinus conditions; also used to prevent or treat motion sickness symptoms |
| antitussives | Used to control coughing; nonprescription cough medicines usually contain dextromethorphan to suppress coughs or guaifenesin as an expectorant; |
| bronchodilators | Prescribed to open airways to ease shortness of breath associated with asthma and emphysema.May be administered IV, orally, and as an inhalant. |
| expectorants | Used to thin mucus so that it can be coughed out, which helps prevent lung congestion leading to pneumonia. |
| All medication orders include what? | date/time of order, name of med, dosage, frequency, route, patient's name, specific reason for administering, prescriber signature |
| T/F If the dose, route, or frequency is not appropriate for the medication you are to notify the patient and or the patient's guardian? | False, you notify prescriber to verify order |
| When do you use a medication administration record? | electronic method of transcribing is not in use or available |
| T/F Always compare the order on the MAR with the prescriber's original order to detect any possible errors before you prepare and administer medications | True |
| Specific ordered frequencies | daily, twice per day, three times per day, four times per day, as needed (prn), stat, one time |
| daily | one time per day, morning OR evening |
| twice per day | every 12 hours, morning AND evening |
| three times per day | every 8 hours or with meals |
| four times per day | every 4 hours or every 6 |
| as needed (prn) | as needed within specified time limits |
| stat | immediately, no more than 15min |
| one time | give one time only , do not continue to administer |
| Abbreviations that are commonly used include? | g, gr, h, IM, IV, kg, mcg, mg, mL, PO, q, subcut |
| Who determined that some medication abbreviations can no longer be used to prevent confusion and errors? | The joint commission |
| apothecary system | used when medications are ordered that have existed for a very long time |
| What measuring system replaced the apothecary system? | the metric system |
| Which measurement system is said to be more accurate and standardized? | the metric system |
| Where may you obtain medications within the healthcare facility? | Computerized cabinets, medication cart, locked bins in patient rooms |
| Is leaving the medication cart Unattended to talk to other nurses permittable? | NO |
| Rights of medications | right medication, dose, route, patient, indication, date and time, documentation |
| T/F Always verify that you have the correct medication by reading label and comparing to MAR | TRUE |
| What should you pay close attention to that can cause over/under dosing if misread during med administration? | decimal placement |
| The doctor prescribed for 30mg of acetaminophen to be administered rectally. You administered med orally. What is this called? | medication error |
| How many methods should be used for patient identification? | 2 |
| What is the window of time that medications should be administered? | 1-hour window |
| T/F document all meds given or not given | TRUE |
| What should be done if patient questions medication? | It should be thoroughly researched |
| Safety Check 1 | verify medication, dose, route, patient, indication, date and time as you remove med from cart |
| safety check 2 | verify the med, dose, and route against MAR before placing in med cup and returning to drawer |
| safety check 3 | verify the patient, medication, indication, dose, and route at the bedside before opening it and administering it to patient |
| Is it ok to leave meds at patient's bedside or ask someone else to administer for you? | NO, ADMINISTER ONLY WHAR YOU PREPARE |
| tips for preventing med errors | read drug names carefully, read doses carefully especially decimals, never administer a medication you are unknowledgeable about, focus on med prep no distractions, ask for clarification |
| What characteristics should a nurse uphold in regards to administering meds? | honesty and integrity |
| 1st safety check when preparing for med administration | Verify the medication, dose, route, patient, indication, date, and time as you remove the medication from the cart, bin, or computerized cabinet |
| 2nd safety check when preparing for med administration | Verify the medication, dose, and route against the MAR before placing it in the medication cup and returning the container to the drawer, if applicable. |
| 3rd safety | Verify the patient, medication, indication, dose, and route at the bedside before opening it and administering it to the patient. |
Created by:
nursebailey
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