Lectures 1 and 2 Flashcards
1
Q
To safely and accurately administer medications, you need knowledge related to(8):
A
1) Legal aspects of health
2) care
3) Pharmacology
4) Pharmacokinetics
5) Life sciences
6) Pathophysiology
7) Human anatomy
8) Mathematics
2
Q
what is medication used for?
A
Diagnosis, treatment, cure, or prevention of health problems
3
Q
When it comes to medication, nurses are responsible for evaluating…
A
1) effects of meds on pt health status
2) teaching pts about meds and side effects
3) making sure they adhere to the med regimen
4) and evaluating the pt/family/caregivers ability to self-administer meds
4
Q
what was the first American law designed to regulate medications?
A
the Pure Food and Drug Act; requires all medications to be free of impurities
5
Q
The Food and Drug Administration (FDA) enforces medication laws to ensure that all medications on the market…
A
undergo vigorous testing before they are sold to the public
6
Q
the federal medication law extended and refined controls on(3)…
A
1) Medication sales and distribution
2) Medical testing, naming, and labeling
3) Regulation of controlled substances
7
Q
the U.S. Pharmacopeia (USP) and the National Formulary set standards for medication(7):
A
1) Strength
2) Quality
3) Purity
4) Packaging
5) Safety
6) Labeling
7) Dose
8
Q
the FDA instituted the MedWatch program.
what is it?
A
a voluntary program that encourages nurses and other healthcare workers to use the MedWatch form to report when a medication, product, or medical event causes serious harm to a patient
9
Q
state and local medication laws must conform to…
A
federal legislation
10
Q
state laws control substances not regulated by…
A
the federal government
11
Q
who regulates the use of alcohol and tobacco?
A
local laws
12
Q
healthcare institutions and medical laws establish policies to meet federal, state, and local regulations. Agency policies are often (BLANK) than governmental controls.
A
more restrictive
13
Q
medication regulations and nursing practice are governed by individual state…
A
Nurse Practice Acts (NPAs)
14
Q
why are Nurse Practice Acts purposefully broad?
A
so nurses’ professional responsibilities are not limited
15
Q
what is the primary purpose of NPAs?
A
to protect the public from unskilled, undereducated, unlicensed personnel
16
Q
drugs can have up to three different names. what are they?
A
1) Chemical names
2) Generic names
3) Trade names
17
Q
describe chemical drug names
A
provides the exact description of the medication’s composition
e.g. N-acetyl-para-aminophenol
18
Q
describe generic drug names
A
The manufacturer who first develops the drug assigns the name, and it is listed in the U.S. Pharmocopeia
e.g. acetaminophen
19
Q
describe drug trade names
A
also known as a brand or proprietary name.
e.g. Tylenol, Panadol, Tempra
20
Q
manufacturers choose trade names so that they are…
A
easy to pronounce, spell, and remember
21
Q
drugs are classified according to their(3):
A
1) Effect on the body system
2) symptoms the med relieves
3) Medications desired effect
22
Q
some meds have more than one classification. what is an example?
A
Aspirin which can be:
* analgesic
* antipyretic
* anti-inflammatory
23
Q
what forms do medications come in?
A
1) solid
2) liquid
3) other oral forms
4) topical
5) parenteral
24
Q
what is pharmacokinetics(6)?
A
the study of how medications:
1) enter the body
2) are absorbed and distributed into cells, tissues, and organs
3) reach their site of action
4) alter physiological functions
5) are metabolized
6) exit the body
Short list:
1) absorbed
2) distributed
3) metabolized
4) excreted
25
You are caring for a patient who has diabetes complicated by kidney disease. You need to make a detailed assessment when administering medications because this patient may experience problems with:
A. absorption.
B. biotransformation.
C. distribution.
D. excretion.
D
26
what is the **absorption** of medication?
the passage of medication molecules into the blood from the site of administration
27
what are the factors that influence the rate of medication absorption?
