NUR1025 CH 32 MEDICATION ADMINISTRATION
Terms in this set (94)
occurs when medication molecules pass into the blood from the site of medication administration.
Harmful or unintended effect of a medication, diagnostic test, or therapeutic intervention.
life threatening, unexpected, severe, sudden reaction---code blue. An acute allergic response involving ige-mediated, antigen-stimulated mast cell activation resulting in histamine release. Exposure to the antigen may result in dyspnea, airway obstruction, shock, urticaria, and in some cases death.
the time it takes for excretion process to lower the amount of unchanged medication by half.
The chemical changes a substance undergoes in the body, such as by the action of enzymes.
Pertaining to the inside of the cheek, the surface of a tooth, or the gum beside the cheek.
break down, and remove biologically active chemicals
An uncommon response to a drug because of a genetic predisposition. Unpredictable effects in which the patient overreacts or under reacts to a medication.
The introduction of a substance, such as a fluid, electrolyte, nutrient, or drug, directly into a vein or interstitially by means of gravity flow.
The act of forcing a liquid into the body by means of a needle and syringe.
A procedure in which a fluid is slowly introduced into a cavity or passage of the body and allowed to remain for a specific length of time before being drained or withdrawn.
an injection of a medication into a joint.
an injection of a medication directly into cardiac tissue.
In the skin.
Pertaining to the interior of muscle tissue.
Pertaining to structures or substances within the eyeball.
Pertaining to the inside of a vein, as of a thrombus or an injection, infusion, or catheter.
The process of washing out a body cavity or wounded area with a stream of water or other fluid. It is also used to cleanse a tube or drain inserted into the body such as an indwelling catheter.
Adverse reaction to a medication such as rash, chills, or gastrointes-tinal disturbances. Once a drug allergy occurs, the patient can no longer receive that particu-lar medication.
Any incorrect or wrongful administration of a medication, such as a mistake in dosage or route of administration, failure to prescribe or administer the correct drug or formulation for a particular disease or condition, use of outdated drugs, failure to observe the correct time for administration of the drug, or lack of awareness of adverse effects of certain drug combinations.
nurses, pharmacists, and other health care providers compare the medication that the patient is taking currently with what the patient should be taking and any newly ordered medications.
A decimal system of measurement based on the meter (39.37 inches) as the unit of length, on the gram (15.432 grains) as the unit of weight or mass, and, as a derived unit, on the liter (0.908 U.S. dry quart or 1.0567 U.S. liquid quart) as the unit of volume.
NURSE PRACTICE ACTS (NPAs)
A statute enacted by the legislature of each of the states or by the appropriate officers of the districts or possessions. The act delineates the legal scope of the practice of nursing within the geographic boundaries of the jurisdiction. The purpose of the act is to protect the public.
Pertaining to the eye.
Giving medication by a route other than the gastrointestinal tract.
The amount of medication in the blood that represents the highest level during a drug administration cycle.
The study of the action of drugs within the body, including the mechanisms of drug absorption, distribution, metabolism, and excretion; onset of action; duration of effect; biotransformation; and effects and routes of excretion of the metabolites of the drug.
The use of a number of different drugs, possibly prescribed by different doctors and filled in different pharmacies by a patient who may have one or several health problems.
An order for medication, therapy, or therapeutic device given by a properly authorized person, which ultimately goes to a person properly authorized to dispense or perform the order.
PRESSURIZED METERED-DOSE INHALERS (pMDIs)
deliver medications that produce local effects such as bronchodilation. Use a medical propellant to push the medication out of the inhaler and require the patient to apply approximately 5-10 lbs of pressure to the top of the canister to administer the medication.
a predictable and often unavoidable adverse effect produced at a usual therapeutic dose.
A mixture of one or more substances dissolved in another substance. The molecules of each of the substances disperse homogenously and do not change chemically. A solution may be a gas, a liquid, or a solid.
Beneath the skin.
Pertaining to the area beneath the tongue.
