Test Mod A
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| MAR | Medication Administration Record
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| PRN | when needed/as needed
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| Safe Administration | 1. Wash hands
2. Check MAR
3. New Order
4. Check allergies
5. One patient at a time
6. Check SEVEN rights
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| Seven Rights of Medication Administration | Drug, Dose, Document, Route, Reason, Patient, Time
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| Enteral Medications | oral, sublingual, buccal, NG, G-tube, rectal
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| Parenteral Medications | IV, subcut, IM, intradermal
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| Topical Medications | eye, ear, nose, inhaled, meds to skin, vaginal
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| Considerations when administering a medication | -proper timing
-proper administration: with/without food
-NPO or testing
-LOC/swallowing ability
-current health status
-storage considerations
-troubleshooting
-right to refuse
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| NPO | nothing by mouth
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| Intravenous | directly into the blood stream
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| Intramuscular | directly into the muscle tissue
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| High Alert Medications | medications & classifications that pose significant risk in the acute clinical setting
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| Consent form | grants permission to the health care facility and provider to provide treatment
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| Order form | all procedures & treatments ordered by a physician. Includes: general care, tests, results, etc.
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| Graphic record | the manual recording of temperature, pulse, respiration, blood pressure and pain
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| Kardex Records | large index type card that is usually kept in a flip file/separate folder that contains pertinent information (e.g.: name, dx, allergies, history, and nursing care plan)
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| Narcotic control systems | policy that controlled substances are issued in a single-unit package and kept in a lock cabinet
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| Unit-dose | use single-unit packages of drugs that are dispensed to fill each dose requirement as it is ordered
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| Prescription must contain | -patient's full name
-date
-drug name
-route of administration
-dose
-duration of order
-signature of provider
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| Stat Order | drug used on emergency level, be administered A.S.A.P. but only once
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| Single Order | administration at a certain time, but only once
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| Standing Order | a medication is to be given for a specified number of doses (e.g.: cefazolin 1q q6h x 4 doses)
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| Medication Errors | the failure of a planned action to be completed as intended or the use of a wrong plan to achieve a goal
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| Adverse Drug Events | serious complications from medication errors
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| Percutaneous Administration | refers to the application of medications to the skin or mucous membrane
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| Parts of a syringe | -Tip
-Barrel
-Plunger
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| Parts of a needle | -Hub
-Shaft
-Bevel
-Needle cover
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| Drug Routes | IM - intramuscular
IV - intravenous
PO - by mouth
SC - subcutaneous (subcut)
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| Nursing Responsibilites | -know expected therapeutic effect
-know nursing implications
-educate patient: REPORTABLE signs and symptoms
-7 rights (and allergies)
-3 label check
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| Buccal (dissolvable) | between the cheek and lower molar teeth: rapid absorption
(no swallowing, chewing or water)
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| Sublingual (dissolvable) | under the tongue: rapid absorption
(no swallowing, chewing or water)
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| Ophthalmic | medications for use in the EYES only
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| Otic | medications for use in the EARS only
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| Nasal Solutions | nose drops or sprays
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| Aerosols | flow of air or oxygen under pressure to disperse the drug throughout the respiratory tract
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| Intravaginally | administration of medications into the vagina
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| Douches | irrigation fluid to wash the vagina
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| 3 routes of drug administration | Enteral
Parenteral
Percutaneous
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| Capsules | small, cylindrical, gelatin containers that hold dry powder or liquid medicinal agents
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| Time-released capsules | (sustained) provide a gradual, but continuous release of a drug because the granules in the capsule dissolve at different rates
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| Pills | capsules/tablets
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| Tablets | dried powdered drugs that have been compressed into small disks
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| Caplet | tablet shaped in the form of a capsule
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| Orally disintegrating tablet | tablet that rapidly dissolves, under tongue, buccal, or on top of the tongue
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| Elixirs | clear liquids that are comprised of drugs that have been dissolved in alcohol and water
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| Emulsions | dispersions of small droplets of water-in-oil or oil-in-water (gelatin)
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| Suspensions | liquid dose forms that contain solid, insoluble drug particles dispersed in a liquid base
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| Syrups | contain medical agents that have been dissolved in a concentrated solution of sugar
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| Unit-dose packaging | single-use package that provides a single dose of medication in one packet that is ready for dispensing
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| Souffle' Cup | small paper cup that is used to transport solid medication forms such as capsules and tablets to the patient to prevent contamination by handling
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| Medicine Cup | plastic container for measuring liquids
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| Medicine dropper | used to administer eye drops, ear drops, and occasionally pediatric medications
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| Teaspoon | liquid medications: use Tsp. as unit of measure; 1 tsp. is converted to 5 mL
