adverse drug event (ADE)

An injury resulting from a medical intervention involving a medication.

adverse drug reactions (ADR)

Unwanted and non-therapeutic effects of the medication. They can range from mild to severe.

A reaction resulting from a hypersensitivity to an antigen or foreign substance, such as a medication.

A glass container that stores liquid medication.

An acute allergic reaction to an antigen that may result in life-threatening shock, producing vasodilation, bronchospasm, and laryngeal edema.

To pull back on the plunger of a syringe after the needle has been inserted, to determine if the needle is within a blood vessel. If it is in a blood vessel, upon aspirating, blood will flow into the syringe

Administration of a tablet by placing it in the oral cavity between gum and cheek.

Following the healthcare provider s instructions, taking the medication according to the treatment regimen.

A mathematical equation used to determine the amount of medication to administer to a client. The equation uses two factors; the desired dose to be administered and the dose that is available.

A mathematical formula used to determine the amount of medication to administer to a client. It is helpful when needing to convert units of measure such as mg to mcg.

Medication must be dissolved in solution before absorption takes place. The dissolution is dependent upon its initial state and route. Dissolution: the process where a gaseous, liquid, or solid phase dissolves in a solvent to form a solution.

A prescribed quantity of a medication consisting of the dose and the frequency.

The amount of the ordered medication.

drug–drug interactions

The effect that two or more drugs that the client is administered have on each other (ex. enhance actions or block actions, increase or decrease ADR etc).

drug–food interactions

Effects of nutrients on the absorption, distribution, metabolism or excretion of medications

Medications administered via the mouth, stomach or intestines.

Medications that are formulated to be dissolved and released in the small intestines for a slower release and can be administered less frequently during the day.

The passage of oral medications from the small intestine to the hepatic circulation via the mesenteric and portal veins flowing into the liver, before reaching systemic circulation.

Non-trademarked name of a drug assigned by the Food and Drug Administration.

Time it takes for the drug to fall to half its strength through excretion.

Intravenous fluid is administered to surrounding tissue as evidenced by pain, swelling, redness, cool skin temperature around insertion site, skin taunt around IV site, oozing of IV fluid at insertion site and repeated alarming of IV pump.

intermittent venous access device

A peripheral IV catheter inserted via a venipuncture. It is placed for administration of intermittent medication administration to prevent a venipuncture being performed each time an intermittent medication is given.

Medication administered via the dermal layers of the skin.

Medication administered into a specific muscle.

Affects the degree of absorption and the rate at which the drug permeates the cell membranes, which ultimately impacts the distribution of a medication.

The formation of small lumps beneath the skin due to irritated fatty tissue.

medication administration record (MAR)

A record of the medications prescribed for the client by the provider. The MAR is used by the nurse to record and confirm medication administration per the prescription.

A container of medication that holds more than a single dose of medication and should be dedicated to a single client whenever possible. If used for multiple clients, they must never enter the client’s room and must be accessed in a clean area only.

Medication administered via the nostrils.

non-time-critical medications

Medications that can be administered between 1 to 2 hr before or after the scheduled time without causing harm or resulting in substandard pharmacologic effects to the client.

orally disintegrating tablets

Drug form that rapidly dissolves on the tongue or oral cavity.

over-the-counter (OTC) medications

Medications that can be purchased without a healthcare providers prescription.

The nurse removes a medication from the automatic dispensing system before the pharmacist has reviewed the order.

Medication administered by a route that does not involve the gastrointestinal tract. Usually refers to an injection and is administered by a needle such as intravenous or intramuscular.

Highest level of a drug in the bloodstream without being at a toxic level.

The study of how a drug works, its relationship to drug concentrations, and how the body responds.

Study of the absorption, metabolism, distribution, and excretion of drugs in the human body.

Inflammation of the vein as evidenced by localized redness, pain, heat and swelling.

Multiple medications that one person is taking.

