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Funds II Lab > Final Lab Quiz > Flashcards

Final Lab Quiz Flashcards

1
Q

6 Rights of Medication Administration

A

right patient
right medication
right dose
right route
right time (frequency)
right documentation

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2
Q

Preparation of Meds: at bedside vs. outside of room

A

at bedside unless there is a specific reason to prepare outside of room (i.e. multi-dose preparations for infection control purposes)

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3
Q

Where is a multi-dose vial prepared?

A

outside of room

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4
Q

How long can a multi-dose vial be used after it is opened?

A

28 days, check expiration date

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5
Q

What are the three checks of medication administration?

A

1st: when taking med out of drawer
2nd: when prepping med
3rd: in room right before administration

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6
Q

If medications from a vial/ampule are prepared outside of the room:

A

they must be properly labeled

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7
Q

Med Order: furosemide 40 mg IVP daily

A

complete

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8
Q

Med Order: enoxaparin sodium 1mg/kg SC daily

A

complete

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9
Q

Med Order: acetaminophen 2 tabs po every 4 hours prn

A

incomplete: missing dose and reason for prn

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10
Q

Med Order: ambien 5mg po hs

A

complete

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11
Q

Med Order: hydrocodone/acetaminophen 5mg/326 mg 1-2 tabs every 4-6 hours prn pain

A

incomplete: missing route and cannot have 2 ranges in one order

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12
Q

Med Order: morphine 2mg x1

A

incomplete: missing route

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13
Q

MDI vs DPI inhalers

A

MDI: liquid medication that must be shaken before using
DPI: medication is in a capsule; no need for shaking

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14
Q

What does the patient need to do after using a steroid inhaler?

A

rinse mouth out because the steroid can cause a yeast infection in the mouth

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15
Q

Should the patient use a bronchodilator or steroid medication first?

A

bronchodilator because it dilates the bronchioles and opens the airway before giving the steroid inhaler

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16
Q

What is an example of a very common bronchodilator?

A

albuterol

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17
Q

What are the two routes for oral/topical meds?

A

sublingual (under tongue) and buccal (in cheek)

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18
Q

Where does absorption occur for oral/topical meds?

A

in mucous membranes in mouth - very quick absorption

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19
Q

Can you give oral/topical meds to NPO patient?

A

yes

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20
Q

What medications do you NOT crush whatsoever?

A

extended-release, enteric coated, sublingual, buccal

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21
Q

What are contraindications for giving oral meds?

A

vomiting, suction (ex: NG tube connected to suction), unconscious, NPO

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22
Q

What do liquid elixirs consist of?

A

alcohol (ex: nyquil)

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23
Q

Who should you not give liquid elixirs to?

A

children, pregnant women, alcoholics, liver disease pts

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24
Q

How do you pour a liquid medication?

A

palm label to protect label from getting medicine on it

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25
Q

What do liquid syrups consist of?

A

sugar

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26
Q

What type of medication should you not give to diabetics?

A

liquid syrups because they contain sugar

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27
Q

What MUST be worn when giving medication patches?

A

gloves so it doesn’t get on the skin

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28
Q

What needs to be changed frequently when using medication patches?

A

change sites frequently

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29
Q

Where shouldn’t medication patches be placed?

A

places with hair

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30
Q

What needs to be written on med patches?

A

initials, date, and time

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31
Q

Process of administering eye drops

A

tilt head back
pull down conjunctiva until you see conjunctival sac
put drops on conjunctival sac
have patient close eye
hold pressure on lacrimal duct for 30 sec

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32
Q

Process of administering ointment in eye

A

squeeze a little and wipe it off (bc it’s contaminated)
tilt head back
pull down conjunctiva until conjunctival sac is seen
squeeze ointment on conjunctival sac
close eye

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33
Q

How to administer ear drops

A

have patient lay on their side
clean pinna
straighten ear canal (down and back <3, up and back for >3)
gently massage tragus (helps with absorption)
have patient remain on side 5 min after insertion
insert small piece of cotton loosely into ear prn 15-20 minutes

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34
Q

How to apply vaginal meds

A

applicator for creams
privacy
supine with HOB elevated
lubrication if needed (water-based lube)
remain supine for 5-10 min after

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35
Q

How to administer rectal meds

A

wear gloves
left sims position (laying on left, right leg bent)
water-soluble lubricant
round end of suppository goes first

36
Q

Why is aspiration done for injections?

