Exam 1 how to give meds

Question 1

Steps to give nitro patch

Answer 1

1. check order
2. gather supplies
3. educate patient on admin
4. remove old patch and wipe off excess; dispose of gloves
5. assess admin site- rotate site, find hairless spot, trim hair- DO NOT SHAVE
6. apply thin layer of ointment onto measurement paper
7. apply measurement paper, ointment side to patient, directly on skin
8. Date, time and initial measurement paper
9. securely tape measurement paper
10. educate patient on how to care for site of admin
11. monitor for adverse reactions

Question 2

what do we educate patient on nitro administration

Answer 2

locate a clean, hairless area on arm, chest or back
explain that we are going to apply a thin layer of nitro ointment onto an applicator and thinly spread it onto the skin then secure application paper with some tape
may cause a headache, warmness/flushing of face

Question 3

education on how to care for the site of administration for nitro

Answer 3

monitor for redness or irritation around application site
report prolonged or excessive skin reactions
do not ware for 24 hours
keep dry

Question 4

how to admin insulin pen

Answer 4

1. check order
2. gather supplies
3. explain procedure
4. remove cap from pen and use alcohol wipe to clean the rubber seal
5. twist needle onto rubber seal
6. prime the pen
7. dial up insulin
8. choose injection site and clean area
9. inject insulin
10. remove needle and dispose of it
11. document- dose, time, where, type

Question 5

how to admin otic med

Answer 5

1. varify order
2. gather supplies
3. position patient in supine position, than laterally with affected ear up
4. pull ear
5. admin ear drops
6. place cotton ball in affected ear
7. Have a say in this position for 5-10 minutes

Question 6

how to hold ear for otic meds for children over 4 years and adults

Answer 6

draw pinna up and back

Question 7

how to hold ear for otic meds in children under 3 years

Answer 7

pull earlobe down

Question 8

what is patient education after admin of otic meds

Answer 8

have patient sit up for 5-10 minutes after admin
place cotton ball after admin to prevent leakage of meds
inform patient on when to remove cotton ball

Question 9

how to admin rectal meds

Answer 9

1. varify order
2. gather supplies
3. get an assistant to help with positioning
4. have patient remove pants or under garments
5. place pad underneath patient
6. exam anus
7. position in left sims- left side, raise right knee to chest
8. lubricate dominate hand and suppository
9. have patient take a deep breath in and than insert when they exhale
10. ask patient to remain lying on their side for 15-20 min

Question 10

patient education for rectal meds

Answer 10

explain procedure
explain purpose of meds and potential side effects
instruct to remain lying down for specified period
encourage fluids

Question 11

prep of oral controlled substances from dispenser

Answer 11

used for distributing opiate analgesics and hypnotics
legally controlled must be under lock and key
automated controlled substance dispensing machines are used in clinical setting to monitor and control narcotic use

Question 12

how to admin nasal meds

Answer 12

have patient block one nostril and inhale through nose as atomizer is squeezed
should be admin while lying on back with neck hyperextended while med is dropped into nostrils

Question 13

how to admin inhalation meds

Answer 13

device is held in front of mouth and med is inhaled as inhaler is triggered
may require spacer for effective use

Question 14

admin meds via feeding tube

Answer 14

meds in liquid form best
tablets can be used if crushed and placed in liquid
do not mix meds with formula or tube feeding

Question 15

gauge of intradermal

Answer 15

24, 27, 29 gauge

Question 16

angle of intradermal

Answer 16

15 degree

Question 17

What is intradermal used for? for

Answer 17

TB
allergy testing

Question 18

what are sites for subcutaneous

Answer 18

upper outer portion of arm
anterior surface of thigh
abdomen

Question 19

what gauge and size is used for subcutaneous

Answer 19

25, 27 gauge
3/8 to 1/2 inch long

Question 20

what angle is used for subcutaneous

Answer 20

45-90 degree angle

Question 21

where is intramuscular given

Answer 21

deltoid
dorsogluteal
ventrogluteal
vastus lateralis
rectus femoris

Question 22

what gauge and size is used for intramuscular

Answer 22

19-23 gauge
1-3 inches

Question 23

what is the angle for intramuscular

Answer 23

90 degree angle

Question 24

what are subcutaneous used for

Answer 24

insulin
heparin
preoperative meds
narcotics

Question 25

what are intramuscular used for

Answer 25

patient cannot take med orally med not prepared in oral form faster action is desired

Question 26

how to give ophthalmic drops

Answer 26

read order remove contact lenses or glasses assess eye for inflammation, swelling, discharge, change of vision place patient in sitting position/ reclining ask to look at ceiling, tilt affected eye towards you with tissue beneath finger, bring lower lid down to expose conjunctival sac hold eye drops over sac and drop # drops ordered to stop: apply slight pressure with finger over lacrimal gland

Question 27

how to give ophthalmic ointment

Answer 27

order remove contacts, glasses assess eye place patient in sitting/reclining- looking at ceiling expose conjunctival sac apply thin ribbon along the conjunctival sac don't let tip touch eye

Question 28

How to give a nasal spray

Answer 28

have patient clear nose hold one nostril shut patient inserts top of atomizer into other nostril squeeze bottle while breathing in (1-2 squirts) typically repeat with otherside wipe top clean

Question 29

how to give nasal drops

Answer 29

patient lie supine head off bed and neck hyperextended dropper held just above nostril patient needs to remain in this position for a couple of minutes

Question 30

how to use MDI with spacer

Answer 30

sit or stand shake canister for 5 seconds connect MDI with spacer place mouthpiece of chamber in the mouth between teeth and seal lips around exhale completely from nose depress canister breathe in slowly hold breath for 10 seconds, try not to cough exhale through nose if second puff is ordered wait at least 1 minute

Question 31

how to admin vaginal creams

Answer 31

wash hands squeeze cream from tube into the applicator lie with knees drawn toward you insert applicator into your vagina and press applicator plunger downward if applicator is reusable, wash it with mild soap and warm water

Question 32

how to do vaginal irrigation

Answer 32

give 1500- 2000 mL over 10-15 min at room temp

Question 33

steps to give meds through feeding tube

Answer 33

crush meds- make sure they are crushable mix each med with 30 mL of warm water place patient in high fowler attach irrigation syringe tube while clamping tube flush tube with 30 mL of water add 1 med flush with 15-30 mL of water repeat until last med given after final med flush with 30-60 mL of water clamp tube for 30 minutes- don't reconnect leave HOB elevated for at least 30-60 min

Question 34

what needs to be documented on meds

Answer 34

med name, dosage, route, time BP/HR before giving antihypertensives and beta blockers reason for giving PRN assessment data if side effects occur patient education evaluation of therapy

Question 35

medication errors

Answer 35

50% of med errors occur at prescribing stage nurse must be able to interpret med correctly and be able to correctly give med if unclear/incomplete question know what drug is for need to assess patient before giving and after Report as soon as discovered

Question 36

what do you do when med error occurs

Answer 36

report as soon as discovered notify provider nurse who discovers error reports it incident report doesn't go in patient chart only put facts in incident report