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NUR 202 > Chapter 3: Principles of Drug Administration > Flashcards

Chapter 3: Principles of Drug Administration Flashcards

(79 cards)

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1
Q

Rights of Drug Administration

A

1) Right Patient
2) Right Medication
3) Right Dose
4) Right Route
5) Right Time/Frequency

Others:
Right to Refuse
Right Education
Right Documentation

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2
Q

Why do we need the Rights of Drug Administration?

A

-simple, practical guidelines for drug preparation, delivery, administration
-prevent medication error
-nurses are last safety net because they are administering the drugs
-operational basis for safe delivery of medication
recognized by Institution for Safe Medication Practices (ISMP)

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3
Q

Checks of Drug Administration

A

Used in conjunction with the 5 rights
1) Check the drug with the MAR (Medication Administration Record) when removing it from the medication drawee, refrigerator, or controlled substance container
2) Check the drug when preparing it, pouring it, taking it out of the unit-dose container, or connecting the tubing to the IV bag
3) Check the drub before administering to the patient

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4
Q

Nursing Process: Assessment in regards to medication

A

accuracy of Dr’s orders, collect data– Subjective (allergies) Objective (Vital Signs), health literacy,
health history

systemic collection of patient data
assessment of patient receiving medications
-health history, physical assessment, lab values,
assessment of medication effects (therapeutic and side effects)

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5
Q

Nursing Process: Diagnosis in regards to medication

A

-knowledge deficient to medicine regimen (follow up, reasons for use)
-any risk for falls, injury SE
-non adherence (health literacy issues) or no compliance (knows but doesn’t do)

analysis of assessment data, focused on patient problem

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6
Q

Nursing Process: Planning in regards to medication

A

setting goals what patient is able to achieve
outcomes, that you are looking for; measurable things; used to measure goal attainment

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7
Q

Nursing Process: Interventions in regards to medication

A

Administering medications (5 rights, 3 checks), documenting medications and teaching patients

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8
Q

Nursing Process: Evaluation in regards to medication

A

therapeutic effectiveness, monitor adverse effects
compares patient current health status to desired outcome
if the plan of care is appropriate, met or needs revision

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9
Q

Adverse Effect

A

any undesirable experience from the use of a medical product in patient;
described in terms of intensity: mild, moderate, severe, life-threatening
any AE is preventable

