Chapter 31 -- Medication Administration Flashcards Preview

NRS 130 TEST #6 > Chapter 31 -- Medication Administration > Flashcards

Flashcards in Chapter 31 -- Medication Administration Deck (78):

The nurse is having difficulty reading a physician’s order for a medication. He or she knows that the physician is very busy and does not like to be called. What is the most appropriate next step for the nurse to take?

1. Call a pharmacist to interpret the order
2. Call the physician to have the order clarified
3. Consult the unit manager to help interpret the order
4. Ask the unit secretary to interpret the physician’s handwriting

2. Call the physician to have the order clarified

You must have the right documentation and clarify all orders with the prescriber before administering medications.


The patient has an order for 2 tablespoons of Milk of Magnesia. How much medication does the nurse give him or her?

1. 2 mL
2. 5 mL
3. 16 mL
4. 30 mL

4. 30 mL

1 tablespoon = 15 mL; 2 tablespoons = 30 mL.


A nurse is administering eardrops to an 8-year-old patient with an ear infection. How does the nurse pull the patient’s ear when administering the medication?

1. Outward
2. Back
3. Upward and back
4. Upward and outward

4. Upward and outward

Eardrops are administered with the ear positioned upward and outward for patients greater than 3 years of age.


A patient is to receive cephalexin (Keflex) 500 mg PO. The pharmacy has sent 250-mg tablets. How many tablets does the nurse administer?
1. ½ tablet
2. 1 tablet
3. 1 ½ tablets
4. 2 tablets

4. 2 tablets

Using dimensional analysis:
Tablets = 1tablet/250 mg× 500 mg = 500/250 = 2 tablets.


A nurse is administering medications to a 4-year-old patient. After he or she explains which medications are being given, the mother states, “I don’t remember my child having that medication before.” What is the nurse’s next action?

1. Give the medications
2. Identify the patient using two patient identifiers
3. Withhold the medications and verify the medication orders
4. Provide medication education to the mother to help her better understand her child’s medications

3. Withhold the medications and verify the medication orders

Do not ignore patient or caregiver concerns; always verify orders whenever a medication is questioned before administering it.


A patient is transitioning from the hospital to the home environment. A home care referral is obtained. What is a priority in relation to safe medication administration for the discharge nurse?

1. Set up the follow-up appointments with the physician for the patient.
2. Ensure that someone will provide housekeeping for the patient at home.
3. Ensure that the home care agency is aware of medication and health teaching needs.
4. Make sure that the patient’s family knows how to safely bathe him or her and provide mouth care.

3. Ensure that the home care agency is aware of medication and health teaching needs.

A nursing responsibility is to collaborate with community resources when patients have home care needs or difficulty understanding their medications.


A nursing student takes a patient’s antibiotic to his room. The patient asks the nursing student what it is and why he should take it. Which information does the nursing student include when replying to the patient?

1. Only the patient’s physician can give this information.
2. The student provides the name of the medication and a description of its desired effect.
3. Information about medications is confidential and cannot be shared.
4. He has to speak with his assigned nurse about this.

2. The student provides the name of the medication and a description of its desired effect.

Patients need to know information about their medications so they can take them correctly and safely.


The nurse is administering a sustained-release capsule to a new patient. The patient insists that he cannot swallow pills. What is the nurse’s next best course of action?

1. Ask the prescriber to change the order
2. Crush the pill with a mortar and pestle
3. Hide the capsule in a piece of solid food
4. Open the capsule and sprinkle it over pudding

1. Ask the prescriber to change the order

Enteric-coated or sustained-release capsules should not be crushed; the nurse needs to contact the prescriber to change the medication to a form that is liquid or can be crushed.


The nurse takes a medication to a patient, and the patient tells him or her to take it away because she is not going to take it. What is the nurse’s next action?
1. Ask the patient’s reason for refusal
2. Explain that she must take the medication
3. Take the medication away and chart the patient’s refusal
4. Tell the patient that her physician knows what is best for her

1. Ask the patient’s reason for refusal

When patients refuse a medication, first ask why they are refusing it.


The nurse receives an order to start giving a loop diuretic to a patient to help lower his or her blood pressure. The nurse determines the appropriate route for administering the diuretic according to:

1. Hospital policy.
2. The prescriber’s orders.
3. The type of medication ordered.
4. The patient’s size and muscle mass.

2. The prescriber’s orders.

The order from the prescriber needs to indicate the route of administration.


A patient is receiving an intravenous (IV) push medication. If the drug infiltrates into the outer tissues, the nurse:

1. Continues to let the IV run.
2. Applies a warm compress to the infiltrated site.
3. Stops the administration of the medication and follows agency policy.
4. Should not worry about this because vesicant filtration is not a problem.

3. Stops the administration of the medication and follows agency policy.

When an IV medication infiltrates, stop giving the medication and follow agency policy.


If a patient who is receiving intravenous (IV) fluids develops tenderness, warmth, erythema, and pain at the site, the nurse suspects:

1. Sepsis.
2. Phlebitis.
3. Infiltration.
4. Fluid overload.

2. Phlebitis.

Redness, warmth, and tenderness at the IV site are signs of phlebitis.


