Ch. 3 & 7-13 - Medication Safety, Ethical Considerations, Research, Nursing Process, Drug Administration, Cultural, Genetic & Age-related Considerations & Community Settings Flashcards Preview

Pharmacology > Ch. 3 & 7-13 - Medication Safety, Ethical Considerations, Research, Nursing Process, Drug Administration, Cultural, Genetic & Age-related Considerations & Community Settings > Flashcards

Flashcards in Ch. 3 & 7-13 - Medication Safety, Ethical Considerations, Research, Nursing Process, Drug Administration, Cultural, Genetic & Age-related Considerations & Community Settings Deck (112):
1

Assessment

The phase of the nursing process that is characterized by systematic validation & documation of information

2

Nursing Diagnosis

A determination made based on the analysis of assessment data

3

Planning

The phase of the nursing process characterized by goal setting including the development of nursing interventions that be used to assist the patient in meeting the goals

4

Goal Setting

Stating expected outcomes

5

Implementation

The phase of the nursing process in which the nurse provides education, medication, care & other interventions

6

Culturally Sensitive

The awareness of the implications of culture for the patient & his/her family

7

Evaluation

The phase of the nursing process in which the nurse determines how well goals are obtained, revises interventions & teaches patient focusing on goal attainment

8

"Five-Plus-Five" Rights of Medication Administration

(1) RIGHT patient (2) RIGHT drug (3) RIGHT dose (4) RIGHT route (5) RIGHT time (6) RIGHT assessment (7) RIGHT documentation (8) RIGHT to education (9) RIGHT evaluation (10) RIGHT to refuse

9

The Joint Commission (TJC)

Accredation company that regulates healthcare administration...requires patient be identified by two unique forms of ID

10

Unit Dose Method

Method in which drugs are individually wrapped & labeled for single doses for each patient

11

Institute of Medicine (IOM)

a 1999 report that spurred work on changes to decrease medication errors

12

Sublingual

medication placed under the tongue to dissolve

13

Buccal

medication placed between the cheek & gum to dissolve

14

Inhalation

medication inhaled orally into the lungs

15

Transdermal

medication placed on the skin (patch) & absorbed

16

Topical

medication applied to skin surface

17

Intillations

liquid medication given as drops, ointments or sprays

18

Suppositories

medication inserted into the vagina or rectum

19

Parenteral

medication given via injection

20

Intradermal Injection

injection given between epidermis & dermis layers of skin (EX: TB test)

21

Subcutaneous Injection

injection given under the skin in the tissue (EX: insulin, heparin)

22

Intramuscular Injection

injection given under the skin & tissue, in the muscle (EX: vaccines)

23

Z-track Technique

technique used to prevent medication from leaking back through site into subcutaneous tissue

24

Intravenous Injection

injection given into a vein

25

Metered Dose Inhalers (MDI)

handheld devices that deliver medication to the lower respiratory tract when inhaled into the lungs

26

Intraosseous Injection

injection given into the bone marrow

27

Biocultural Ecology

area of study that looks at variations in biological characteristics that are inconsistent for an ethnic group that might pose a concern for a nurse

28

Hereditary

genetic characteristics transferred from parent to offspring

29

Genetic

pertaining to genetics & reproduction

30

Nonadherence

not following medication directions; "noncompliance" (frequent in older adults)

31

Adherence

following prescribed medication regimens; "complicane"

32

Polypharmacy

administration of many drugs together to the same patient (frequent in older adults)

33

Holistic Nursing Approach

a patient-centered approach to healing that strives to meet cognitive, emotional, physical, social & spiritual needs of patients

34

Three Checks of Medication Administration

(1) Before taking it out of the package (2) As placing it in the medicine cup (3) Again before giving it to patient

35

Safety Risks for Medication Administration

New drugs, distractions, fatigue, sleep deprivation, confusing packaging, equipment failures, poor communication, transcription errors, handwriting issues

36

Institute of Medicine (IOM) Report of 1999 "To Err is Human: Building a Safer Healthcare System"

report that spurred changes in healthcare system changes to decrease errors

37

FDA 2002 Rule "Bar Code Label Requirements for Human Drug Products & Blood"

rule implemented by the FDA to increase the prominence of coding...at a minimum, the bar code contains the drug's national drug code that uniquely identifies the drug, its strength and its dosage form

38

The Joint Commission 2013 Patient Safety Goals

(1) Improve staff communication (2) Identify patients correctly (3) Use medicines safely

39

Institute for Safe Medication Practices (ISMP)

organization that puts out monthly newsletter about safety in medication practices...issues a list of error prone abbreviations, symbols & dose designations

40

Quality and Safety in Education in Nursing (QSEN)