Effect resulting from two drugs acting synergistically; the effect of the two drugs combined is greater than the effect that would be expected if the individual effects of the two drugs acting alone were added together.
Desired benefit of a medication, treatment, or procedure.
often develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion.
Medication delivery device in which the medication is saturated on a waferlike disk, which is affixed to the patient's skin. This method ensures that the patient receives a continuous level of medication.
A groove or channel, such as the gingival trough around the neck of a tooth.
an order given verbally to a nurse.
A technique for injecting irritating preparations into muscle without tracking residual medication through sensitive tissues.
• Learning medication classifications improves understanding of nursing implications for administering medications with similar characteristics.
• All controlled substances are handled according to strict procedures that account for each medication.
• A nurse applies understanding of the physiology of medication action when timing administration, selecting routes, initiating actions to promote medication efficacy, and observing responses to medications.
• The older adult's body undergoes structural and functional changes that alter medication actions and influence the manner in which nurses provide medication therapy.
• Verify medication calculations with another nurse to ensure accuracy.
• Medications given parenterally are absorbed more quickly than those administered by other routes.
• Each medication order needs to include the patient's name, order date, medication name, dosage, route, time of administration, drug indication, and health care provider's signature.
• A medication history reveals allergies, medications a patient is taking, and the patient's adherence to therapy.
• The six rights of medication administration contribute to accurate preparation and administration of medication doses.
• The six rights of medication administration are the right medication, right dose, right patient, right route, right time, and right documentation.
• Nurses need to avoid distractions, use NIZs, and follow the same routine when preparing medications to reduce medication errors.
• Nurses administer only medications they prepare, and prepared medications are never left unattended.
• Document medications immediately after administration.
• A nurse uses clinical judgment regarding a patient's clinical status in determining the best time to administer prn medications.
• A nurse reports a medication error immediately.
• When preparing medications, a nurse checks the medication container label against the MAR 3 times.
• The Z-track method for IM injections protects subcutaneous tissues from irritating parenteral fluids.
• Failure to select injection sites by anatomical landmarks leads to tissue, bone, or nerve damage.
You are a new graduate nurse completing your orientation on a very busy intensive care unit. You cannot read a health care provider's order for one of your patient's medications. You have heard from more experienced nurses that this health care provider does not like to be called, and you know that another of the health care provider's patients is very unstable. What is the most appropriate next step for you to take?
Call the health care provider to clarify the order
A toddler is to receive 2.5 mL of an antipyretic by mouth. Which equipment is the most appropriate for medication administration for this child?
An oral-dosing syringe
What statement made by a 24-year-old patient's mother indicates that she understands how to administer her son's eardrops?
"I need to straighten his ear canal before administering the medication by pulling his ear upward and outward."
A nurse admits a 72-year-old patient with a medical history of hypertension, heart failure, renal failure, and depression to a general medical patient care unit. The nurse reviews the patient's medication orders and notes that the patient has three health care providers who have ordered a total of 13 medications. What is the most appropriate action for the nurse to take next?
Review the list of medications with the health care providers to ensure that the patient needs all 13 medications
The nurse is administering an intravenous (IV) push medication to a patient who has a compatible IV fluid running through intravenous tubing. Place the following steps in the appropriate order. 1. Release tubing and inject medication within amount of time recommended by agency policy, pharmacist, or medication reference manual. Use watch to time administration. 2. Select injection port of intravenous (IV) tubing closest to patient. Whenever possible, injection port should accept a needleless syringe. Use IV filter if required by medication reference or agency policy. 3. After injecting medication, release tubing, withdraw syringe, and recheck fluid infusion rate. 4. Connect syringe to port of intravenous (IV) line. Insert needleless tip or small-gauge needle of syringe containing prepared drug through center of injection port. 5. Clean injection port with antiseptic swab. Allow to dry. 6. Occlude intravenous (IV) line by pinching tubing just above injection port. Pull back gently on syringe plunger to aspirate blood return.
2, 5, 4, 6, 1, 3,This is the appropriate order for a nurse to administer an intravenous (IV) push medication to a patient who has a compatible IV fluid running through intravenous tubing.