A medication order written by the provider that includes the name of drug, amount to be give, the route and frequency of administration. The order needs to have the client s name, the date and time the order was written and the provider s name and title.

As needed. medications given as required for specific conditions or issues, such as pain, nausea, etc

Contain inactive chemicals that are activated through metabolism to exert their therapeutic effects.

One method of calculating dosages. It uses ratios, which are expressed as fractions and placed in an equation that allows for the comparison of like units, referred to as proportions.

STAT medication prescriptions

Medications that are required to be given immediately

A medication administered beneath the skin or dermal layer.

Tablets designed to release medication slowly over an extended period.

Medications that can cause fetal defects, pregnancy loss, prematurity or developmental disabilities.

therapeutic drug monitoring (TDM)

Method used by health care providers to monitor drug level concentrations.

The desired effects of a medication.

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ATI Module

Medication Administration Theory (Exam 2)

Question	Answer
adverse drug event (ADE)	An injury resulting from a medical intervention involving a medication.
adverse drug reactions (ADR)	Unwanted and non-therapeutic effects of the medication. They can range from mild to severe.
allergic reaction	A reaction resulting from a hypersensitivity to an antigen or foreign substance, such as a medication.
ampule	A glass container that stores liquid medication.
anaphylaxis	An acute allergic reaction to an antigen that may result in life-threatening shock, producing vasodilation, bronchospasm, and laryngeal edema.
aspirate	To pull back on the plunger of a syringe after the needle has been inserted, to determine if the needle is within a blood vessel. If it is in a blood vessel, upon aspirating, blood will flow into the syringe
buccal route	Administration of a tablet by placing it in the oral cavity between gum and cheek.
compliance	Following the healthcare provider s instructions, taking the medication according to the treatment regimen.
desired over have	A mathematical equation used to determine the amount of medication to administer to a client. The equation uses two factors; the desired dose to be administered and the dose that is available.
dimensional analysis	A mathematical formula used to determine the amount of medication to administer to a client. It is helpful when needing to convert units of measure such as mg to mcg.
dissolution	Medication must be dissolved in solution before absorption takes place. The dissolution is dependent upon its initial state and route. Dissolution: the process where a gaseous, liquid, or solid phase dissolves in a solvent to form a solution.
dosage	A prescribed quantity of a medication consisting of the dose and the frequency.
dose	The amount of the ordered medication.
drug–drug interactions	The effect that two or more drugs that the client is administered have on each other (ex. enhance actions or block actions, increase or decrease ADR etc).
drug–food interactions	Effects of nutrients on the absorption, distribution, metabolism or excretion of medications
enteral route	Medications administered via the mouth, stomach or intestines.
enteric-coated	Medications that are formulated to be dissolved and released in the small intestines for a slower release and can be administered less frequently during the day.
first-pass effect	The passage of oral medications from the small intestine to the hepatic circulation via the mesenteric and portal veins flowing into the liver, before reaching systemic circulation.
generic	Non-trademarked name of a drug assigned by the Food and Drug Administration.
half-life	Time it takes for the drug to fall to half its strength through excretion.
infiltration	Intravenous fluid is administered to surrounding tissue as evidenced by pain, swelling, redness, cool skin temperature around insertion site, skin taunt around IV site, oozing of IV fluid at insertion site and repeated alarming of IV pump.
intermittent venous access device	A peripheral IV catheter inserted via a venipuncture. It is placed for administration of intermittent medication administration to prevent a venipuncture being performed each time an intermittent medication is given.
intradermal	Medication administered via the dermal layers of the skin.
intramuscular	Medication administered into a specific muscle.
ionization	Affects the degree of absorption and the rate at which the drug permeates the cell membranes, which ultimately impacts the distribution of a medication.
lipohypertrophy	The formation of small lumps beneath the skin due to irritated fatty tissue.
medication administration record (MAR)	A record of the medications prescribed for the client by the provider. The MAR is used by the nurse to record and confirm medication administration per the prescription.