After seeing a patient, the physician gives a nursing student a verbal order for a new medication. The nursing student first needs to:

1. Follow ISMP guidelines for safe medication abbreviations.
2. Explain to the physician that the order needs to be given to a registered nurse.
3. Write down the order on the patient’s order sheet and read it back to the physician.
4. Ensure that the six rights of medication administration are followed when giving the medication.

2. Explain to the physician that the order needs to be given to a registered nurse.

Nursing students cannot take orders.


A nurse accidently gives a patient a medication at the wrong time. The nurse’s first priority is to:

1. Complete an occurrence report.
2. Notify the health care provider.
3. Inform the charge nurse of the error.
4. Assess the patient for adverse effects.

4. Assess the patient for adverse effects.

Patient safety and assessing the patient are priorities when a medication error occurs.


A patient is taking albuterol through a pressurized metered dose inhaler (pMDI) that contains a total of 200 puffs. The patient takes 2 puffs every 4 hours. How many days will the
pMDI last?
__________ days

16 days.

Two puffs × 6 times a day = 12 puffs per day; 200 puffs/12 puffs per day = 16.67 days, or about 16 days. This cannot be rounded up since the inhaler will not last a total of 17 days.


What is the role of the federal government in relation to the regulation of medications?

-The federal government protects the health of the people by ensuring that medications are safe and effective.
-The Food and Drug Administration (FDA) ensures that all medications undergo vigorous testing before they are sold.


What is the role of the state government in relation to the regulation of medications?

The state governments conform to federal legislation but also have additional controls such as alcohol and tobacco.


What is the role of health care institutions in relation to the regulation of medications?

Health care institutions have individual policies to meet federal and state regulations.


What is the role of the Nurse Practice Act in relation to the regulation of medications?

The Nurse Practice Act defines the scope of a nurses professional functions and responsibilities.


What is the chemical name of a medication?

A chemical name provides an exact description of the medication's composition and molecular structure.


What is the generic name of a medication?

A generic name is created by the manufacturer who first develops the medication; this becomes the official name.


What is the trade name of the medication?

The trade name is one that the manufacturer has trademarked to identify the particular version they manufacture.


What does the classification of a medication indicate?

A medication classification indicates the effect of the medication on a body system, the symptoms the medication relieves, or the medications desired effect.


What does the form of a medication determine?

The form of the medication determines it's route of administration.


What is pharmacokinetics?

The study of how medications enter the body, reach their site of action, metabolize, and exit the body.


What is absorption?

Refers to the passage of medication molecules into the blood from the site of administration.


What factors influence drug absorption?

-Route of administration
-Ability of the medication to dissolve
-Blood flow to the site of administration
-Body surface area
-Lipid solubility


What factors affect the rate and extent of medication distribution?

-Membrane permeability
-Protein binding


Explain the role of metabolism:

After a medication reaches its site of action, it becomes metabolized into a less active or inactive form that is easier to excrete.


What is the primary organ for drug excretion and what happens if the organ's function declines?

-The kidneys are the primary organ for drug excretion
-When renal function declines, a patient is at risk for medication toxicity.


What is the therapeutic effect of drugs?

The expected or predictable physiological response to a medication.


What are side effects of drugs?

Predictable and often unavoidable secondary effects a medication predictably will cause.


What are adverse effects of drugs?

Unintended, undesirable, and often unpredictable severe responses to medication.


What are toxic effects of drugs?

Toxic effects develop after prolonged intake of a toxic medication or when a medication accumulates in the blood because of impaired metabolism or excretion.


What are idiosyncratic reactions to drugs?

Unpredictable effects in which a patient overreacts or under reacts to a medication or has a reaction that is different from normal.


What are allergic reactions to drugs?

Unpredictable responses to a medication.


What are anaphylactic reactions to drugs?

Allergic reactions that are life-threatening characterized by:
-sudden constriction of bronchiolar muscles
-edema of the pharynx and the larynx
-severe wheezing


What are medication interactions with drugs?

Occurs when one medication modifies the action of another medication.
-It may alter the way another medication is absorbed, metabolized, or eliminated from the body.


What is the synergistic effect of drugs?

When the combined effect of two medications is greater than the effect of the medications when given separately.


What is minimum effective concentration (MEC)?

The plasma level of medication below which the medication's effect will not occur.


What is peak concentration?

The highest serum level concentration.


What is trough concentration?

The lowest serum level concentration.


What is biological half – life?

The time it takes for excretion processes to lower the serum medication concentration by half.


What are the three types of oral routes?



What are the four major sites for parenteral injections?



What are the five methods for applying medications to mucous membranes?

-Directly apply a liquid or ointment
-Inserting a medication into a body cavity
-Instilling fluid into a body cavity
-Irrigating a body cavity


What is the benefit of the inhalation route?

Readily absorbed and work rapidly because of the rich vascular alveolar capillary network present in the pulmonary tissue.


What three types of measurements are used in medication therapy?