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10
Q

Side Effect

A

non-therapeutic reaction to drug; includes allergic and anaphylactic reactions

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11
Q

Demographic at risk for AE

A

very young, old, ill, or people taking multiple medications

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12
Q

Routes of Administration

A

1) Enteral
2)Topical
3)Parenteral

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13
Q

ac

A

before meals

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14
Q

ad lib

A

as desired

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15
Q

AM

A

morning

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16
Q

bid

A

twice a day

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17
Q

cap

A

capsule

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18
Q

gtt

A

drop

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19
Q

h or hr

A

hour

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20
Q

IM

A

intramuscular

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21
Q

IV

A

intravenous

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22
Q

no

A

number

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23
Q

pc

A

after meals

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24
Q

po

A

by mouth

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25
prn
as needed
26
qid
four times a day
27
q2h
every two hours
28
q6h
every six hours
29
q8h
every eight hours
30
Rx
take
31
STAT
immediately; within 5 minutes
32
tab
tablet
33
tid
three times a day
34
PM
afternoon/evening
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q4h
every four hours
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q12h
every twelve hours
37
ASAP
within 30 minutes of written order
38
Single Order
pre op? drug given once at specific time
39
Standing order
written order to use under certain circumstances
40
Allergic Reaction
side effect acquired response of the body defense to a foreign substance (allergen) i.e.skin rash w/ or w/o itching, red eyes with tearing, edema, runny nose
41
Anaphylactic reaction
side effect severe allergic reaction that produces a massive systemic release of histamine and other mediating factors that will cause inflammation that is life-threatening
42
Treatment for allergies
diphenhydramine (Benadryl)
43
Symptoms of Anaphylactic Shock
i.e acute dyspnea (labored or difficult breathing); sudden tachycardia or hypotension following drug administration shortly after -swelling of face, eyes, mouth, throat -wheezing -extremely low BP -cardiac arrest
44
Treatment of Anaphylactic Shock
reestablishment of airway and oxygen therapy administer epinephrine to raise blood pressure and dilate the respiratory bronchi; give Benadryl to stop additional release of histamine
45
Enteral (Broad)
ingestion and absorption in the digestive tract
46
Topical (Broad)
passive transfer through porous tissue i.e. skin, alveoli in lungs, mucous membranes
47
Parenteral (Broad)
insertion directly to inferior tissues intramuscular (muscle), intravenous(veins), subcutaneous
48
Which route is the safest
Enteral-ORAL; skin barrier is not compromised
49
Roles and Responsibilities of nurses regarding safe drug administration
legal and ethical
50
Types of Enteral Routes
A. Oral (tablets, capsules, liquids) B. Buccal C. Sublingual D. Nasogastric and gastrostomy
51
Advantages and Disadvantages of Enteral Drug Administration
Advantages: Convenient, doesn't compromise skin barrier, OVERDOSE--> vomit unabsorbed medication, vast absorptive surfaces skin, stomach, small intestine Disadvantages: depends on their gastrointestinal mobility and motility, First pass effect: inactivation of drug by processing in liver; inactivated by enzymes, may be difficult to swallow by some patients, may be inactivated if capsules and tablets are crushed
52
Enteric-coated tablets
CANT BE CRUSHED has hard waxy coating that resists acidity in the stomach target= small intestine
53
Sustained release tablets or capsules/extended release (XR) or Long -acting (LA) medication
DO NOT CRUSH designed for a longer duration; dissolves slowly helps increase compliance by reducing frequency of dosage
54
ODT
ONDANSETRON place on tongue and will dissolve within 30 min; eliminates need for external water; aids compliance
55
Sublingual
tablet is kept in mouth under tongue rapid onset because rich blood supply taken after other oral methods do not eat or drink anything until completely dissolved
56
Buccal
tablet or capsule placed in oral cavity between gum and cheek; Buccal mucosa is less permeable than sublingual providing slower absorption; do not generally cause irritation
57
NG tube
Nasogastric soft flexible tube inserted through nose (nasopharynx) to stomach can use crushed or dissolved drugs (liquid form) but can clog DO NOT USE SUSTAINED RELEASE
58
G tube
Gastrotomy surgically placed in stomach can use crushed or dissolved drugs (liquid form) but can clog DO NOT USE SUSTAINED RELEASE
59
Applications of Topical Drug Administration
1) Dermatologic Preparation 2) Instillation and Irrigation 3) Inhalation
60
Applications of Topical Drug Administration
1) Dermatologic Preparation -drugs applied on skin -lotions, gels, power, spray, cream 2) Instillation and Irrigation -applied to oral cavities or orifices -eyes, nose, ears, urinary bladder, vagina, rectum 3) Inhalation -applied to respiratory tract -inhalation, nebulizers
61
Advantages and Disadvantages of Topical Drug Administration
Advantages: -many used for local effect; can be use for systemic effect too -fewer SE Disadvantages -absorbed slower
62
Local effect example
antibiotics on skin to treat skin infection
63
Systemic effect example
suppository inserted rectally not to treat disease of rectum but to alleviate nausea; rectal and nasal
64
Transdermal Delivery System
transdermal patch contains a specific amount of drug; rate of delivery is variable; AVOIDS FIRST PASS EFFECT of liver and enzyme; alternate spots of patches; document location
65
Ophthalmic Administration
used to treat local conditions in the eye and surrounding structures -Common indication of problems: dry, dilation of pupil during eye exam, infection, glaucoma Available in drops, irrigation, ointments, medicated disks
66
Otic Administration
treat local conditions in the ear such as infections and soft blockages in auditory canal - irrigation or drops -used for cleaning purposes
67
Nasal Administration
BOTH LOCAL AND SYSTEMIC EFFECT excellent absorptive surface bypasses digestive enzymes high safety margin even though some may cause cilia damage or mucosal irritation proper positioning local astringent effect: shrink swollen mucous membranes or loosen secretions and facilitate drainage drops or sprays are used to shrink swollen mucous
68
Vaginal Administration
used to treat local infection; vaginal pain or itching -creams, suppositories, foam, jellies -need to explain what you are going to do and purpose of treatment FIRST; ALWAYS provide privacy -ask patient to empty out bladder to prevent more discomfort; injury to vaginal lining -should always offer perineal pad after administration
69
Rectal Administration
USED FOR BOTH SYSTEMIC AND LOCAL ADMINISTRATION -safe and effective administration is using when patient is comatose or vomited -slow and steady absorption -usually is suppository form; laxative given as enema avoid first pass effect
70
Which route is more invasive
PARENTERAL route is most invasive; ASPETIC TECHNIQUE must be used to prevent pathogens of being introduced into blood or body tissue
71
Precaution for nurses to know for parenteral route
Know the anatomical location and how to safety dispose/handle hazardous material
72
Types of Parenteral Administration
1) Intradermal 2) Subcutaneous 3) Intramuscular 4)Intravenous
73
Intradermal
Administered to dermis of skin; absorbed more than subcutaneous; used for allergy, local anesthetic, or disease screening
74
Subcutaneous
injection to deepest part of the skin -used for easy access and rapid absorption; ID absorbed faster -Vaccines, Heparin -important to rotate injection sites -aspiration is not necessary but depends on drug
75
Intramuscular
delivers meds to specific muscles more rapid onset compared to Subcutaneous, ID, and Oral injection site is important: needs to avoid bone, nerves, blood vessels -can accept a larger volume of medication that subcutaneous
76
Intravenous
Fastest onset of drug medication or fluids administered directly into bloodstream; immediate use by the body DANGEROUS because: once inject cant be received potential risk for pathogens to enter at injection site
77
Parenteral Advantages and Disadvantages
advantages -bypass first pass effect and enzymes -patients who are unable to take medications orally disadvantages -only small doses can be used -possible pain and swelling at injection site area
78
HIGH TO LOW ONSET
Parenteral: IV, IM, ID, SUBQ, oral topical
79
Types of Intravenous Administration
1) large volume infusion used for fluid maintenance, replacement, or supplementation 2)intermittent infusion small volume of IV SOLUTION used in tandem with or piggy backed to primary large volume bag; instill adjunct medications i.e. antibiotics or analgesics for a short period of time 3)bolus(push) administration concentrated dose administered directly into bloodstream via syringe to administer single dose medications

NUR 202 (7 decks)

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