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| Oral syringe | plastic syringe used to measure liquid medications accurately
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| Nipple | nipple w/ holes to administer oral medications to infants
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| Nasogastric tube | used to give patients who have impaired swallowing, are comatose, or esophagus disorders medications
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| Suppository | solid form of medication that is designed for introduction into a body orifice
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| 2 types of Syringe tips | -Luer-Slip
-Luer-Lok
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| Luer-Slip | male tapered end
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| Luer-Lok | a threaded locking collar
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| 3 sizes of syringes | 1 mL - 3 mL - 5 mL
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| millimeter scale | represents the units whereby medications are routinely ordered
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| Tuberculin syringe | 1 mL; measures small volumes of medications
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| Insulin syringe | has a scale that has been specifically calibrated for the measurement of insulin
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| Insulin important facts | -only use insulin syringe for insulin
-U-100 concentration = 100 unites of insulin
-U-40 concentration = 40 units of insulin
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| Prefilled cartridges/syringes | already measured; time saver, diminishes contamination
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| Insulin Pen | prefilled syringe; patient carries discreetly; for diabetic patients
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| Epi-Pen | prefilled with epinephrine to use in an emergency for allergic reactions
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| Needle Gauge | the diameter of the hole through the needle
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| Subcut | 25-29 gauge; 3/8, 1/2, 5/8 in.
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| Adult IM | 20-23 gauge; 1-1/2 in.
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| Child IM | 21-25 gauge; based on patient
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| Intradermal (e.g. TB testing) | 26-28 gauge; 1/4-1/2 in.
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| Safety devices | sleeve that is stored around the syringe barrel while the syringe is being filled; then sleeve is pulled forward fully to lock the shield permanently in place to cover the needle
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| Ampules | glass containers that usually contain a single dose of medication; never put air into Ampule; always use a filter
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| Vials | glass/plastic containers that contain one or more doses of a sterile medication
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| Liquid syringe | always BROWN in color
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| Intradermal | injections that are made into the dermal layer of the skin just below the epidermis
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| Anergic Reaction | no reaction to the allergens, especially to the positive control
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| Subcutaneous | injections that are made into the loose connective tissue between the dermis and the muscular layer; slower absorption; longer drug action
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| Intramuscular | injections that are made by penetrating a needle through the epidermis, dermis and the subcut tissue into the muscle layer; rapid absorption; 90 degree angle for injecting
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| Deltoid Muscle | easy access to area when patient is standing, sitting, or prone position; 1 mL or less
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| Intravenous (IV) | the introduction of fluids directly into the venous blood stream; most rapid; most comfortable for patient
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| Intravascular | within the vascular system (arteries, veins, capillaries)
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| Intracellular | within the cells
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| Interstitial | within the spaces between the cells
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| Extracellular | composed of the intravascular and interstitial compartments and it contains about 1/3 of the total body water
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| IV Administration set | an apparatus that connects a large volume of parenteral solution w/ the IV access device in the patients vein
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| Macro-drip | 10, 15, or 20 drops/mL
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| Micro-drip | 60 drops/mL
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| Blood-drip | 10 drops/mL
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| Intravenous IV Solutions | consist of water that contains one or more types of dissolved particles
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| Phlebitis | inflammation of a vein
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| Thrombophlebitis | inflammation of a vein with the formation of a thrombus in the area of inflammation (redness, warmth, tenderness, swelling or burning)
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| Infiltration | the leakage of an IV solution into the tissue that surrounds the vein
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| Extravasation | the leakage of an irritant chemical (medication) into the tissue surrounding the vein
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| AIR BUBBLE IMPORTANCE | If air bubble is found in the tubing, clamp tubing immediately, swab injection site, insert needleless device below the bubble and withdraw the air pocket
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| Air Embolism | occurs as a result of an air bubble entering the cardiovascular system
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| Pulmonary Edema | caused by infusing fluid too rapidly or by giving to much fluid
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| Pulmonary Embolism | occurs as a result of foreign materials being injected into the vein or from a blood clot that breaks loose and travels to the lungs, where it lodges in the arterioles
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| Speed Shock | occurs as a systemic reaction to a foreign substance that is given to rapidly into the bloodstream (rapid IV)
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| Medication Administration | -time frame
-check label 3 times
-unwrap dose at bedside
-correct route
-contraindications: antacids
-check ID and 2 other identifiers
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| Patient Assessment before medication | if blood pressure medication - what is the blood pressure
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| Patient Education | what does the patient need to know? allow for questions; maintain dignity/provide privacy/is pt. comfortable
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| Remember after administration | -did patient swallow meds?