Robert Woods Johnson Foundation...addressing and all about safety in nursing

41

Basic Ethical Principles in Medication Administration

Respect for person (autonomy), Beneficence, Justice, Veracity, Informed Consent

42

Phase I of Human Clinical Experimentation

phase of HCE determining human dosage range based on healthy subjects and identifying pharmacokinetics

43

Phase II of Human Clinical Experimentation

phase of HCE demonstrating safety and efficacy of drug in a limited number of subjects with disease to be treated

44

Phase III & IV of Human Clinical Experimentation

phase of HCE demonstrating safety and efficacy of drug for well client population (including long-term data if chronic regimen)

45

Role of the Nurse in Human Clinical Experimentation

(1) Recruit & assess study subjects (2) Understand protocols including inclusion & exclusion criteria (3) Know validity & reliability of measurement instruments (4) Communicate & work with other healthcare providers & sponsors

46

FDA Pregnancy Categories

a classification system related to the effects of drugs on a fetus used to optimize informed decision making for pregnant patients

47

Pregnancy Category A

No risk to the fetus. Studies have not shown evidence of fetal harm.

48

Pregnancy Category B

No risk to fetus in animal studies but well-controlled studies in pregnant women is not available. It is assumed there is little to no risk in pregnant women.

49

Pregnancy Category C

Animal studies indicate a risk to the fetus but controlled studies in pregnant women is not available. Risk vs. benefit must be determined.

50

Pregnancy Category D

A risk to the human fetus has been proved. Risk vs. benefit of the drug must be determined. It could be used in life-threatening conditions.

51

Pregnancy Category X

A risk to the human fetus has been proved. Risk outweighs the benefit & the drug should be avoided during pregnancy.

52

Physiologic Changes in GI System of Geriatric Patient

increased pH gastric secretions, decreased peristalsis with delayed gastric emptying time, decreased motility, decreased first-pass effect--->SLOWER ABSORPTION OF ORAL DRUGS

53

Physiologic Changes in Cardiac & Circulatory Systems of Geriatric Patient

decreased cardiac output, decreased blood flow --->DELAYS TRANSPORTATION OF DRUGS TO TISSUE

54

Physiological Changes in Hepatic System of Geriatric Patient

decreased enzyme function, decreased blood flow--->DRUGS METABOLIZED MORE SLOWLY & LESS COMPLETELY

55

Physiological Changes in Renal System of Geriatric Patient

decreased blood flow, decreased nephron function, decreased glomerular filtration rate--->DRUGS EXCRETED LESS COMPLETELY

56

Strategies to Increase Geriatric Patient Compliance with Drug Therapy

(1) Education of patients & families (2) Help cut costs of medications (3) Be available for questions (4) Review medications with patient (5) Advise patient to use one pharmacy

57

The phase of the nursing process that is characterized by systematic validation & documation of information

Assessment

58

A determination made based on the analysis of assessment data

Nursing Diagnosis

59

The phase of the nursing process characterized by goal setting including the development of nursing interventions that be used to assist the patient in meeting the goals

Planning

60

Stating expected outcomes

Goal Setting

61

The phase of the nursing process in which the nurse provides education, medication, care & other interventions

Implementation

62

The awareness of the implications of culture for the patient & his/her family

Culturally Sensitive

63

The phase of the nursing process in which the nurse determines how well goals are obtained, revises interventions & teaches patient focusing on goal attainment

Evaluation

64

(1) RIGHT patient (2) RIGHT drug (3) RIGHT dose (4) RIGHT route (5) RIGHT time (6) RIGHT assessment (7) RIGHT documentation (8) RIGHT to education (9) RIGHT evaluation (10) RIGHT to refuse

"Five-Plus-Five" Rights of Medication Administration

65

Accredation company that regulates healthcare administration...requires patient be identified by two unique forms of ID

The Joint Commission (TJC)

66

Method in which drugs are individually wrapped & labeled for single doses for each patient

Unit Dose Method

67

a 1999 report that spurred work on changes to decrease medication errors

Institute of Medicine (IOM)

68

medication placed under the tongue to dissolve

Sublingual

69

medication placed between the cheek & gum to dissolve

Buccal

70

medication inhaled orally into the lungs

Inhalation

71

medication placed on the skin (patch) & absorbed

Transdermal

72

medication applied to skin surface

Topical

73

liquid medication given as drops, ointments or sprays

Intillations

74

medication inserted into the vagina or rectum

Suppositories

75

medication given via injection

Parenteral

76

injection given between epidermis & dermis layers of skin (EX: TB test)

Intradermal Injection

77

injection given under the skin in the tissue (EX: insulin, heparin)

Subcutaneous Injection

78

injection given under the skin & tissue, in the muscle (EX: vaccines)

Intramuscular Injection

79

technique used to prevent medication from leaking back through site into subcutaneous tissue

