What is important for the nurse to do when receiving a telephone order?
read it back to the physician.
Can you recap syringes?
What are the 4 keys to pharmacokinetics? (what the body does to the drug)
1. Absorption - by intestine (GI)
2. Distribution - by blood (CV)
3. Metabolism - by liver
4. Excretion - by kidney
What is the pharmacodynamic?
the drug action and the effect within the body.
(what the drug does to the body)
What is the half-life of a drug?
the time required for the body to eliminate 50% of the drug. It is important for dosing.
What is the primary effect of a drug?
the desired or therapeutic effect.
What are the secondary effects of a drug?
all other effects other than the primary effects. These effects may be desirable or undesirable.
What is the term for nearly unavoidable secondary drug effects produced at therapeutic levels (drowsiness)?
What is the term for an undesirable response from a drug that may be fatal, life threatening, or permanently disabling?
What is the term for severe drug side effects caused by excessive levels of drug (resp. failure and Morphine).
What is the name of the drug reaction when the combined effects of 2 drugs is equal to the sum of each given alone (1+1=2)?
Additive drug reaction.
What is reaction called when 2 drugs produce an effect greater together than the sum of their separate actions (1+1=4)?
What is the reaction called when one drug interferes with another, neutralizing the effect?
What are 6 factors influencing drug response?
Age, weight, gender, pathological condition/disease, route of administration, and genetics/ethnicity.
What are the 7 rights?
right patient, drug, dose, route, time, documentation, and right to refuse.
How do you check the label 3x?
- check when looking at the pts. screen.
- check when collecting medications.
- check before administering to the patient.
Can you divide unscored tablets?
How many times should the label and drug order be checked before administering meds to patient?
Is it okay to write down the dose as ".5" and verbally say "point five milligrams"?
NO. Must write as "0.5" and say "Zero point five milligrams". Don't forget the "zero".
Enteral route = _________.
via GI tract.
Parenteral Route = ___________.
Not GI tract. Only IM, SQ, ID, and IV.
Topic route = ___________.
Intravenous route = __________.
Transdermal route = __________.
Is it okay to use abbreviations?
NO. spell out the times. Ex: NOT q.o.d., but "every other day".
How long does the nurse have to give a patient his or her meds?
within 30 minutes of the scheduled time.
Can you document/sign off medication before it is given?
NO. only afterwards.
What type of environment should meds be kept in?
a "dry, cool, and dark" area.
Can you administer a medication that another nurse prepared?
Can you administer a medication that is NOT labeled in the pt's drawer?
When a Single Order is made, how many times is the medication to be given?
What do Standing Orders establish?
guidelines for treating a particular disease or set of symptoms.
If medication orders are given verbally rather than in writing, what should the nurse document?
The nurse should write "VO" in the order.
If a nurse refuses to give a medication, what should he or she do next?
notify the supervisor immediately and document what ensued.
Where can the nurse verify the orders from the MAR?
Check the MAR's against the original order sheet.
Why do we not use abbreviations?
Abbreviations lead to medication errors.
Who has made recommendations on the use of abbreviations?
Joint Commission on Accreditation of Health Organizations (JACHO).
When reporting an med error, what should the nurse do?
In patient's chart: - document observations related to the incident.
-information on the med given.
-the pt's reaction.
-interventions taken to minimize harm to the pt.
When reporting an error, does it become a part of the pt's medical records?
What 2 purposes do incident reports serve?
1. to inform administrators so that they can consider changes that will prevent similar incidences in the future.
2. to alert administrators and the facility's insurance company to potential liability claims.
to protect the public from drugs of poor quality and questionable potency, the federal and state governments have enacted legislation designed to:
standardize the ingredients in medicinal agents.
PPQ = Purity, Potency, and Quality.
What is the Food and Drug Act and when was it established?
1906. Purity, Potency, and Quality.
When was the Harrison Narcotic Act established and what is it?
1914 - the sale of narcotic drugs/prescription.
When was the Comprehensive Drug Abuse Prevention and Control Act established?
What is the Food, Drug, and Cosmetic Act and when was it established?
1938 - control of manufacture, sale of drugs, and safety.
What did the Controlled Substances Act (CSA) of 1970 do?
strengthen the law enforcement in the control of drug abuse and established a system of drug classification for controlled substances.
What are Schedule I substances?
High abuse potential ex: Heroin, Marijuana, LSD.
What are Schedule II substances?
High abuse potential w/ physical /psychological dependence. ex:morphine, barbiturates
What are Schedule III substances?
Less abuse potential ex: Nonbarbiturate Sedatives
What are Schedule IV substances?
What are Schedule V substances?
Codeine used in antitussives/antidiarrhea
What's the difference between Malpractice and Negligence?
Malpractice - did something you weren't supposed to do.
Negligence - did not do something you were supposed to do.
Are nurses responsible for their own actions?
Errors of omission = __________.
neglect of duty.
Errors of Commission = _________.
performing an act of malpractice.
Is the employer responsible for the acts of his or her employees while they are engaged in service to the employer?
What are the inactive substances used for nonspecific psychological effects without the patient's knowledge that is it being given?
Can a nurse legally administer any medication without an order, even in the case of a placebo?
Can a patient refuse a placebo even during a test?