A nursing student is administering ampicillin PO. The expiration date on the medication wrapper was yesterday. What is the appropriate action for the nursing student to take next?
Return the medication to pharmacy and get another tablet
A nursing student is administering medications to a patient through a gastric tube (G-tube). Which of the following actions taken by the nursing student requires the nursing instructor to intervene?
The nursing student crushes a nifedipine extended-release tablet and mixes it with water before administering it.
A pediatric nurse takes a medication to a 12-year-old female patient. The patient tells the nurse to take it away because she is not going to take it. What is the nurse's next action?
Ask the patient's reason for refusal
After seeing a patient, the health care provider starts to give a nursing student a verbal order for a new medication. The nursing student first needs to:
Explain to the health care provider that the order needs to be given to a registered nurse.
A nurse accidently gives a patient the medications that were ordered for the patient's roommate. What is the nurse's first priority?
Assess the patient for adverse effects.
A health care provider ordered enalapril (Vasotec) 2 mg IV push for a patient with hypertension. The pharmacy sent vials marked 1.25 mg enalapril/mL. How many mL does the nurse administer?______ mL
"1.6"Use dimensional analysis to solve the problem.
A child is taking albuterol through a pressurized metered-dose inhaler (pMDI) that contains a total of 64 puffs. The dose is 2 puffs every 6 hours. How many days will the pMDI last? ___________ days.
"8"The patient is taking 2 puffs every 6 hours which is 8 puffs a day. The inhaler has 64 puffs in it. To determine how many days the inhaler will last, divide the number of puffs by the number of doses per day that the patient takes; 64 puffs/8 puffs per day = 8 days.
After receiving an intramuscular (IM) injection in the deltoid, a patient states, "My arm really hurts. It's burning and tingling where I got my injection. What should the nurse do next? (Select all that apply.)
Assess the injection site, Notify the patient's health care provider of assessment findings,Document assessment findings and related interventions in the patient's medical record
You are working in a health clinic on a college campus. You need to administer medroxyprogesterone acetate intramuscularly (IM) to a female patient for birth control. You look up this medication in a reference manual and determine that it is viscous and injections can be painful. On the basis of this information, you plan which of the following when administering this medication? (Select all that apply.)
Administer the medication in the ventral gluteal site, Use the z-track method when administering the medication, Ask the patient questions about her major and which classes she is taking during the injection to provide distraction
One medication modifies/enhances the action of another medication being administered to a patient
Timing of Medication Dose
Goal is to achieve a constant blood level of the medication within a safe therapeutic range
Time during which the medication is present in concentration great enough to produce a response
Bolus (IV Therapy)
A fixed amount, given quickly
Blood serum concentration of a medication reached and maintained after repeated fixed doses
the time required to reduce by one half the amount of drug concentration in the body
Has high concentration of sugar, given in a central line
Can be given in a peripheral line
Unit dose: 24 hour supply of medication for each patient
Automatic Medication Dispensing System
Legal Aspects of Drug Administration
1. Be informed
2. To refuse
3. Qualified staff
Role of the Nurse
Prevention of Medication Errors
Six Rights of Medication Administration
Possible Nursing Diagnosis:
Knowledge deficit of drug therapy
Implementation of Drug Therapy
Patient and Family Teaching
Accurate dose calculation and measurement
Recording Medication Administration
Special considerations for administration of medications to specific age-groups
Nursing implications Overview
factors the nurse must consider:
Evaluation of Drug Therapy
Did the patient verbalize / demonstrate understanding?
Medication doing it's job?
Adverse side effects?
Types of Orders in Acute Care Agencies
Standing orders or Routine medication orders
Single (one time) orders
Topical Route of Administration
Routes of Administration
Epidural - epidural space
Intra-thecal - subarachnoid space
Intra-osseous - bone marrow
Intra-pleural - pleural space
Intra-arterial - into the arteries
Intra-cardiac - into cardiac tissue
Intra-articular - into the joint