-did you document?
-reassess: did you see the desired effect?
-document your reassessment
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| Do you administer another medication for another nurse????? | NO NO and NO!!!!!!! "Do it yourself HOMIE!!!!! Not going to be my ASS!!!!"
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| Written orders | order by a physician, dentist, nurse practitioner, or other designated health professional for a medication to be dispensed by a pharmacy for administration to a patient
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| Verbal Orders | orders given verbally by a health care provider, must sign within 24 hours; risk for med error; in an emergency situation only
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| Phone Orders | medication orders taken from a licensed health care provider over the phone, must sign within 24 hours; always repeat orders back to the physician for confirmation; risk for error
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| Liquid Medications | shake, if required, remove cap and place upside down on clean surface, label against palm, hold med cup at eye level, check meniscus, pour excess in drain, wipe rim before replacing cap
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| Crushed medications | -when and why?
-pill crusher
-mix in small amount of soft food after crushing
-clean the equipment!
-DO NOT crush enteric coated tabs or time release tabs
-may open capsules and mix with soft food
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| Splitting/Cutting Tablets | -ONLY split scored tablets
-DO NOT split enteric-coated or timed released tablets
-use a cutting device
-line up score with blade cutter
-DON'T touch med
-discard the extra portion properly
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| Sublingual Meds | -place med under patient's tongue
-instruct patient not to chew or swallow
-med should dissolve completely
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| Powdered Meds | mix with appropriate amount of appropriate liquid at the bedside
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| Enteral Tube Administration | must be liquid or suspension form; pills must be crushed into a fine powder
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| Parenteral Meds | -7 rights
-needle and syringe selection
-prepare injection
-change needle, if indicated
-select site
-inject
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| Ampules | -medication should be in body of ampule
-place an alcohol wipe in unopened package around neck
-snap neck away from you
-use filter needle to draw up med
-may invert, but don't touch rim of ampule
-aspirate med, remove air bubbles
-recap and change
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| Vials | -unused vial; remove cap
-previously used vial; cleanse rubber seal w/ alcohol wipe; dry
-draw up air equal to amount of med to be withdrawn and inject into vial
-invert vial, aspirate correct amount of med
-dislodge bubbles and eject from vial
-remo
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| Viscosity of a medication | very "thick" meds may be better tolerated in a larger muscle, or in smaller divided doses
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| Z-Track injections | -used to prevent irritating or staining meds from leaking to skin or subcut tissues
-apply downward pressure to skin
-inject as usual; wait 10 seconds
-when ready to withdraw needle, withdraw then release traction on skin
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| Electrolytes | solutes that dissolve in water and dissociate into ion particles; because the ions give water the ability to conduct electricity
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| Isotonic Solution | IV solution and the blood have approximately the same osmolatity; 270 - 310 mOsm/L; acute blood loss due to trauma
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| Hypotonic Solution | solution that have fewer dissolved particles than the blood
˄310 mOsm/L (cellular dehydration)
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| Hypertonic Solution | solution that have a higher concentration of dissolved particles
˅270 mOsm/L (severe low sodium)
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| Normal Saline | 0.9% solution of sodium chloride; isotonic solution with an osmolality of 308 mOsm/L
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| Tandem, Piggyback, or IV rider | intermittent infusion; secondary to a primary set-up; small volume of fluid infused over 20-60 minutes
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| Solutes for IV Solutions | -sodium chloride
-dextrose
-potassium chloride
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| Comma placing for units | no commas unless it has at least 5 numbers
NO - 1,000 YES - 1000
YES - 15,000
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| Milliequivalent | mEq
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| 1 part drug to 1000 parts solution | 1:100
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| 1 part drug in 5 parts solution | 1:5
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| IM | intramuscular
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| IV | intravenous
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| PO | by mouth
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| SC | subcutaneous (also SQ, subq) under the skin
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| AC | before meals
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| PC | after meals
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| Ad lib | as desired
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| Bid | twice daily
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| h | hour
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| HS | hours of sleep
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| qd | every day
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| qh | every hour
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| qid | 4 times a day
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| qod | every other day
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| STAT | at once
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| tid | three times a day
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| mL/hr ordered 500 mL in 6 hours | 500mL
_______ = 83.3 or 83 mL/hr
6
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| mL/24 hrs ordered 125 mL/hr | 125 x 24 = 3000 mL in 24 hr
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| 750 mL of saline to infuse over 8 hours. how many drops/min? (15 tubing) | 750mL x 20 11,250
____________ = _______ = 23.4 or 23 gtt/min
8 x 60 480
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| 1000 mL to L | 1 L (move decimal point 3 places to the right)
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| 1 L to mL | 1000 mL (move decimal point 3 places to the left)
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| five hundred milliliters | 500 mL
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| two-tenths of a milligram | 0.2 mg
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| two and five tenths kilograms | 2.5 kg
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| sixty milliequivalents | 60 mEq
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| tablets: ordered 50 mg available 25 mg | 50/25 = 2 tabs
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| tablets: ordered 37.5 mg available 75 mg | 37.5/75 = 0.5 tabs
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| tablets ordered 300 mg available 100 mg | 300/100 = 3 tabs
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| tablets ordered 62.5 mcg available 0.25 mg (convert) | 62.5/250 = 0.25 NO, cannot give a quarter of tablet, must call
pharmacy!!!!!!!!!!!
