Nursing Pharmacology > Med Administration > Flashcards

Med Administration Flashcards

Review the basics of med administration: MARs, med recs, med rights, math, side effects vs. adverse effects, and all the different routes. (80 cards)

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1
Q

What is the medication administration record?

(MAR)

A

A record of all the medications that the client takes.

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2
Q

What is a medication reconciliation?

(“med rec”)

A

The list of medications that the HCP reviews when the client is:

  • admitted
  • discharged
  • transferred to another unit
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3
Q

When should the nurse ask the client about medication allergies?

A
  1. At the admission assessment when getting data about what medications the client takes.
  2. Before giving medications.
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4
Q

What are the 5 medication rights?

A
  1. right client
  2. right medication
  3. right dose
  4. right time
  5. right route
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5
Q

What are the 4 additional medication rights?

A
  1. right reason
  2. right documentation
  3. client has the right to refuse the med
  4. right response to the med
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6
Q

Can the nurse discuss with the client simple risks of NOT taking medications?

A

Yes!

Example: if you don’t take this betablocker, your blood pressure will get very high.

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7
Q

What information is included on an ID wrist band?

A
  • full name
  • birthday
  • medical record number
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8
Q

What information is included on an allergy wrist band?

A
  • meds
  • substances
  • foods
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9
Q

What are some client identifiers for medications and treatments?

A
  1. client name
  2. birthday
  3. medical record number
  4. phone number
  5. social security number
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10
Q

How many client identifiers are required before giving medication or a treatment?

A

Two:

  1. Client name and
  2. One more identifier such as:
    • birthday
    • medical record number
    • phone number
    • social security number
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11
Q

What should NOT be used to identify a client when giving meds or a treatment?

A

Never use the room number or crib number.

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12
Q

How should medication doses be written?

A
  • with a preceding zero e.g. 0.5 mg (NOT .5 mg)
  • no trailing zeros e.g. 10 mg (NOT 10.0 mg)
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13
Q

What are 8 unacceptable medication abbreviations?

A
  1. do not write U: write “unit” instead
  2. do not write IU: write “international unit” instead
  3. do not write anything with a q or Q: write “every day” or “every other day” instead
  4. do not write MS or MG: write “morphine sulfate” or “magnesium sulfate” instead
  5. do not write cc: write mL instead
  6. do not write OS: write “left eye” instead
  7. do not write hs: write “bedtime hour of sleep” instead
  8. do not write sc/subq: write subcutaneous instead
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14
Q

What are high alert meds?

A

When there is a high risk of death or injury if the med is given improperly such as IV push or IV meds.

PINCH: Potassium IV, Insulin, Narcotics, Chemotherapy and Heparin IV are examples of high alert meds.

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15
Q

What is a side effect of a medication?

A

Unintended effects of a medication but are more likely to be expected or may resolve over time.

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16
Q

How should side effects be managed?

A
  • having the nurse teach the client how to deal with that side effect
  • provide safety measures when taking the medication
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17
Q

What is an adverse effect (reaction) of a medication?

A

Unexpected and severe side effects of a medication.

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18
Q

How should adverse effects (reaction) be managed?

A
  • holding the medication and notifying the HCP
  • possible life-saving interventions
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19
Q

What are some common side effects of medications?

A
  • mild nausea or diarrhea - take med with food
  • sedation - use caution when driving or using big machines
  • orthostatic hypotension - sit at the side of the bed for a few minutes before getting up
  • photosensitivity - stay out of the sun and wear sunscreen
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20
Q

What are 6 adverse effects (reactions) of medications?

(Immediate Complication)

A
  1. anaphylactic shock or difficulty breathing
  2. rash
  3. significant changes in vital signs or level of consciousness
  4. angioedema
  5. severe muscle rigidity
  6. nausea/vomiting/diarrhea all at once

Notify the HCP immediately.

