Unit III-1
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| Are most NPA (Nurse Practice Acts) narrow or broad and why? | Broad. to nurses' professional abilities are not limited.
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| What are the five factors that influence absorption (the passage of med molecules into the blood from the site of medication administration)? | 1. route of admin
2.ability to dissolve
3. blood flow to admin. site
4. body surface area (BSA)
5. lipid solubility of med.
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| Meds placed on these two sites are quickly absorbed because these tissues contain many blood vessels. | 1. mucous membranes
2. respiratory airways
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| This site of admin. produces the most rapid absorption because meds are immediately available when they enter the systemic circulation. | Intravenous (IV) injection
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| What two things does the ability of an oral med to dissolve depend largely on? | form or preparation
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| Which form does the body absorb more quickly? Solutions and suspensions in a liquid state or a tablet/capsule? | solutions and suspensions in a liquid state
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| What causes a site to more quickly absorb medication? | a richer blood supply
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| What explains why the majority of meds are absorbed in the small intestine and not the stomach? | when the medication comes in contact with a larger surface area it is absorbed at a faster rate
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| do highly lipid-soluble meds cross cell membranes more or less easily/quickly? | more quickly and more easily because the cell membrane has a lipid layer.
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| What can or cannot medications bound to albumin do? | they cannot exert pharmacological activity
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| Why are older adults (or patients with liver disease/malnutrition) at more of a risk for increased medication activity and/or toxicity? | because they have lower albumin levels and therefore more "unbound" medication.
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| After medications are metabolized, they exit the body through which 5 parts of the body? | 1.kidney
2.liver
3.bowel
4.lungs
5.endocrine glands
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| When do adverse effects occur? | some are immediate, whereas others take weeks or months to develop
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| When do toxic effects occur? (Note: 2 part answer) | 1.after prolonged intake of a med
2.when med accumulates b/c of impaired metabolism/excretion
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| What treats medication toxicity? | antidotes
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| which class of meds cause a high incidence of allergic reactions? | antibiotics
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| What are the 4 characteristics of anaphylactic reaction? | 1. life threatening
2.sudden constriction of bronchiolar muscles
3.edema of the pharynx/larynx
4.sever wheezing/shortness of breath
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| What are the four major sites of parenteral medication administration? | 1. intradermal
2. subcutaneous
3. intramuscular
4. intravenous
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| When are epidural (spine) meds usually used? | regional analgesia for surgical procedures
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| when are intrathecal (subarachnoid) meds usually used? | with long-term medication administration through surgically implanted catheters
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| When are intraosseous meds used? | 1. Commonly used with infants and toddlers who have poor access to their intravascular space
2. when an emergency arises and IV is not accessible
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| When are intraperitoneal meds usually used? | to give chemotherapeutic agents, inslin, and antibiotics
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| When are intrapleural meds usually used? Note: 2 answers | 1.chemotherapeutic agents
2.persistent pleural effusion
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| When are intra-arterial meds usually used? | Continuous infusion of clot-dissolving agent for arterial clots.
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| What is an intraarticular med? | A med that is injected into a joint.
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| Do topical meds usually have localized or systemic effects? | Localized
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| When does a topic med result in a system effect? Note:3 answers | 1. a patients skin is thin or broken down
2. the medication concentration is high
3. contact with the skin is prolonged
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| Meds are administered to mucous membranes in five ways, what are they? | 1. Directly applying(eyedrops, garggling)
2.Insertion into body cavity (suppository)
3.Instilling fluid into body cavity (eardrops, nose drops)
4. Irrigating body cavity (flushing eye, ear.fluid is NOT retained)
5. spraying (instillation in2 nose)
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| What percent of drug errors is due to the similarity of drug names? | 25%
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| When should verbal communication of prescriptions be used? | urgent situations
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| Which agents should under NO CIRCUMSTANCES be prescribed verbally? | antineoplastic
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| When does a now order need to be given. | Quickly, but not right away (as for a STAT order)... the nurse has up to 90 minutes to administer a NOW ORDER
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| When should a part of med administration be delegated to nursing assistive personnel? | Never
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| What are the first two steps a nurse must take when a medication error has occured? | 1. assess patient/notify health care provider
2.reports the incident (to manager or supervisor)
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| When does a medication error occurence report become part of the patient's medical record? | Never
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| Does a medication error need to be reported when it does not cause any harm to the patient? | Yes. All medication errors must be reported.
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| When does medication reconciliation occur? | Whenever a nurse admits a new patient to ah atlh care setting, she compares the medications that hte patient took in the previous setting with his or her current medication orders.
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| When a patient is being discharged to another health facility, what should a nurse do in regards to the patient's medication? | Communicate the patient's current medications
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| When a nurse is unfamiliar with a medication who should she consult? Note: 4 answers | 1. expert nurse
2. pharmacist
3. prescriber
4. medication book
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| What should a nurse carefully review prior to administering medication? Note; 4 answers | 1. history
2.physical exam
3. orders
All found in the patients medical record.
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| 6 Rights? | patient, drug, dose, time/frequency, route, documentation
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| What are three things a nurse must assess about her patient regarding med admin by trying to better understand what three things? | 1. their current med routine
2. ability to afford meds
3. beliefs and expectations
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| What is an effective dosage schedule planned around, keeping in mind patient-centered care. | Their diet: eating patterns and food preferences
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| When assessing a patient's attitude about medication use it is always important to observe the patient's behavior for evidence of what two things? | dependance/avoidance
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| It is unlikely for a patient to adhere to medication schedules if they lack what two things? | motivation and knowledge
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| What are some nursing diagnosis that can be applied to a patient during med admin? Note: 8 answers | 1. anxiety
2. ineffective health maintenance
3. readiness for enhanced immunization status
4.deficient knowledge
5.disturbed visual sensory perception
6. impaired swallowing
7.effective therapeutic regimen management
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| Which medication should be administered first if a person has high blood pressure? | blood pressure medications should be administered first
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| When teaching a patient about insulin and its side effects, in which order should the nurse teach the patient? | Hypoglycemia is a serious side effect of insulin and therefore the nurse should first teach the patient how to identify and treat hypoglycemia and then go on to teach how to administer an insulin injection.
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| Who usually reinforces the importance of medication regiments in the home setting? | family members
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| When should a med be administered to a sleeping child? | never
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| How can you reduce pain perception with children? | distraction
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| What two things should be checked before an NG med is administered? | 1. placement of NG tube
2. stomach contents residual amount
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| What needs to be done with meds before administered through NG tube? | crushed and mixed with water
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| After meds are instilled in NG tube, what must be done? | water must be instilled to clear the tube
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| If NG is connected to suction, what must be done after med administered? | Wait for 20 minutes for meds to be absorbed then reconnect suction
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| What is a stock supply? | Meds are available in large quantities in stock containers (narcatoics, tylenol
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| What is a unit-dose system? | Portable carts that are stocked with 24-hour supply of medications for each client
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| What is the most desirable way to administer a drug? | orally
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