A

to ensure med is not being administered into a blood vessel

37
Q

What injection site requires aspiration?

A

only IM injections
dorsogluteal HAS to be aspirated because of major vessels at site

38
Q

How long do you have to pull back on the plunger when aspirating?

A

a minimum of 5 seconds, maybe more

39
Q

What do you do if you see blood enter the syringe when aspirating?

A

start over and dispose of the current medication properly
controlled substances disposed of by having another RN watch you waste it

40
Q

How is the deltoid site landmarked for injection?

A

2 fingers under acromion process
do not go below axillary line

41
Q

When is the deltoid site best used?

A

immunizations

42
Q

What is the max amt of med that can be administered in deltoid site?

A

1 mL

43
Q

Needle size for deltoid injection

A

1”, 22 to 25 gauge (based on med thickness)

44
Q

Gauge sizes for needles

A

bigger the number, the smaller the hole is
based on thickness of med

45
Q

Ventrogluteal injection site landmarks

A

palm of hand on greater trochanter (hip) with fingers facing up towards head
find iliac crest and make a “V” with fingers (index and middle) and insert between them

46
Q

When is ventrogluteal site best used?

A

best practice/safest for a large vol IM injection bc not many large vessels or nerves run close to location
antibiotics, some pain meds

47
Q

Max amt allowed in ventrogluteal site

A

3 mL

48
Q

Needle size for ventrogluteal inj

A

1.5”
20 to 25 gauge for aqueous fluids
18 to 21 gauge for viscous or oil-based solutions

49
Q

How is vastus lateralis injection site landmarked?

A

on outside of leg
divide into thirds, inject in MIDDLE,OUTER third

50
Q

When is vastus lateralis best used?

A

used for infants bc it is biggest muscle they have until they become mobile

51
Q

How is rectus femoris injection site landmarked?

A

divide upper leg into thirds, inject in ANTERIOR, MIDDLE third

52
Q

When is rectus femoris best used?

A

self-administration
epi-pen

53
Q

How is NG tube measured to determine the correct length for insertion?

A

from tip of nose to earlobe and then to xiphoid process
put a piece of tape on tubing to mark it

54
Q

How is the patient’s head positioned during NG tube insertion?

A

head back
hyperextend head until tube is at posterior oropharynx
bring head forward when tube is at posterior oropharynx, and then have patient drink and swallow
use water-based lubricant

55
Q

What is the best practice for confirming NG tube placement?

A

checking gastric pH, which should be between 1-5

56
Q

What is Blessing Hospital Policy for confirming NG tube placement?

A

inject 30 mL of air and listen for bubbling over stomach

57
Q

What is done to prevent aspiration when removing NG tube?

A

Nurse: inject air bolus into tube to get everything out of the tube prior to removing
Patient: take deep breath and hold it so the epiglottis is closed to protect the airway

58
Q

What types of medications cannot be crushed?

A

extended release
enteric coated
sublingual and buccal

59
Q

Cleaning Process for Foley Insertion: Male

A

circumcised: circular motion from tip to base using separate swab for each stroke
Uncircumcised: same as usual but pull back foreskin before and then replace

60
Q

Cleaning Process for Foley Insertion: Female

A

spread labia, top to bottom, outer to inner, down the middle, different swab each swipe

61
Q

Procedure for Foley - How far to insert in male/female?