1) route of administration
2) ability of medication to dissolve
3) blood flow to the site of administration
4) body surface area
5) lipid solubility
28
each route of administration has a different rate of absorption. describe the speed of each route:
1) skin- slow absorption
2) mucous membrane and respiratory tract - quick rate of absorption
3) intravenous - fastest absorption rate
4) Oral - faster than skin and slower than IV
29
the blood supply to the site of administration will determine...
how quickly the body can absorb the drug
30
when a medication comes in contact with a larger surface area...
it is absorbed at a faster rate
31
when taken orally, where is most of the medication absorbed?
in the small intestine
32
why do highly lipid-soluble medications absorb quickly?
because cell membranes have a lipid layer and the drug can cross those membranes easily
33
why is it often appropriate to administer medication before or after meals, with meals, or on an empty stomach?
because some medications interact with food
34
What is the **distribution** of medication?
the delivery of medication to tissues, organs, and specific sites of action after it is absorbed into the blood
35
distribution depends on:
1) physical and chemical properties of the medication
2) physiology of the person taking it:
* circulation
* membrane permeability
* protein binding
36
what type of medication can pass through the blood-brain barrier that surrounds the CNS?
lipid-soluble medications
37
most medications bind to albumin to some extent. what happens when medication binds to albumin?
it becomes inactive. unbound free floating medication is its active form
38
how are medications metabolized?
mostly in the liver but can also occur in:
* lungs
* kidneys
* blood
* intestines
39
what is biotransformation?
a fancy word for metabolism
40
what happens when patients with liver disease take medication?
medication metabolizes more slowly and can lead to accumulation leading to medication toxicity
41
what determines the organ that medication is excreted from?
the chemical makeup of the medication
42
what is the main organ of excretion?
the kidneys
43
what is the livers role in medication elimination?
breaks down medications
44
what is the lungs' role in medication elimination?
anesthetics and alcohol is excreted through the lungs in the form of gas
45
what is the bowels role in medication elimination?
after chemicals enter the intestine through the biliary tract, the intestines resorb them and they exit with feces
46
what is the exocrine glands' role in medication excretion?
exocrine glands excrete lipid-soluble medications
47
what is a therapeutic effect of medication?
the expected/desired effect of a medication
48
what is an adverse effect of medication?
unintended/undesirable effect of a medication
49
what types of adverse effects of medication are there(5)?
1) side effect
2) toxic effect
3) idiosyncratic reaction
4) allergic reaction
5) medication interaction
50
describe side effects(2)
* predictable, unavoidable secondary effect of medication
* can range from harmless to serious
51
describe a toxic effect(3)
* accumulation of medication in the bloodstream
* occurs with prolonged medication use + impaired metabolism or excretion
* antidotes can treat specific types of medication toxicity
52
describe an idiosyncratic reaction
an overreaction/underreaction or a different reaction from normal
53
adverse effects of medication range from...
mild to severe
54
how quickly do adverse effects to medication happen?
they can happen immediately or develop over time
55
how does an allergic reaction to a medication develop?
1) no reaction on the first initial dose (pt becomes sensitized)
2) when administered a second time, pt develops an allergic response to it, its preservatives, or a metabolite
3) the medication or chemical component acts as an antigen triggering release of antibodies
56
antibiotics cause a high incidence of...
allergic reactions
57
what kind of allergic reactions are life-threatening?
severe or anaphylactic reactions
58
describe a medication interaction
* when one medication modifies the action of another; common when multiple meds are being taken
* some meds can increase/diminish the action of others or alter absorption, metabolism, or excretion
59
what happens when two medications have a **synergistic effect**?
their combined effect is greater than when given separately
e.g. Vicodin
60
A postoperative patient is receiving morphine sulfate via patient-controlled analgesia (PCA). The nurse assesses that the patient’s respirations are depressed. The effects of the morphine sulfate can be classified as:
A. allergic.
B. idiosyncratic.
C. therapeutic.
D. toxic.
D
61
What is therapeutic range?
a constant blood level within a safe range between minimum effective range and toxic range (desired)
highest level = peak
lowest level = trough
62
What is the minimum effective concentration(MEC)?
plasma level of a medication below which the effect of the medication does not occur
63
what is peak concentration and trough concentration?
* peak concentration is the highest level within the therapeutic range
* trough concentration is the lowest level within therapeutic range
64
describe how IV medications fluctuate in the therapeutic range
when administered, peak concentration occurs quickly but serum levels begin to fall immediately
65
what is a biological half-life?