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21
Q

Fill in the answer:

1 gram (g) = _____ milligram (mg)

A

1 gram (g) = 1000 milligram (mg)

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22
Q

Fill in the answer:

1 microgram (mcg) = _____mg

A

1 microgram (mcg) = 0.001 mg

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23
Q

Fill in the answer:

1 kilogram (kg) = ______ g

A

1 kilogram (kg) = 1000 g

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24
Q

Fill in the answer:

1 kilogram (kg) = ____ pounds (lbs)

A

1 kilogram (kg) = 2.2 pounds (lbs)

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25
# Fill in the answer: 1 liter (L) = ___ mL
1 liter (L) = **1000** mL
26
# Fill in the answer: 1 teaspoon (tsp) = ___ mL
1 teaspoon (tsp) = **5** mL
27
# Fill in the answer: 1 Tablespoon = ___ mL
1 Tablespoon = **15** mL
28
# Fill in the answer: 1 ounce (oz.) = ___ mL
1 ounce (oz.) = **30** mL
29
# Fill in the answer: 1 cup = __ oz.
1 cup = **8** oz.
30
What does giving a medication **"PO"** mean?
To give the med by mouth and **have the client swallow the med.**
31
What is a **sublingual** medication?
Administered under the tongue.
32
What is a **buccal** medication?
Placed in the cheek.
33
What types of meds should **_NOT_** be crushed?
* enteric-coated * buccal * sublingual * ER (extended-release) * SR (sustained-release) * iron pills ## Footnote These meds are designed to be released over a long period of time and will affect absorption.
34
How are **crushed** medications given?
Can be **sprinkled over apple sauce** or another very soft food and administered with a spoon.
35
What is an **otic medication**?
Administered in the ear.
36
How are **otic medication** given in a client **\< 3 years old**?
Pull the ear **DOWN and back**.
37
How is an **otic medication** given in a client **\> 3 years old**?
Pull the ear **UP and back**.
38
What is an **optic medication**?
Administered in the eye.
39
Where on the eye is the **eye drop placed**?
In the lower conjunctival sac.
40
How long is **pressure placed on the inner canthus** after administering an eye drop?
1-2 minutes ## Footnote This prevents systemic absorption.
41
How long should the client wait **in between different eye drop medications**?
3-5 minutes
42
How is **eye ointment** administered?
By squeezing a thin layer from inner to outer canthus.
43
What is the **order of administration** for eye drops and eye ointment?
Give eye drops first, then eye ointment second for better absorption.
44
What is the order of administration for **inhalers**?
1. **bronchodilator** first to open the airways 2. **steroid** is given second to decrease inflammation
45
What are the **steps** to **using an inhaler**?
1. Use the bronchodilator first, then the steroid 2. remove cap and hold inhaler upright 3. shake inhaler 4. tilt head back and breathe out 5. press down on inhaler to release medicine 6. breathe in slowly for 3-5 seconds 7. hold breath for 10 seconds 8. wait 1 minute in between puffs ## Footnote Click [HERE](http://www.youtube.com/watch?v=fHYTz-ZoRLw) to view a video on how to use an inhaler.
46
What is a **spacer** for an inhaler?
Placed in between the mouth and inhaler to prevent throat irritation, bad taste in the mouth and to disperse medication better.
47
What sized needle is used for an **intramuscular (IM) shot**?
Use a large bore needle for IM shot: **18 gauge**.
48
What is the **Z-track method** for IM shots?
For giving IM shots that **prevent leaking of medicine out of the skin**.
49
What are the **steps for giving an IM shot** with the Z-track method?
1. pull skin laterally (to the side) 2. inject needle at 90 degree angle 3. aspirate to make sure a blood vessel wasn't entered 4. inject the med 5. remove the needle 6. release the skin
50
Where is a **transdermal (skin patch) medication** placed?
In areas: * that are **_NOT_** hairy * that are **_NOT_** in a skin fold
51
Before placing the skin patch on the skin, what is **written on the patch**?
* date * time * nurse initials
52
What are **4 common skin patch medications**?
1. nicotine 2. birth control 3. nitroglycerin 4. fentanyl
53
How is a **topical skin medication** administered?
* wash hands and apply gloves * assess area for improvement or worsening * wash area * apply a thin film of ointment or cream * possible dressing covering the area
54
How is a **suppository** medication administered?
Inserted into the **anus**.
55
How are **intravenous (IV) meds** administered?