multidose vial	A container of medication that holds more than a single dose of medication and should be dedicated to a single client whenever possible. If used for multiple clients, they must never enter the client’s room and must be accessed in a clean area only.
nasal	Medication administered via the nostrils.
non-time-critical medications	Medications that can be administered between 1 to 2 hr before or after the scheduled time without causing harm or resulting in substandard pharmacologic effects to the client.
ophthalmic	Pertaining to the eyes.
orally disintegrating tablets	Drug form that rapidly dissolves on the tongue or oral cavity.
otic	Pertaining to the ears.
over-the-counter (OTC) medications	Medications that can be purchased without a healthcare providers prescription.
override	The nurse removes a medication from the automatic dispensing system before the pharmacist has reviewed the order.
parenteral route	Medication administered by a route that does not involve the gastrointestinal tract. Usually refers to an injection and is administered by a needle such as intravenous or intramuscular.
peak blood level	Highest level of a drug in the bloodstream without being at a toxic level.
pharmacodynamics	The study of how a drug works, its relationship to drug concentrations, and how the body responds.
pharmacokinetics	Study of the absorption, metabolism, distribution, and excretion of drugs in the human body.
phlebitis	Inflammation of the vein as evidenced by localized redness, pain, heat and swelling.
polypharmacy	Multiple medications that one person is taking.
prescription	A medication order written by the provider that includes the name of drug, amount to be give, the route and frequency of administration. The order needs to have the client s name, the date and time the order was written and the provider s name and title.
PRN	As needed. medications given as required for specific conditions or issues, such as pain, nausea, etc
prodrugs	Contain inactive chemicals that are activated through metabolism to exert their therapeutic effects.
ratio and proportion	One method of calculating dosages. It uses ratios, which are expressed as fractions and placed in an equation that allows for the comparison of like units, referred to as proportions.
STAT medication prescriptions	Medications that are required to be given immediately
subcutaneous route	A medication administered beneath the skin or dermal layer.
sustained-release	Tablets designed to release medication slowly over an extended period.
teratogenic	Medications that can cause fetal defects, pregnancy loss, prematurity or developmental disabilities.
therapeutic drug monitoring (TDM)	Method used by health care providers to monitor drug level concentrations.
therapeutic effects	The desired effects of a medication.
therapeutic range	A method used by health care providers to monitor drug concentrations to determine therapeutic dose and avoid toxicity.
time-critical medications	Medications that should be given within either 30 min before or after the scheduled administration time.
toxicity	An adverse effect in which the body is unable to metabolize or excrete a medication; it can cause irreversible damage to organs.
transdermal	Delivery of a specially prepared medication designed to be absorbed by the skin.
trough blood level	Lowest concentration of a medication in the systemic circulation.
unit-dose medication	A medication that is prepared and packaged by the hospital’s pharmacists or the drug manufacturer in a single unit dose container that is specific to the provider’s prescription for the client.
vaginal route	Delivery of a specially prepared medication designed to be absorbed through the vaginal mucosa.
workaround	The practice of avoiding a policy or procedure in a system that is there to protect client safety.
Pharmacokinetics Principles of ADME	Absorption, Metabolism, Excretion
Factors that affect the rate of absorpotion	- Route - Ionization - Dissolution - Blood Flow - Lipid Solubility - Surface area of the absorptive site - Client- specific factors (Pathophysiological process, diseases, or injury, age and son on.
The nurse recently administered oral medications to a client who notified the assistive personnel (AP) that they just vomited. Which of the following actions should the nurse take first?	Inspect the vomitus for any presence of the medication
Distribution	is the process of medication delivery to the target organ or tissues following absorption into the circulatory system
Distribution is affected by	the client’s circulatory status or blood flow and the medication’s solubility and protein-binding ability.
affects onset and duration of effect.	Highly vascular areas such as the heart, brain, liver, and kidneys receive the greatest blood supply, with the bones, skin, and adipose tissue receiving a lesser amount