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| IM ordered 15 mg available 2%, 20 mg/mL 2 mL vial | 15mg/20mg = 0.75 mL or 0.8 mL
remember to round to the tenths for tablets and IV's
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| IV 1000 mL saline in 6 hours and 1 L bag on hand, tubing 10, how many drops/min. | 1000 mL x 10 10,000
______________ = _______ = 27.7 gtt/min or 28 gtt/min
6 x 60 360
remember to circle or box your final answer!!!!!!!
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| IV 1000 mL saline in 6 hours and 1 L bag on hand, tubing 10, how many drops per hour? | 1000 mL / 6 = 166.6 mL/hr or 167 mL/hr
remember to circle or box your final answer!!!!!!!
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| FOR CALCULATIONS!!!!!!!!!!!!! | REMEMBER TO SHOW YOUR WORK AND CIRCLE OR BOX YOUR ANSWERS!!!!!!!!!!!!!!!!!!!!!!!!!
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| WHO'S GROUP KICKS ASS?????????????? | THAT'S RIGHT!!!! THE LPN'S KICK ASS!!!!!!!!!
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| 3 teaspoons | 1 tablespoon
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| 2 tablespoons | 1 ounce
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| 8 ounces | 1 glass
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| 1000 mL | 1 liter
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| 1000 micrograms | 1 milligram
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| 1000 milligrams | 1 gram
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| 1000 grams | 1 kilogram
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| 5 mL | 1 teaspoon
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| 30 mL | 1 ounce
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| 2 tablespoons | 1 ounce
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| 1 quart | 1 liter
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| 2.2 lb | 1 kg
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| 2.54 cm | 1 inch
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| tab | tablet
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| syp | syrup
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| NS (N/S) | normal saline
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| Pharmacokinetics | the study of four major processes; medication absorption, distribution, metabolism, and excretion
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| Absorption | passage of medication molecules from the site of administration into the blood
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| Therapeutic Effect | the intended or desired physiological response of a medication
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| Toxic Effects | capable of causing injury/death; excess amounts of medication within the body
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| Idiosyncratic Reactions | individual sensitivity to effects of a drug caused by inherited or other bodily constitution factions
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| Allergic Reactions | unfavorable physiological response to an allergen to which a person has previously been exposed and to which the person has developed antibodies
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| Synergist effect | their combined effect is greater than their effects when given separately
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| Half-life | the time it takes for the body to lower the amount of unchanged medication by half (ex: 12-6-3)
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| Peak | concentration is the highest plasma level
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| Trough | concentration is the lowest plasma level
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| Transdermal disk/patch | disk/patch firmly holds the medicated ointment to the skin
(ex: nicotine patch)
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| Solution | a given mass of solid substance dissolved in a known volume of fluid or a given volume of fluid dissolved in a known volume of another fluid
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| NOW orders | must be given within 60 minutes
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| Polypharmacy | a patient uses two or more medications to treat the same illness, takes two or more medications from the same chemical class
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| Anaphylactic Reactions | hypersensitive condition induced by contact with certain antigens
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| Apothecary System | System of measurement.
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| Biotransformation | the chemical changes that a substance undergoes in the body, such as by the action of enzymes
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| Medication Interaction | the response when one drug modifies the action of another drug
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| ASAP | as soon as possible
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| gm | gram
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| gtt | drop
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| kg | kilogram
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| oz | ounce
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| q6h | every 6 hours
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| Infusion | slow and/or prolonged intravenous delivery of a drug or fluids
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