* the time it takes for the excretion process to lower the amount of unchanged medication by half
* meds with short half-life will be given more frequently than those with a higher half-life
66
according the the Institute for Safe Medication Practices guidelines, hospitals need to...
determine which medications are time critical and which are non-time critical
67
what are time-critical medications?
meds that early or delayed administration of maintenance doses(more than 30 minutes before or after scheduled dose) will likely result in harm or subtherapeutic responses to pts
68
what are non-time-critical medications?
meds that can be administered within 1-2 hours of their scheduled time
69
describe the oral route of medication administration(4)
1) given by mouth and swallowed with fluid
2) easiest and most commonly used
3) slower onset but more prolonged effect than IV medication
4) generally preferred by patients
70
describe sublingual route of medication administration(2)
1) placed under tongue where it dissolves
e.g. nitroglycerine
2) instruct patients not to swallow medication or drink anything until medication is completely dissolved
71
describe the buccal route of medication administration(4)
1) solid medication is placed against the mucous membranes of the cheek until it dissolves
2) can act locally on the mucosa or systemically because it is swallowed in the persons saliva
3) alternating cheeks can avoid mucosal irritation
4) pts should not chew/swallow the medication or take it with liquids
72
describe parenteral medication administration
injection of medicine into body tissues
73
what are the four major sites of parenteral administration?
1) intradermal (ID)
2) subcutaneous
3) intramuscular (IM)
4) Intravenously (IV)
74
describe intradermal (ID) medication administration
injection into the dermis just under the epidermis
e.g. TB test/PPD
75
describe the subcutaneous medication administration
injection into the tissue just below the dermis
76
describe intramuscular (IM) medication administration
injection into the muscle
77
describe IV medication administration
injection into a vein
78
whether or not you administer a medication, you are responsible for...(3)
1) monitoring the integrity of the medicine delivery system
2) understanding the therapeutic value of the medicine
3) evaluating the patients response to the therapy
79
what are the subroutes of topical medication administration?
1) skin
2) mucous membranes
80
do medications applied to the skin and mucous membranes typically have local or systemic effects?
local
81
how do you apply topical medications(4)?
1) spreading the med over an area
2) applying moist dressings
3) soaking body parts in a solution
4) giving medication baths
82
when can applying topical medications have systemic effects?
when applied over an area of skin that Is thin or broken down
83
describe transdermal disks or patches
1) has systemic effects
2) can be left in place for as little as 12 hours and as long as 7 days
3) topical route
84
describe the application of topical medications through mucous membranes(5)
1) direct application of medication or ointment to mucous membranes
2) insertion of a med into a body cavity
3) instillation of a fluid into a body cavity
4) irrigation of a body cavity
5) spraying meds into a body cavity
85
describe the difference between instilling and irrigating
instilling - fluid is retained
irrigating - fluid is not retained
86
how are inhaled medications administered?
1) nasal or oral passages
2) endotracheal
3) tracheostomy tubes
87
describe inhaled medication administration
1) readily absorbed and work rapidly because of the heavily vascularized alveolar capillary network
2) can have local or systemic effects
88
describe intraocular administration of medication
inserting a medication similar to a contact lens into a patient's eye
89
describe an intraocular medication disk(2)
1) two soft outer layers with medication enclosed in them
2) remains in eye for up to one week
90
describe intramuscular injections(4)
1) faster absorption than subcutaneous route
2) many risks; verify injection is justified
3) angle of administration 90 degrees
4) body mass index (BMI) and adipose tissue influence needle size selection
91
describe intradermal injections(6):
1) used for skin testing (TB, allergies)
2) slow absorption from the dermis
3) requires nurse to be able to clearly see injection site for changes
4) tuberculin or small hypodermic syringe used for skin testing
5) angle of insertion: 5-15 degrees, bevel up
6) small bleb will form
92
what are the three methods of intravenous administration
1) as mixtures within large volumes of IV fluids
2) by injection of a bolus or small volume of medication through an existing IV line or intermittent venous access
e.g. heparin or saline lock
3) by piggyback infusion of a solution containing the prescribed medication and a small volume of IV fluid through an existing IV line
93
approx. 5.6 million healthcare workers in the United States are at risk for occupational exposure of bloodborne pathogens such as...
HIV and Hep B
94
occupational exposure often occurs through...
accidental needle sticks and sharps injuries
95
needlestick injuries often occur when healthcare workers...
1) recap needles
2) mishandle IV lines and needles
3) leave needles at a patients bedside
96
what is one of the most deadliest hazards a nurse is at risk for?
exposure to bloodborne pathogens
97
with the implementation of safe needle devices, most needlestick injuries are...
preventable
98
the Needlestick Safety and Prevention Act mandates...
the use of special needle safety devices to reduce the frequency of needlestick injuries
99
describe safety syringes
syringes that have a sheath or guard that covers the needle immediately after it is withdrawn from the skin
100
what are the rules with sharps containers(4)?
