chapter 21

Question 1

What is the angle for IM, sq and intradermal injections?

Answer 1

90, 45, 15

Question 2

what is the maximum amount of medication administered at deltoid?

Answer 2

1 ml

Question 3

medications that cannot be crushed, broken or dissolved in water?

Answer 3

enteric coated, time release or extended release

Question 4

what would you do if you cannot crush an enteric coated medication?

Answer 4

all physician and get an order for another route

Question 5

what is the first thing you do when there is a discrepancy between the medication ordered and the medication in the drawer?

Answer 5

hold the medication and check the order

Question 6

medication absorbed by the skin is called?

Answer 6

transdermal

Question 7

what should you do when you sew blood during aspiration?

Answer 7

remove needle and prepare another injection

Question 8

how do you administer medication in the ear of child under 3 years old?

Answer 8

pull pinna back and down

Question 9

how do you instill ear medication for a child 3 and up?

Answer 9

up and back

Question 10

how do you administer nose drops?

Answer 10

• supine with head tilted backwards
• hold dropper above nostrils- do not touch the nostrils being treated
• instruct patient not to blow nose for 5 minutes after drop insertion

Question 11

contraindication for PO route?

Answer 11

• coma
• difficulty swallowing
• vomiting
• absence of gag reflex
• NPO
• Decreased GI motility

Question 12

The IM site that has the highest risk for injury?

Answer 12

Dorsogluteal site

Question 13

how do you draw medication from an ampule?

Answer 13

use a filtered needle

Question 14

how do you administer medications in the eye?

Answer 14

• ask patient to look up and lower conjunctival sac, apply pressure on the innate canthus for 1-2 minutes

Question 15

what is the purpose of cold applications?

Answer 15

constrict blood vessels
decrease edema
numbs pain

Question 16

how do you pour liquid medications?

Answer 16

label against palm— to prevent soiling of the label

Question 17

abbreviation for - p.c, h.s, q hr, b.i.d, t.i.d, a.c, pen, ad lib - as desired

Answer 17

???

Question 18

need length for an morbidly obese patient for IM

Answer 18

longer than 1 1/2 inches

Question 19

what is the purpose of Z track injection?

Answer 19

minimize pain and prevent staining of tissues

Question 20

medications administered through rectum are called?

Answer 20

suppository

Question 21

gauge for sq injection?

Answer 21

30

Question 22

five rights of medication administration?

Answer 22

right client
right drug
right dose
right time 
right route

Question 23

actions performed by the nurse before giving medications?

Answer 23

check over for accuracy
read label 3 times
wash hands
check expiration date
5 rights

Question 24

what does routine medications mean

Answer 24

administered on a regular basis until d/ed

Question 25

what is a stat order?

Answer 25

give immediately

Question 26

what is a standing order and give an example?

Answer 26

written for special circumstances. | Increased BS

Question 27

what should you do when administering oral medications?

Answer 27

crush medications if not contraindicated, stay with the client until medication is swallowed

Question 28

what does MAR stands for?

Answer 28

?

Question 29

true or false- medication orders are transcribed from physician order from onto the MAR

Answer 29

?

Question 30

true or false- the prescription label should match the drug listed on the MAR

Answer 30

?

Question 31

what are the uses of MAR?

Answer 31

- To document all routinely administered medications - Document PRN medications and their effectiveness - Document medications not given and the reason - Document sites of injections administered by nurse

Question 32

where do you document medication errors?

Answer 32

on a medication error report form

Question 33

explain controlled substances-in terms of abuse potential, locking system, counting, and wasting-

Answer 33

High potential for abuse Kept in a double locking system Each controlled drug when used is entered in a log book Count before you remove a controlled substance Counted at the end of every shift- by the incoming nurse and outgoing nurse If count is incorrect- identify issue before anyone leaves the facility When wasting- nurse must have a witness Counted even if it is not given

Question 34

How do you check placement of an NG tube?

Answer 34

aspirating gastric contents and checking PH.

Question 35

what would you do if a patient refuses a medication?

Answer 35

patient has the right.

Question 36

where do you place buccal medication?

Answer 36

between upper molar teeth and cheeks.

Question 37

before administering enteral tube feedings, a nurse should?

Answer 37

- verify presence of bowel sounds - check placement - elevate HOB 30 degrees during and 30-45 minutes after feeding - Flush the tube before and after with 30-50 ml

Question 38

what are the signs of infiltration?

Answer 38

``` coolness to touch pallor pain edema- loosen tape at once - drip flow may decrease ```

Question 39

what are the signs of phlebitis

Answer 39

erythema warmth edema pain/discomfort

Question 40

what is the first thing you do in case of infiltration

Answer 40

discontinue immediately and choose another site

Question 41

what are the 3 label checks?

Answer 41

A. when taking the container rom the drawer B. Before/ when removing the dose or before you take it to the patients room C. Before/when replacing the container back other checks

Question 42

What is the acceptable time to administer a medication?

Answer 42

30 minutes before or after the scheduled time

Question 43

what is the position for PO administration?

Answer 43

90 degree angle

Question 44

Medication label is checked against what, in the 3 label checks?

Answer 44

MAR

Question 45

How do you apply an ointment?

Answer 45

ask patient to look upwards squeeze ointment into the lower conjunctival sac-from inner to outer canthus Instruct patient to close eyes gently and to move the eyes with lid shut- to spread the medication

Question 46

what are the signs of anaphylactic shock?

Answer 46

respiratory distress- restlessness, dyspnea, wheezing and cyanosis. From bronchospasms skin reactions - pruritus (itching) or urticarial (hives) Circulatory collapse- BP down Pulse Up (weak and thready) or vertigo GI symtoms- nausea, vomiting and diarrhea

Question 47

a juice of which fruit can interfere with the metabolism of certain medications?

Answer 47

grapefruit