Metabolism, or biotransformation	s the chemical process of converting a medication’s structure. Metabolism can result in amplified medication activity, inactivation of the medication, or increased excretion via the kidneys, and it can toxicity levels of medications.
Most medications are metabolized in	the liver, although the kidneys and sections of the small intestine may also be responsible for some medication metabolism.
clients with kidney and liver disease	may have a slower rate of medication clearance
Medications are transformed by a group of liver enzymes, known as	cytochrome P-450
The CYP enzymes found on liver cells play a role in medication metabolism by	regulating the rate at which a medication is broken down and the amount of time the medication stays in the body.
Excretion is the process by	which a medication is removed from the body
the primary organ responsible for medication excretion	The kidneys. The skin, lungs, exocrine glands, liver, mammary glands, and intestines excrete medications to a lesser extent
The rate of medication excretion is affected by	kidney, heart, and liver function, which influence the medication’s concentration in the body.
TDM is used for	those medications that have a narrow therapeutic window as a means of providing adequate and safe medication administration without causing an adverse medication reaction.
What will guide the health care provider in maintaining therapeutic medication levels	Peak and trough blood levels
The concentration of a medication is within the therapeutic range when	the medication produces the desired effects
Onset of action	is the time the medication takes to produce a therapeutic effect after its administration.
The peak effect	occurs when absorption is complete, the medication is distributed throughout the body, and the medication is at its highest concentration
Duration of action	comprises the period of time for which the medication maintains its therapeutic effects.
Receptors	are molecules that are found on the cell membrane or within the cell cytoplasm and are responsible for chemical signaling between and within cells
cell receptor can either activate or inactivate a receptor.	Activation has the potential to increase or decrease a specific cell function.
agonist	A medication that activates receptors to initiate a preferred response
antagonist	medication that prevents the activation of a receptor
Before administering medications, the nurse must assess	contraindications, relevant laboratory values, appropriate vital signs, allergies, and potential medication interactions of the medication
Serious and/or unexpected ADEs and ADRs should be reported to	the FDA through appropriate reporting systems (institutional processes and/or the FDA’s MedWatch program) to improve safety outcomes, revise medication labels and warnings, and, when needed, withdraw medications from the market.
A boxed warning (often called a “black box warning”) is	used in prescribing information to highlight the serious risks of a medication
The initial treatment for a client experiencing an allergic reaction is to	discontinue the medication immediately.
Stevens-Johnson syndrome (SJS)	It is a severe cutaneous adverse reaction that is usually medication associated and typically develops within days to weeks after starting the causative medication.
The nurse’s role related to allergic medication reactions	check allergies before administering a medication, recognizing and responding to suspected reactions, stop the medication and initiating emergency response, documenting the incidence of the reaction, and notifying the health care provider of the reaction
A nurse is reviewing actions to be taken to address medication interactions with a newly licensed nurse. Which of the following nursing actions are appropriate when addressing medication interactions?	Using facility-approved medication reference resources to screen for interactions. Reviewing the client’s medication list for concurrent use of herbal supplements Communicating identified interaction concerns to the provider and pharmacist
factors may influence the individual response to a given medication	developmental changes, age, weight, gender, ethnicity, genetics, nutritional status, and disease states.
teratogenic substances	include alcohol, angiotensin-converting enzyme (ACE) inhibitors, anticancer medications, cocaine, lithium, nonsteroidal anti-inflammatory drugs (NSAIDs), streptomycin, tetracycline, and warfarin.
A nurse is caring for an older adult client who is taking multiple medications. Which of the following nursing actions support safe medication administration considering age-related physiological changes?	- Review medication list for potential drug-drug interactions. - Monitor for medication toxicity, - Adjust medication dosages based on age-related physiological changes. - pharmacists to assess the appropriateness of the medication regimen.