A

male: insert until you see urine and go to the Y-bifurcation
female: insert until you see urine then go 2 more inches

62
Q

Key Principles of Sterile Technique

A

outer wrap/covering is not sterile
sterile items that are out of sight are unsterile
no coughing/sneezing over sterile field
hands/objects must stay above waist/table height
do not reach over sterile field
when using forceps (tweezers), tips stay pointed down

63
Q

Wound Cleansing: Saline

A

does not disinfect
moves bacteria
clean top to bottom, in to out

64
Q

Wound Cleansing: Betadine

A

antimicrobial agent
used to clean for Foley insertion
clean top to bottom, out to in
cleanest to dirtiest

65
Q

Wound Cleansing: Chlorhexidine

A

antimicrobial agent
friction scrub back and forth for 30 seconds

66
Q

Telfa Dressing

A

slick/shiny surface that is absorbent (middle part of bandaid)
non-adherent
does not stick to wound, need to put adhesive dressing on top

67
Q

Island Dressing

A

telfa with an adhesive border, eliminates need for outer dressing

68
Q

Surgipad or Abdominal (ABD) Pads

A

very absorbent; often used over addition dressings
blue stripe faces outward
need to tape it down

69
Q

Transparent Film (Tegaderm)

A

semipermeable, nonabsorbent
used to cover IV sites (so you can see site)
small = IV site
large = central line

70
Q

Impregnated Nonadherent (Vaseline Gauze)

A

material is impregnanted with petroleum jelly or other agents
covers partial and full thickness wounds WITHOUT drainage
requires outer dressing

71
Q

Hydrocolloids (DuoDerm)

A

waterproof adhesive wafer
gelatinous/rubbery
absorbs drainage and forms an occlusive seal
can stay on up to 7 days
used for pressure ulcers

72
Q

Alginate (Algiderm, Curasorb)

A

non-adherent dressing available in many forms
very absorbent (up to 20x their weight)
made from seaweed
all previous alginate must be removed prior to adding new
need something on top of it

73
Q

Who should be the first person to change surgical dressing?

A

surgeon or doctor

74
Q

Wound Assessment

A

signs of healing or infection (no redness, wound edges together)
foreign bodies (glass, magnets, splinters, dirt, sand, etc)

75
Q

Wound Drainage Assessment

A

location, color, consistency, odor, amount

76
Q

Ileostomy

A

small intestine
liquid consistency, mild odor
more at risk for skin breakdown

77
Q

Ascending Ostomy

A

liquid - pudding like
more odor

78
Q

Transverse Ostomy

A

mushy and stinky

79
Q

Descending Ostomy

A

more formed/solid
may not need appliance
can regulate w/ diet and irrigation

80
Q

Sigmoid Ostomy

A

formed stool
may not need appliance

81
Q

Assessment of Stoma: Peristomal skin should be what?

A

dry and intact

82
Q

Stoma Appearance should be?

A

pink or red; moist; pt does not feel (getting blood flow)

83
Q

How often should the ostomy appliance be changed?

A

once a week unless there is skin breakdown

84
Q

Changing Ostomy Appliance

A

-determine need to change appliance
-select appropriate time
-position pt (sitting up)
-empty the pouch and remove skin barrier (drain when half full)
-clean and dry peristomal skin
-assess stoma and peristomal skin (no breakdown or redness)
-measure stoma (1/8” clearance around stoma)
-cut skin barrier to appropriate size and apply
-if two pieces, attach pouch to skin barrier

85
Q

Enteral - how to administer

A

NG tube, etc
Crush meds and mix with tap water
Liquid meds are best
Turn off suction
Check placement (pH, air bolus; depending on agency policy)
Flush with 30 mL of warm tap water
Administer meds (best practice, one at a time)
Flush with 30 mL of warm tap water after
Turn tube feeding back on, turn on suction after 30 minutes

86
Q

Subcutaneous Injection

A

lenth 5/8”
gauge 25-27
insulin, heparin, Lovenox
45 degree, pinch up
90 degree for obese

87
Q

Intradermal Injection

A

bevel up for the bleb
TB/allergies
30 gauge
5/8” length
15 angle
scapula/forearm

Funds II Lab (5 decks)

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