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Review 2-Pharm
PharmacoLOGY
| Question | Answer |
|---|---|
| The six rights of drug administration | Right patient, right drug, right dose, right route, right time & right documentation |
| 2 methods of identifying the patient | check the patient's name on wristband or ask the patient to identify him/herself |
| The provider's order must include | name, drug name, dosage form and route, dose to be administered, frequency of administration and provider's signature |
| Nursing consideration before administering a drug to a patient | Allergy history, previous adverse reactions, patient comments, change in patient condition |
| Given when the patient is to receive the drug as prescribed on a regular basis | Standing Order |
| Administer the drug one time only | Single Order |
| Administer the drug as needed | PRN Order |
| One time order given as soon as possible | STAT order |
| Non profit organization that studies medication errors and their prevention | The institute for Safe Medication Practices (ISMP) |
| Method of dispensing medications in which drug orders are filled and medications are dispensed to fill each patient's medications orders for a 24 hr period | Unit Dose system |
| Drug dispensing systems that frequently used in nursing homes and small hospitals | Floor stock |
| The most frequent route of drug administration and rarely causes physical discomfort in patients | Oral route |
| Parenteral Route | Subcutaneous, Intramuscular, Intravenous, Intradermal |
| Sensitivity Testing (tuberculin test/allergy test) | Intradermal route |
| Intradermal injection sites | inner part of the forearm & the upper back |
| intradermal injection syringe & needle size | <0.5 mL with 26-27 gauge needle, 1/4 to 5/8inch long |
| Intradermal injection degree angle | 10-15 |
| Injection produces a small wheal (raised area) on the outer surface of the skin | intradermal injection |
| A type of injection that places the drug into the tissue between the skin and the muscle | Subcutaneous injection |
| Subcutaneous injection sites | the upper arm, the upper abdomen, the upper thighs |
| Subcutaneous injection angle | 45 or 90 degree angle |
| Subcutaneous syringe and needle size | 0.5 to 1 mL with25-30 gauge needle, 3/8 to 5/8 inch long |
| Space in the mouth between the gum and the cheek in either the upper jaw or lower jaw | Buccal |
| 90 degree angle injection | intramuscular |
| Aspiration is not necessary | Intradermal Injection |
| Place pressure on the area after removing the needle | Intramuscular, Subcutaneous, Intravenous |
| Absorption is slow and allows for good results when testing for allergies or administering local anesthetics | Intradermal Injection |
| The area should be hairless | Intradermal injection |
| Aras near moles or scars or pigmented skin should be avoided | transdermal injection |
| The nurse should not aspirate the syringe or massage the area | Intradermal injection |
| Drugs commonly give by the subcutaneous route | Heparin, Insulin |
| Aspiration is not recommended when administering this drug | Heparin |
| Drugs given by this route are absorbed more rapidly than drugs given by the SC route because of the rich blood supply in the muscle | Intramuscular injection |
| An administration of drug into a muscle | Intramuscular injection |
| 3 mL, 22 gauge needle, 1 1/2 inches long | Intramuscular syringe |
| injecting the ventrogluteal & dorsogluteal muscles (patient position) | prone position |
| injection of drug into the vastus lateralis (patient position) | Recumbent position |
| This method of IM injection is used when a drug is highly irritating to SC tissues or has the ability to permanently stain the skin | Z Track Technique |
| Iron, chepalosporins | Z Track Technique |
| Draw the drug up into the syringe, discard the needle and place a new needle on the syringe, pull the plunger down to draw approximately 0.1 to 0.2 mL of air into the syringe | Z Track Technique |
| A drug administered by the IV route is injected directly into the blood by a needle inserted into a vein | Intravenous Injection |
| Drugs administered by the IV route may be given rapidly | IV Push |
| Situations that require consideration before a drug is given | Problems associated with the drug, comments regarding the drug, change in patient's condition |
| Nursing teaching for pt before taking oral medication | Advise the patient to take a few sips of water before placing the tablet/capsule in the mouth |
| 1 gr equals mg | 60 mg |
| Determine whether shaking or dilution is required. The meniscus (lowest fluid line) is at the level of the desired dos | Liquid, suspension and elixirs |
| Patches should not be cut to prevent underdosing/overdosing | Administering the transdermal medication |
| Apply with a glove, tongue blade, or cotton-tipped applicator. Never apply with bare hand | Topical |
| Instruct the client to have medication remain in place until absorb. Client should not eat/drink while tablets is in place | Sublingual/buccal |
| Type of technique when instilling medications in eyes | Surgical Aseptic technique |
| If the client asks for PRN medication | Assess the symptoms that prompted the client's request |
| Medication administration by way of the digestive tract | Enteral |
| Medication administration into part of the body other than by way of gastrointestinal tract | Parenteral |
| Disadvantage of oral drug administration | Slower absorption rate, slower onset of action |
| All syringes consist of three parts | tip, barrel, plunger |
| Needles consist of three parts | hub/hilt, shaft, bevel |
| When injecting more than 1 mL subcutaneously | the dose is divided into two syringes and administered in 2 injections. |
| A glass container that holds a pre measured single medication dose | Ampule |
| A glass container equipped with a self-sealing rubber stopper, may contain pre measured or multi dose medication | Vial |
| Do not use the subcutaneous route | if the volume of medication is greater than 1 to 2 mL |
| Type of injection given in the muscles situated below the dermal and subcutaneous skin layers | Intramuscular Injection |
| Dorsogluteal | Back of hip |
| Ventrogluteal | Side of hip |
| Deltoid | Upper arm |
| Vastus lateralis | side of thigh |
| Rectus Femoris | Anterior thigh |
| Best type injection when medication given less deeply irritate the client's tissues or when large amounts of medications are necessary | Intramuscular Injection |
| maybe used for some cancer immunotheraphy injection | intradermal |