All clients have the right to	expect their health care team and facility to deliver quality care and provide a safe environment
One of the major processes to promote safety	is the rights of medication administration.
rights of medication administration, to ensure safe practices	Right client Right medication Right dose Right route Right time Right assessment Right documentation Right to refuse Right education Right evaluation
Right client:	Verify the client’s identity using two client identifiers.
Right medication:	Confirm the name and form of the medication is correct.
Right dose:	Check medication and dosage against the order in the client’s medical record.
Right route:	Confirm the route of medication per the provider’s order in the client’s medical record.
Right time:	Confirm the time medication is to be given and the last time the medication was administered.
Right assessment:	Confirm the client’s medication allergies, that the medication is appropriate for the client’s condition, and any drug–drug or drug–food interactions that may need addressed. Check lab work or vital signs, per the medication.
Right documentation:	Document the time the medication was administered and any other pertinent information.
Right to refuse:	The client has the right to refuse the medication.
Right education:	Provide education to the client addressing the name of the medication, the expected benefits, and the potential adverse medication effects.
Right evaluation:	Check the client’s medications to determine if an untoward interaction may occur. Monitor the client’s response to the medication.
The nurse is preparing to administer medications to a client. The pharmacy has delivered the correctly prescribed medications, but they are labeled with another client’s name and medical record number. What action should the nurse take?	Collaborate with the pharmacist
This three-check procedure should occur at the following times during medication administration.	When the medication is obtained by the nurse from the client’s medication drawer or from an automated medication dispensing machine During preparation of the medication At the client’s bedside immediately prior to administration
A complete medication prescription (medication order) should contain the following information:	client’s name, date/time that the prescription was written, medication name (generic), dosage, route of administration, frequency, and provider’s identification (name/credentials or electronic signature)
The goal of medication reconciliation is to	develop, update, coordinate, and communicate accurate client medication information during transitions of care.
A nurse is admitting a client to the medical surgical unit. Place the steps of the medication reconciliation process in the correct order as performed by the nurse.	-document a complete list of home medications -Compare home medication list with new medications - Reconcile discrepancies between home medications and current - Update the MAR and repeat the process. -Communicate MAR to the next provider. - Educate
three factors reported by nurses as contributing to medication errors are	identification, interruption, and correction
high-alert medications include	opioids, antithrombotics, insulins, and injectable potassium chloride.
A nurse is reviewing the factors contributing to medication errors	Interruption, identification, corrections, Workarounds, Hight-alert medications
Interruption what is the appropriate risk reduction strategies.	Minimize disruptions during medication preparation and administration.
what is the appropriate risk reduction strategies for identification	adhere to the rights of medication administration and enhance knowledge about medications
what is the appropriate risk reduction strategies for High-alert medications	Follow established safeguards and protocols for medication with increased risk of harm
what is the appropriate risk reduction strategies for workarounds	Follow policies and procedures without taking shortcuts
what is the appropriate risk reduction strategies for corrections	Pay attention to alerts and warnings and avoid ignoring them
Oral unit-dose medications:	May be opened at the bedside immediately before administration after verifying the client’s identity and the medication. They must be administered promptly and never left unattended at the bedside.
Parenteral medications (IV, IM, subcutaneous):	are prepared using aseptic technique in a designated clean medication preparation area, not at the bedside, and are administered promptly after preparation. Bedside preparation is reserved only for emergent or life-threatening situations.
A nurse is preparing to administer medications to a client. Which of the following actions should the nurse take to support safe medication administration?	-Perform hand hygiene and apply gloves as needed before preparing and administering medications. - Prepare all unit dose medications at the bedside and open them immediately prior to administration.