What is a solution?

-A given mass of solid substance dissolved into a known volume of fluid.
-Given volume of liquid dissolved in a known volume of another fluid.


What formula is used to determine the correct dose preparing solid or liquid forms of medications?

Dose ordered/Dose on hand x Amount on hand = Amount to administer


What is a verbal medication order?

The order is given verbally to the nurse by the provider.


What is a standing or routine medication order?

Carried out until the prescriber cancels it by another order or until a prescribed number of days elapse.


What is a PRN medication order?

A medication that is given only when a patient requires it.


What is a single (one-time) medication order?

Given only once at a specified time.


What is a STAT medication order?

Describes a single dose of a medication to be given immediately and only once.


What is a now medication order

-Used when a patient needs a medication quickly but not right away.
-The nurse has up to 90 minutes to administer.


List the medication distribution systems:

-Unit dose
-Automated medication dispensing systems (AMDS)


What common medication errors can cause patient harm?

-Inaccurate prescribing
-Administration of the wrong medicine
-Giving the medication using the wrong route or time interval
-Administering extra doses
-Failing to administer a medication


Identify the process for medication reconciliation:



What are the six rights of medication administration?

-The right medication
-The right dose
-The right patient
-The right route
-The right time
-The right documentation


Briefly summarize "The Patient Care Partnership" related to medication administration:

-Be informed of the medications name, purpose, action, and potential undesired effects.
-Refuse a medication regardless of the consequences.
-Have qualified nurses or physicians access a medication history.
-Be properly advised of the experimental nature of medication therapy and give written consent.
-Receive label medications safely without discomfort.
-Receive appropriate supportive therapy.
-Not receive necessary medications.
-Be informed if medications are part of a research study.


What areas does the nurse need to assess to determine the need for and potential response to medication therapy?

-History of allergies
-Medication data
-Diet history
-Patient's perceptual coordination problems
-Patient's current condition
-Patient's attitude about medication use
-Patients knowledge and understanding of medication therapy
-Patient's learning needs


What are potential nursing diagnoses used during the administration of medications?

-Ineffective health maintenance
-Readiness for enhanced immunization status
-Deficient knowledge
-Effective therapeutic regimen management
-Impaired swallowing


Identify the outcomes for a patient with newly diagnosed type 2 diabetes:

-Will verbalize understanding of desired effects and adverse effects of medications.
-Will state signs, symptoms, and treatment of hypoglycemia.
-Will monitor blood sugar to determine if medication is appropriate to take.
-Will establish a daily routine that will coordinate timing of medication with meal times.


What factors can influence the patient's compliance with the medication regimen?

-Health beliefs
-Personal motivations
-Socioeconomic factors


What are the components of medication orders?

-Patient's full name
-Date and time that the order is written
-Medication name
-Route of administration
-Time and frequency of administration
-Signature of provider


What does the recording of medication include?

-The name of the medication
-Exact time of administration


Why does polypharmacy happen to a patient?

-When patients need to take several medications to treat their illnesses
-Take two or more medications from the same chemical class
-Use two or more medications with the same or similar actions or mix nutritional supplements or herbal product with medication


What are goals are safe and effective medication administration?

-Patient responds to therapy
-Patient has the ability to assume responsibility for self–care


What are precautions to take when administering any oral preparation to prevent aspiration?

-Determine the patients ability to swallow and cough and check for gag reflex
-Prepare oral medications in the form that is easiest to swallow
-Allow the patient to self-administer medications if possible
-If the patient has unilateral weakness, place the medication on the stronger side on the mouth.
-Administer pills one at at time, ensuring that each medication is properly swallowed properly before the next one is introduced
-Thicken regular liquids or offer fruit nectars if the patient cannot tolerate thin liquids.
-Avoid straws bc they decrease the control the patient has over volume intake, which increases the risk of aspiration
-Have the patient hold the cup and drink it if possible
-Time medications to coincide with meal times or when the patient is well-rested and awake if possible
-Administer administrations using another route if risk of aspiration is severe


What are the guidelines to ensure safe administration of transdermal or topical medications?

-Document where the medication was placed in the MAR
-Assess if the patient has an existing patch before application
-Medication hx and reconciling medications
-Apply a noticeable label to the patch
-Document removal of medications in the MAR


What is the most common form of nasal installation?

Decongestant spray or drops


What are the four principles for administering eye installations?

-Avoid instilling any eye medication directly into the cornea
-Avoid touching the eyelids or the other eye structures with eye droppers or ointment tubes
-Use medication only for the patient's affected eye
-Never allow a patient to use another patient's eye medications


Failure to instill ear drops at room temperature causes:



What is a pressurized metered-dose inhaler (pMDI)?

Delivers a measured dose of medication with each push of a canister often used with a spacer.


What is a breath–actuated metered-dose inhaler (BAI)?

Releases medication when a patient raises a level and then inhales.


What are dry powder inhalers (DPIs)?

Hold dry, powdered medication and create an aerosol when the patient inhales through a reservoir that contains the medication.


Vaginal medications are available as: