Lecture 2

Question 1

condition or circumstance for which drug has been approved
A particular drug may have multiple indications

Answer 1

Indication

Question 2

the use of pharmaceutical drugs for an unapproved indication or in an unapproved age group, dosage, or route of administration

Answer 2

Off-label indication

Question 3

Condition that renders treatment improper or undesirable

Answer 3

Contraindication

Question 4

a representative drug from a class that is used as a point of comparison for related versions of that drug
Learning one drug can allow nurse to extend knowledge to other similar drugs within that class

Answer 4

Prototype Drug

Question 5

Rate/extent to which active ingredient is absorbed from the drug and then becomes available at site of drug action

Answer 5

Bioavailability

Question 6

Means by which a drug carries out a therapeutic effect

Answer 6

Mechanism of Action

Question 7

Describes the mechanism by which the therapeutic effect is achieved
Examples: beta-blockers, diuretics, ACE inhibitors, calcium-channel blockers

Answer 7

Pharmacological Classification

Question 7

Describes condition for which drug is being given
Examples: antibiotics, antihypertensives, antidepressants, anticoagulants

Answer 7

Therapeutic Classification

Question 7

Inhibiting blood clotting

Answer 7

Anticoagulants

Question 8

Lowering blood cholesterol

Answer 8

Antihyperlipidemics

Question 9

Lowering blood pressure

Answer 9

Antihypertensives

Question 10

Restoring normal cardiac rhythm

Answer 10

Antidysrhythmics

Question 11

Treating angina

Answer 11

Antianginals

Question 12

Lowering plasma volume

Answer 12

Diuretic

Question 13

Blocking heart calcium channels

Answer 13

Calcium channel blocker

Question 14

Blocking hormonal activity

Answer 14

Angiotensin-converting enzyme inhibitor

Question 15

Blocking stress-related activity

Answer 15

Andrenergic antagonist

Question 16

Dialating peripheral blood vessls

Answer 16

Vasodilator

Question 17

A drug has only one chemical name
IUPAC
7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-Benzodiazepin-2-one”  “diazepam”
NaCl

Answer 17

Chemical names

Question 18

(International Non-Proprietary Name) lower case and most commonly used by HCPs

Answer 18

Generic names

Question 19

(proprietary or brand name) Often the original patented name is best known (20 years of exclusive use).

Answer 19

Trade names

Question 20

drugs with more than one active generic ingredient
New trade name.
Look “active ingredients” list the generic drug names in the product.

Answer 20

Combination drugs

Question 21

Advil, ibuprofen.

Answer 21

Labelling

Question 22

By prescription only and provided by a pharmacist, includes:
All prescription drugs
Schedule F: “Pr”
Controlled drugs (Part G)
Narcotic Drugs

Answer 22

Schedule I

Question 23

Dispensed by pharmacist, no public access

Answer 23

Schedule II

Question 24

Available at the pharmacy, but OTC

Answer 24

Schedule III

Question 25

Available in any store

Answer 25

Unscheduled

Question 26

carried out until the prescriber cancels it by writing a new order or until a prescribed number of days have elapsed

Answer 26

Routine

Question 27

given when the patient requires it

Answer 27

PRN (“as-needed”)

Question 28

given one time only for a specific reason at a specific time (e.g., before surgery)

Answer 28

Single (one-time, x1)

Question 29

written in advance for specific conditions

Answer 29

Standing Orders

Question 30

STAT: given immediately in an emergency

Question 31

med is needed quickly but not stat

Answer 31

NOW

Question 32

varies by agency, like a ‘forced review’

Answer 32

Automatic Stop

Question 33

to be taken outside the hospital

Answer 33

Prescriptions

Question 34

Sublingual*, buccal*, feeding tubes, by mouth (liquid, solid, crushed)

Answer 34

Enteral

Question 35

(no first-pass effect) Intradermal (ID), subcutaneous (SC), intramuscular (IM), intravenous (IV), epideral Intrathecal, intraosseous, intraperitoneal, intrapleural, intra-arterial

Answer 35

Parenteral

Question 36

Lotions, creams Transdermal patches Optic Otic (ear) Inhaled Vaginal Rectal

Answer 36

Topical

Question 37

Incident report + med errors need to be disclosed to ________: important

Answer 37

patients or family members

Question 38

RCA stands for

Answer 38

Root Cause Analysis

Question 39

Potential for significant harm should error happen Concentrated Electrolyte Solutions (KCl) Heparin Insulin Morphine Neuromuscular medications (paralyzing agents) Chemotherapy medications

Answer 39

High alert medications

Question 40

Need a two nurse check

Answer 40

High alert medications

Question 41

$$$ Not covered by insurance Complicated dosing regimens, with or without polypharmacy issues Adverse / side effects that impact lifestyle choices Headaches and dizziness GI effects impotence

Answer 41

Factors affecting adherence

Question 42

The right medication The right dose The right patient The right route The right time and frequency The right documentation The right reason The right to refuse The right patient education The right evaluation

Answer 42

10 Rights

Question 43

Capsule: particles/powder in gelatin shell Tablet: powder compressed into caplet Enteric-Coated tablet: coated tablet, dissolves in intestine Pill: any solid medication Sustained Release: tablet or capsule, contains small particles Lozenge: flat, dissolves in the mouth

Answer 43

Solid Forms (Oral)

Question 44

Elixir: meds, water, alcohol, clear Extract: Syrup or dried; evaporated Oral Solution: Medication dissolved in water Oral Suspension: Fine particles dispersed in liquid, settle to bottom Syrup: Med dissolved in [ ] sugar; shake well! Aerosol: spray; absorbed in mouth/upper airway

Answer 44

Liquid Forms

Question 45

Infection Prevention and Control Swallowing Safety Assess for dysphasia Assess LOC Patient positioning Special Assessments Heart Rate Blood Pressure Crush pills safely

Answer 45

Oral administration

Question 46

Medication administered under the tongue

Answer 46

Sublingual

Question 47

medicine given between the gums and the inner lining of the mouth cheek

Answer 47

buccal

Question 48

Wear gloves if you are placing the tablet into the mouth Patient instructions: dissolve completely, do not swallow tablet or saliva Not taken with fluids Buccal: Alternate sides Give after other oral meds are swallowed Document on MAR Monitor for therapeutic response and adverse reactions

Answer 48

Sublingual & Buccal

Question 49

Container that cannot be reused, and is developed to hold a drug quantity intended for single-dose administration

Answer 49

Unit Dose Container

Question 50

If a fluid is concave in the measure device measure the _______ of the curve

Answer 50

bottom

Question 51

If the fluid is convex in the measuring device, measure at the ______ of the curve

Answer 51

top

Question 52

Stay with patient until med is swallowed. If you are unsure:

Answer 52

ask patient to open mouth and inspect

Question 53

Always wear gloves Gastric Residual volume Positioning Compatibility with feed Compatibility of medication with crushing Technique: clamping, pinching!

Answer 53

Enteral medication administration

Question 54

NG tubes may be placed for different reasons: Food/meds Gastric Decompression (double lumen) Medications administered by enteral tubes should be liquid, but oral medication tablets may be administered if crushed or dissolved first.

Answer 54

Meds through a feeding tube

Question 55

Take barrel (plunger) out while syringe is attached to patient and pour meds in one-by-one

Answer 55

Gravity

Question 56

vacuum up your prepared med into the syringe then connect to the patient and push on the plunger to administer (Do not force)

Answer 56

Syringe

Question 57

document in nurses’ notes and EHR the method used to check placement of enteral tube, GRV, and pH of stomach aspirate

Answer 57

For enteral

Question 58

Document __________ that each medication was administered on MAR immediately after administration, NOT BEFORE. Include initials or signature

Answer 58

actual time

Question 59

1. Assess patient’s sensory functions, including sight, hearing, touch, and physical coordination. 2. Patients often receive more than one oral medication at a time. 3. Always assess for medication allergies. 4. Evaluate whether patient can take medication with food. 5. For all medications administered, review the prescription for patient’s name and medication, dosage, route, and time of administration. 6. For all medications, use the correct equipment for administering the medication. 7. For all medications administered, gather information pertinent to the medication(s) prescribed, including purpose, normal dosage and route, common side effects, time of onset and peak, contraindications, and nursing implications. 8. Determine whether medications require any specific nursing actions before administration. 9. If patients are mentally and physically able, prepare them for discharge by instructing them in self-administration techniques. 10. Check the expiration date for all medications.

Answer 59

Safety Guidelines