Appropriate medication administration actions include	pening oral unit-dose medications at the bedside immediately before administration and documenting required assessment findings, such as vital signs, before leaving the bedside.
The three major categories of medication administration are	enteral, parenteral, and topical
Enteral administration refers to	delivery of medications through the GI tract
parenteral administration refers to	delivery of medications by injection or infusion that bypasses the GI tract
Topical administration refers to	application of medications directly to the skin or mucous membranes, primarily for local effects.
The oral route is the most	convenient, costs less, and is typically a safer route of medication administration.
Enteric-coated, sustained-release, and extended- or delayed-release medications and capsules should	not be crushed or opened, as adverse effects can result in adverse effects or reduced therapeutic effect.
An enteral feeding tube (EFT) is placed for	unable to absorb nutrition or medications through the GI tract or to deliver nutrition and medications to clients who are unable to take them in through the oral cavity.
different types of EFTs	inserted surgically through the abdominal wall into the stomach (gastrostomy tube [GT]) or into the jejunum (jejunostomy tube [JT]). through the nose(nasogastric (NG) tube), which is placed into the stomach, or a nasoduodenal (ND) tube, (duodenum)
after Ophthalmic Medication Administration	Punctal occlusion improves eye drop effectiveness by preventing medication from draining into the nasal passages and bloodstream.
Otic medications	Never administer cold solutions into the ear canal. Prior to instilling the eardrops, pull the pinna up and back. Position the client in a side-lying recumbent position with the affected ear facing up
Nasal medications	For these nasal medications to be absorbed, the nostrils must be clean of mucus. Decongestant nasal sprays can be purchased as OTC medications for the treatment for congestion
If the nasal decongestant is used too frequently or for too long, the client can experience	rebound congestion. the blood vessels in the nose narrow, causing the inside of the nose to shrink. Once the effects of the nasal spray wear off, the nasal tissue swells. Permanent swelling of the tissue with continued use of the nasal spray.
Syringes are designed to have	either a Luer connection tip or a non-Luer tip
the difference between insulin and TB syringes	The units of measurement are different on the syringes, and the length of the needle is shorter on the TB syringe
Insulin syringes	are specifically designed for U-100 insulin and are commonly available in 0.3 mL, 0.5 mL, and 1 mL sizes, allowing the nurse to match syringe capacity to the prescribed insulin dose for accurate measurement
Tuberculin (TB) syringes	hold a maximum of 1 mL and measure medication in hundredths of a milliliter, making them appropriate for precise intradermal dosing.
Luer-lock syringes	allow the needle to twist and lock securely onto the syringe tip,
non-Luer (slip-tip) syringes	permit the needle to slide on and off without a locking mechanism
Safety needles	used for intramuscular, subcutaneous, or intradermal injections incorporate protective guards or auto-retract features to reduce the risk of accidental needlestick injury.
Needleless systems	re used for intravenous medication administration and allow the nurse to deliver medications through an established IV access port without using a needle, reducing occupational exposure risk.
For most intramuscular and subcutaneous injections in adults, the CDC recommends	22 to 25G needles
Needle length should be chosen based on	the injection site, the size of the muscle, and the amount of fatty tissue over that area, as well as the volume to be given and the technique needed.
The intended route/purpose of administration determines	how deep the needle must enter—into the dermis for intradermal injections, the fatty tissue layer for subcutaneous injections, or the muscle for intramuscular injections
A nurse is preparing to administer parenteral injections to clients. Which of the following should the nurse consider when selecting the appropriate needle size?	- The type of the injection - The viscosity of the medication
Three types of parenteral injections require the nurse to insert a needle into a specific location of the client’s body to deliver a prescribed medication:	intradermal injection, subcutaneous injection, and intramuscular injection.
Parenteral Injections the nurse now needs to understand:	- How to locate the anatomic site of injection - The angle and depth of the needle insertion - Any medication-specific interventions that should be implemented - Use of relaxation techniques to help relax the muscle for intramuscular injection