1) always dispose of needles and other instruments considered sharps into a clearly marked and appropriate sharps container
2) containers need to be puncture and leak proof
3) never force a needle into a full sharps container
4) never put needles and syringes into a wastebasket, pocket, pt's meal tray, or at the bedside
101
what are the controlled substance classifications(5)?
1) class 1
2) class 2
3) class 3
4) class 4
5) class 5
102
when did the FDA start overseeing drugs in the US?
beginning of the 20th century
103
in the 1970s, the FDA...
released the classifications of drug schedules under the Controlled Substance Act (CSA)
104
what do the drug classification schedules do?
organize drugs into groups based on risk of abuse or harm
105
describe schedule 1 drugs
high risk and no counter balancing benefit and are banned from medical practice
106
what is the purpose of drug scheduling(3)?
substances are scheduled based on:
1) whether they have a currently accepted medical use in the US
2) their relative abuse potential
3) likelihood of causing dependence when abused
107
what are some examples of schedule one substances(6)?
1) heroin
2) LSD
3) marijuana
4) peyote
5) methaqualone
6) ecstasy
108
describe schedule 2/2N substances
substances that have a high potential for abuse and may lead to severe psychological or physical dependence
109
what are some examples of schedule 2 narcotics(8)?
1) hydromorphone (Dilaudid)
2) methadone (Dolophine)
3) meperidine (Demerol)
4) oxycodone (OxyContin, Percocet)
5) fentanyl (Sublimaze Duragesic)
6) morphine
7) opium
8) codeine
110
what are some examples of schedule 2N stimulants(3)?
1) amphetamine (Dexedrine, Adderall)
2) methamphetamine (Desoxyn)
3) methylphenidate(Ritalin)
111
describe schedule 3/3N substances
have less of a potential for abuse than schedule 1 or 2 substances but may lead to moderate/low physical dependence or high psychological dependence
112
what are some examples of schedule 3 narcotics(3)
1) drugs that contain less than 15 mg of hydrocodone per dose
2) drugs containing no more than 90 mg of codeine per dose
3) buprenorphine (suboxone)
113
what are some examples of schedule 3N non-narcotics(4)?
1) benzphetamine (Didrex)
2) phendimetrazine
3) ketamine
4) anabolic steroids such as Depo-Testosterone
114
what are schedule 4 controlled substances?
substances with a low potential for abuse relative to substances in schedule 3
115
what are some examples of schedule 4 controlled substances(9)?
1) alprazolam (Xanax)
2) carisoprodol (Soma)
3) clonazepam (Klonopin)
4) clorazepate (Tranxene)
5) Diazepam (Valium)
6) lorazepam (Ativan)
7) midazolam (Versed)
8) temazepam (Restoril)
9) triazolam (Halcion)
116
What are schedule 5 controlled substances(2)?
1) substances with a low potential for abuse relative to substances listed in schedule 4
2) consist primarily of preparations containing limited quantities of certain narcotics
117
what are some examples of schedule 5 controlled substances(2)?
1) cough medications containing no more than 200mg codeine/100mL or 100g (robitussin AC, Phenergan with codeine
2) exogabine
118
describe zero placements before and after a decimal in medication calculations
* numbers less than 1 have a zero placed before the decimal
e.g. 0.1mg
* never place zeros after a decimal
e.g. 1.0mg
119
what is the disadvantage of household measurements?
inaccuracy
120
household measurements are familiar to most people. encourage patients...
to never use household measuring devices to give liquid medicines
121
what is the definition of a solution(2)?
1) a given mass of solid substance dissolved in a known volume of fluid
or
2) given volume of liquid dissolved in a known volume of another substance
122
The Institutes of Medicine published the book To Err Is Human: Building a Safer Health System. what did this book accomplish?
created national awareness of problems within the healthcare system
123
how many people die in any given year from medical errors that occur in hospitals?
an estimated 98,000 people
124
when a verbal medication order is given to a nurse over the phone, what must happen(3)?
1) nurse writes the complete order or enters it into a computer
2) nurse reads it back to the prescriber to verify accuracy
3) prescriber countersigns the order at a later date (usually within 24 hours)
125
when can nursing students take medication orders?
never. the RN takes and verifies order before a student can administer a newly given medication
126
what is CPOE?