1. **IV push:** dilute with normal saline and manually push over about 5 minutes into a vein * *always check to see if the medication is diluted and how fast to push it in* 2. **IV piggyback:** place on a pump and above the main bag of IV fluids * *given over 15 minutes or up to several hours depending on what is appropriate for the particular med*
56
In regards to IV fluids, what needs to be checked **before** an IVPB medication is given?
Check to see if the medication in the IVPB is **compatible** with the main bag of IV fluids.
57
What is done **before and after** an IV medication is given?
Clean the hub with an alcohol swab and flush the IV line with normal saline.
58
What is an **ampule** medication?
Medication in a **small glass vile** drawn up by a needle and given intravenously.
59
What are the **nursing considerations** for giving an ampule medication?
* tap ampule to get rid of the bubbles * use gauze around neck and snap off top while holding it away from you due to glass shards * use a needle to draw up medication
60
How is a **subcutaneous** medication administered?
Given in the **fat tissue** using a 25-30 gauage needle at a 45-90 degree angle. ## Footnote Examples are insulin, enoxaparin and heparin.
61
What is the advantage of using a **central venous access device (CVAD)** to administer meds?
* **more meds at once** can be given through the different lumens * **higher concentrations** of meds can be given
62
How should **nasogastric meds** be administered: one at a time or all the medications crushed at once?
Crushed and given **one at a time** with a flush of normal saline or water in between each medication. ## Footnote Do this in case there is a reaction with one of the meds.
63
How often is the **pH of gastric secretions** **checked** when giving meds through an NG tube?
Before every med administration. ## Footnote There is no need to check the pH before giving several meds in a row.
64
What should the **pH** of gastric secretions be before NG tube med administration?
Gastric secretions: pH **equal or < 5**. ## Footnote If it is \> 5, hold the meds and get an x-ray to assess for possible tube dislodgement.
65
What is **aspirated** before NG tube med administration?
The amount of gastric secretions. This is to assess if the client is digesting the NG tube feeding and meds.
66
# Complete the sentence: If the gastric secretions are \> **than \_\_\_\_\_\_\_**, hold the NG tube feeding.
In general, if the gastric secretions are \> **than** **100 mL**, hold the NG tube feeding. ## Footnote HCP/hospitals have different policies for when to hold feedings or meds.
67
Can needles be **recapped**?
**Never** recap a dirty needle! ## Footnote It's OK to put the cap back on a needle if it hasn't been used on a client yet. Otherwise, put the dirty needle into the sharps container.
68
# Complete the sentence: The **smaller the size (gauge)**, the ________ the needle or IV catheter.
The smaller the size (gauge), the **_BIGGER_** the needle or IV catheter.
69
What is a **16 gauge IV catheter** used for?
Giving blood and rapid fluid administration.
70
What is an **18 gauge IV catheter or needle** used for?
* for IM shots * giving blood * rapid fluid administration
71
What is a **20 gauge IV catheter or needle** used for?
It is used for **smaller veins:** * possibly for giving blood * giving meds * IV fluids
72
What is a **22 gauge IV catheter or needle** used for?
Giving meds and IV fluids.
73
What is a **24 gauge IV catheter or needle** used for?
A very small IV catheter or needle for **pediatric clients**.
74
What is a **25-30 gauge IV catheter or needle** used for?
Subcutaneous needle used **to give insulin and heparin**.
75
In which population are **most medications contraindicated**?
Pregnant clients.
76
Which 2 groups have a **higher risk of medication toxicity**?
1. children 2. older adults ## Footnote These groups have decreased kidney function making it difficult for medications to be metabolized.
77
What **labs** are commonly checked before giving medications?
1. **BUN and creatinine**: many meds are nephrotoxic 2. **ALT and AST**: many meds are hepatotoxic 3. **Electrolytes**: many meds affect levels 4. **Blood glucose**: some meds affect levels ## Footnote Get a baseline of lab and vital sign measurements before med administration due to side effects and adverse reactions.
78
What **time method** is frequently used for telling time in the healthcare setting?
Military time
79
Give an **example** of a medication that is given sublingual.
nitroglycerin
80
Give an **example** of a medication that is given buccal?
Pediatric liquid medications.
Nursing Pharmacology
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