A fourth type of parenteral injection requires the nurse to deliver the medication directly into	the bloodstream through a peripheral or central intravenous catheter and IV tubing
Medications given by the subcutaneous route	delivered into the adipose tissue, Common medications administered subcutaneously include insulin and low-molecular-weight heparins. injection should be pinched to reduce the risk of administering the medication into the muscle
Subcutaneous route angle of the needle	can be anywhere between 45° and 90°, depending on the amount of estimated adipose tissue.
The intramuscular (IM) route permits medication	large skeletal muscle, where a faster rate of absorption can be achieved and a larger volume of medication . Three muscles are commonly used for IM injections: vastus lateral, ventrogluteal, and deltoid
The nurse should select the site, the syringe size, and needle size for IM injection based on the following factors.	The age and size of the client The amount of medication to be given The condition of the anticipated site
Routine aspiration during intramuscular (IM) injections ((NOT recommended procedure))	apply gentle negative pressure for 5 to 10 seconds and watch for blood return. If blood is present, do not inject. Instead, withdraw the needle; dispose of the medication, syringe, and needle; and prepare another dose of the medication.
Appropriate IM administration includes	electing recommended sites such as the ventrogluteal muscle for viscous medications, avoiding compromised or inflamed tissue, and administering injections at a 90° angle to ensure medication delivery into muscle tissue.
IV medications can be given	-intermittently via piggyback—that is, diluted in a large volume of IV fluid - infused by gravity or infusion pump—over a period of time - PUSH a small amount of med slowly, directly into the client’s IV catheter, closest to the point of insertion.
method of administration, termed IV push, is used to	rapidly treat a life-threatening condition, to quickly achieve a therapeutic level of a medication, and to avoid fluid overload in clients who have cardiac or renal disease.
Administration of medications via piggyback allows medications to be	infused at a controlled rate using gravity or an infusion pump that otherwise could be harmful to the client if delivered rapidly or undiluted.
An intermittent venous access device is a	peripheral IV catheter inserted via a venipuncture. This approach avoids the need to perform a venipuncture each time an intermittent medication is given
Central venous access devices (CVADs) are	atheters inserted into a large centrally located vein for the purpose of administering blood products, medications, fluids, and other therapies. Medications given through CVADs are delivered directly into the client’s central blood circulation.
Types of CVADs include	peripherally inserted central catheter (PICC) and the surgically placed central venous catheter (CVC).
To prevent infiltration of the medication	the nurse should check for a venous blood return from the venous access device. If blood return is seen in the catheter, syringe, or tubing, this confirms that the catheter is in a vein.
To prevent the development of phlebitis	properly secure the IV catheter to avoid movement of the catheter, which could cause mechanical irritation to the vein. Some medications can also be irritants to the vein.
cues of infiltration	discoloration, pain, edema, and cool skin around the IV site
preferred site for infants	is the vastus lateralis muscle in the anterolateral thigh. no more than 0.5 mL should be injected at this site. smallest-gauge (25 to 25G). length of needle 1 inch for infants from 1 month to 1 year of age and 5/8 inch for neonates. 90° angle.
Client-teaching strategies include	using open-ended questions, applying active listening skills, and using the teach-back method to assess understanding.
Health Literacy	Ability to understand and use health information
Nurse Evaluation	Uses teach/back return demonstration to determine if further education is needed
Sixth- Grade Reading Level	Recommended readability for client education material to support comprehension
Teach- back method	Client explains medication information in their own words after teaching
Client Education	Promotes client understanding and meaning collaboration with health care personnel
Return Demonstration	Client performs a taught medication related skill (insulin administration)
Provide client education as needed.	Medication name and purpose Potential adverse effects Procedure for the administration medication Verify client’s understanding and their right to refuse.
Document the care provided as applicable.	Date and time Nurse’s initials/signature Medication, dose, and route Findings (for example, apical heart rate for a client receiving digoxin) Client education provided Client’s response to medication Unexpected outcomes and notification of provider

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