Z-track Technique

80

injection given into a vein

Intravenous Injection

81

handheld devices that deliver medication to the lower respiratory tract when inhaled into the lungs

Metered Dose Inhalers (MDI)

82

injection given into the bone marrow

Intraosseous Injection

83

area of study that looks at variations in biological characteristics that are inconsistent for an ethnic group that might pose a concern for a nurse

Biocultural Ecology

84

genetic characteristics transferred from parent to offspring

Hereditary

85

pertaining to genetics & reproduction

Genetic

86

not following medication directions; "noncompliance" (frequent in older adults)

Nonadherence

87

following prescribed medication regimens; "complicane"

Adherence

88

administration of many drugs together to the same patient (frequent in older adults)

Polypharmacy

89

a patient-centered approach to healing that strives to meet cognitive, emotional, physical, social & spiritual needs of patients

Holistic Nursing Approach

90

(1) Before taking it out of the package (2) As placing it in the medicine cup (3) Again before giving it to patient

Three Checks of Medication Administration

91

New drugs, distractions, fatigue, sleep deprivation, confusing packaging, equipment failures, poor communication, transcription errors, handwriting issues

Safety Risks for Medication Administration

92

report that spurred changes in healthcare system changes to decrease errors

Institute of Medicine (IOM) Report of 1999 "To Err is Human: Building a Safer Healthcare System"

93

rule implemented by the FDA to increase the prominence of coding...at a minimum, the bar code contains the drug's national drug code that uniquely identifies the drug, its strength and its dosage form

FDA 2002 Rule "Bar Code Label Requirements for Human Drug Products & Blood"

94

(1) Improve staff communication (2) Identify patients correctly (3) Use medicines safely

The Joint Commission 2013 Patient Safety Goals

95

organization that puts out monthly newsletter about safety in medication practices...issues a list of error prone abbreviations, symbols & dose designations

Institute for Safe Medication Practices (ISMP)

96

Robert Woods Johnson Foundation...addressing and all about safety in nursing

Quality and Safety in Education in Nursing (QSEN)

97

Respect for person (autonomy), Beneficence, Justice, Veracity, Informed Consent

Basic Ethical Principles in Medication Administration

98

phase of HCE determining human dosage range based on healthy subjects and identifying pharmacokinetics

Phase I of Human Clinical Experimentation

99

phase of HCE demonstrating safety and efficacy of drug in a limited number of subjects with disease to be treated

Phase II of Human Clinical Experimentation

100

phase of HCE demonstrating safety and efficacy of drug for well client population (including long-term data if chronic regimen)

Phase III & IV of Human Clinical Experimentation

101

(1) Recruit & assess study subjects (2) Understand protocols including inclusion & exclusion criteria (3) Know validity & reliability of measurement instruments (4) Communicate & work with other healthcare providers & sponsors

Role of the Nurse in Human Clinical Experimentation

102

a classification system related to the effects of drugs on a fetus used to optimize informed decision making for pregnant patients

FDA Pregnancy Categories

103

No risk to the fetus. Studies have not shown evidence of fetal harm.

Pregnancy Category A

104

No risk to fetus in animal studies but well-controlled studies in pregnant women is not available. It is assumed there is little to no risk in pregnant women.

Pregnancy Category B

105

Animal studies indicate a risk to the fetus but controlled studies in pregnant women is not available. Risk vs. benefit must be determined.

Pregnancy Category C

106

A risk to the human fetus has been proved. Risk vs. benefit of the drug must be determined. It could be used in life-threatening conditions.

Pregnancy Category D

107

A risk to the human fetus has been proved. Risk outweighs the benefit & the drug should be avoided during pregnancy.

Pregnancy Category X

108

increased pH gastric secretions, decreased peristalsis with delayed gastric emptying time, decreased motility, decreased first-pass effect--->SLOWER ABSORPTION OF ORAL DRUGS

Physiologic Changes in GI System of Geriatric Patient

109

decreased cardiac output, decreased blood flow --->DELAYS TRANSPORTATION OF DRUGS TO TISSUE

Physiologic Changes in Cardiac & Circulatory Systems of Geriatric Patient

110

decreased enzyme function, decreased blood flow--->DRUGS METABOLIZED MORE SLOWLY & LESS COMPLETELY

Physiological Changes in Hepatic System of Geriatric Patient

111

decreased blood flow, decreased nephron function, decreased glomerular filtration rate--->DRUGS EXCRETED LESS COMPLETELY

Physiological Changes in Renal System of Geriatric Patient

112

(1) Education of patients & families (2) Help cut costs of medications (3) Be available for questions (4) Review medications with patient (5) Advise patient to use one pharmacy

Strategies to Increase Geriatric Patient Compliance with Drug Therapy