| the site of injection that is recommended for infants and children <2 of age | Vastus lateralis |
| the site of injection that is recommended for children after 2 years | ventral gluteal |
| what kind of syringe for solution volume <0.5 mL | tuberculin syringe |
| type of injection appropriate for small doses of non irritating , water soluble medication | subcutaneous |
| type of injection appropriate for irritating medication , solution in oils and aqueous suspension | intramuscular |
| type of medication that is stored in refrigerator | suppositories |
| what nursing intervention should be performed to minimize risk of skin irritation when administering drugs by the transdermal route? | remove the old patch for next dose |
| The correct site for subcutaneous injection for thin patient | Upper abdomen |
| two types of drugs that are often associated with errors | heparin and insulin |
| Nurses are responsible for which part of the drug distribution process | administering |
| the escape of fluid from a blood vessel into surrounding tissues while the needle or catheter is in the vein | Extravasation |
| What is the formula for an infusion regulator? | mL/hr |
| The higher the gauge | the smaller the needle |
| Where do you put eye ointment? | conjuntiva sac |
| the longest absorption time of all parenteral routes | Intradermal route |
| IV solution infuses into tissue instead of the vein | infiltration (swelling) |
| Swelling around the needle may indicate one of two things | Extravasation and infiltration |
| inner diameter of the needle | gauge |
| how long do you aspirate for IM injection | 5-10 secs |
| What is a sign that an IV has infiltrated the tissue? | swelling |
| how many doses in an ampule | single dose |
| subcutaneous injection sites | outer aspect of the upper arm, the abdomen, the anterior aspect of the thigh, the upper back, the upper gluteal area |
| can you pinch the or bunch the skin for subcut injection? | When the pt is thin or the long needle is used. once needle is inserted, release the skin |
| Nebulizer | Converts liquid to droplets, open airways to work on respiratory |
| eye drop application position | fowler's or semi fowlers |
| when selecting a site for IM injection, what are the consideration | age of the patient, medication type and volume |
| complication incorrect of IM injections | abscesses, cellulites, injury to blood vessels, bones and nerves, lingering pains, tissue necrosis and periostitis |
| IM injection recommended site for infant | vastus lateralis |
| IM injection recommended site for toddlers/children | vastus lateralis or deltoid |
| IM injection recommended site for adult | ventrogluteal or deltoid |
| IM injection recommended site for medications that are known to be irritating, viscous or oily solution | ventrogluteal |
| most common IM injection sites | dorsogluteal(back hip), ventrogluteal (side of hip), deltoid (upper arm), vastus lateralis (side of thigh), rectus femoris (anterior thigh) |
| to use dorsogluteal site | assist the client to a side lying or prone position, if on the side, bend the knees, if on the stomach point the toes inward |
| ventrogluteal site is less painful and safer than? | dorsogluteal site |
| 1 mL is the maximum size for this site | deltoid site |
| rotating insulin injection is very important because insulin can to do what? | atrophy tissue (lipodystrophy) |
| Z track method only for this site | gluteal |
| can you massage the site after z-track method? | No |
| when checking the order what should we know about the medication | what the common doses are |
| how many times do we check the MAR? | 3 times |
| what is special about administration of heparin | always confirm with another nurse |
| how much air do we put in a vial, before taking the medication out? | the exact amount that you are taking out |
| if the infusion time is less than 1 hour, what is the formula? | total mL ordered over/total min ordered x 60 min/h=mL/h |
| what medication we do not aspirate | TB, insulin, heparin, z track |
| what volume is used for a typical subcut inject? | 0,5 - 1 mL, if more than 1 mL is ordered though subcut, the injection is given in 2 sites |
| which muscle is least often used for IM injection? | deltoid |
| why do we use z track | to deeply seat the medication |
| what site do we inject the z track | gluteus maximus |
| you would use an 18 gauge needle for | an IV |
| how much air do you add to seal an IM shot? | 0,1 to 0,2 mL air |
| what does the syringe have? | calibrated mL except for insulin |
| lour lock means? | the syringe has a screw on the hub |
| how many doses in a vial | multiple |
| when do change the needle for ztrack | after drawing the medication |
| when is the best time to give a vaginal suppository | before bedtime |
| how frequently do you change a hep lock | every 72 hrs |
| what position do you place the patient for a rectal suppository | left sims |
| what position do you place the patient in for a vaginal suppository | lithotomy |
| how long should a patient hold their breath with an inhaler | 10-15 seconds |
| how long do you have to wait to administer a 2nd puff? | 1 min |
| what is the disadvantage of the oral route | hydrocloric acid breaks down |
| enteral route | oral, orogastric, nasogastric, sublingual, buccal, rectal |
| ampules | flick top to get air out, use gauze to break off, use one time filtered needle, unused portion throw away |
| how far do you inset vaginal meds? | 2 inches |
| disadvantage of IV administration | fluid overload, air embolism, septicemia, hematoma, pain, hypersensitivity, thrombophlebitis, infection |
| when giving a piggy back medications? | check compatibility with main solution, that no interaction with result |
| what does a plunger have> | a flange |
| how much fluid do you use to flush the g-tube? | 2 to 4 mL |
| which injection would you not massage? | ID and z track |
| when MDI is not effective | when you do not hold your breath in |
| how long do you press the naso-lacrimal sac? | 1-2 min |
| nitroglycerin is commonly given by | sublingual route |
| when do you confirm the right medication with MAR? | when you remove the meds from the storage area, when placing it in the meds cup/envelope, when opening the meds unit/dose package at the client's bedside |
| what is the greatest error in medication error? | Not reporting the error |
| two drugs may potentiate each other | potentiation |
Created by:
ninjania
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