Computerized Physician Order Entry is a system being implemented by many hospitals to handle medication orders which decreases the incidence of medication errors
127
how does CPOE work?
the prescriber fills out all computerized fields before the order is filled which helps to avoid incomplete or illegible order
128
the use of abbreviations when ordering medications is often the cause of (BLANK)
medication errors
129
how do you avoid medication errors caused by abbreviations?
use only abbreviations approved by your specific healthcare agency
130
who can prescribe medication(3)?
1) physicians
2) nurse practitioners
3) physician's assistants
131
how can medication orders be given(3)?
1) written (electronically or by hand)
2) verbally
3) over the phone (also verbally)
132
what does the type of medication order given depend on(2)?
1) urgency
2) how frequently they are needed
133
describe a **standing/routine** order(2)
1) an order that is carried out until the prescriber cancels it by another order or the prescribed number of days elapses
2) often includes a final date or number of treatments/doses
134
what is a **prn** order?
to be given only when a patient requires it
135
what is a **single** medication order?
given one time for a specific reason
e.g. postoperative meds or meds given before a diagnostic exam
136
what is a **now** medication order(2)?
1) when a medication is needed quickly, but not STAT
2) Nurse has up to 90 minutes to administer the medication once the order has been given
137
what is a **STAT** medication order?
a single dose of medication to be given immediately (in emergency) and only once
138
what is a **prescription** medication order?
medications to be taken outside of the hospital
139
beginning January 1, 2022(2)...
1) all prescriptions issued by a licensed practitioner to a california pharmacy must be submitted electronically
2) all california pharmacy must have the capability to receive prescriptions electronically
140
describe pharmacists(2):
1) prepares and distributes prescribed medications
2) work with physicians, nurses, and other healthcare providers to evaluate the effectiveness of pts' medications
141
pharmacists in healthcare agencies rarely mix compounds or solutions. what is the exception?
IV solutions
142
what are the main responsibilities of pharmacists(3)?
1) filling prescriptions accurately and making sure the prescriptions are valid
2) dispensing the correct medication, in the right dosage and amount, with an accurate label
3) providing info about side effects, toxicity, interactions, and incompatibilities
143
what is the nurses responsibilities when it comes to administration of meds(5)?
1) determine if the med ordered is the correct med
2) assess pt's ability to self-administer the med
3) determine whether pt should receive med at a given time
4) administer meds correctly
5) closely monitor their side effects
144
what part of medication administration can be delegated to a NAP?
none. never delegate any part of medication administration to a NAP
145
what are the most common medication administration systems found in healthcare agencies(2)?
1) Unit dose system
2) Automated Medication Dispensing System (AMDS)
146
describe a Unit Dose System(5)
1) Pharmacists make single dose packages containing the dose ordered for patient and stock the cart at a designated time everyday
2) each capsule or tablet is wrapped separately
3) usually no more than a 24 hour supply is stocked at any given time
4) some UDS are carts with each drawer labeled with a patients name and room number (containing a 24 hour supply of meds for that patient
5) contains limited amounts of prn and stock medications for special situations
6) controlled substances are kept in a larger locked drawer
147
what are the benefits of Unit Dose Systems(3)?
1) reduces medication errors
2) decreases the amount of medication stocked in patient care areas
3) saves time for nurses and pharmacists
148
describe Automated Medication Dispensing Systems (AMDSs)(5):
1) nurses access system by entering a security code (some require bioidentification as well)
2) nurses select patient's name and drug profile before AMDS dispenses the med
3) you are allowed to select desired med, dose, and route from a list displayed on the computer screen
4) system records activity (including the nurses name) and charges medication to the patient
5) many AMDS use the Barcode Medication Administration (BCMA) system
149
what are the benefits of AMDS w/ BCMA?
often reduces incidence of medication errors
150
medications can lead to inappropriate medication use or harm. errors include(5):
1) inaccurate prescribing
2) administering the wrong med
3) wrong route or time interval
4) administering extra doses
5) failing to administer a med
151
what is top priority when a medication error occurs?
the patient's safety and well-being
152
what must be done when a medication error occurs?
1) first assess and examine the pt's condition and notify the healthcare provider
2) once patient is stable report the incident to appropriate person within the agency to file an incident report as soon as possible
153
when it comes to medication errors, what is the nurses responsibility(3)?
1) filing an occurrence or incident report asap
2) reporting all medication errors including ones that did not cause harm
3) also responsible for reporting near misses
154
is an incident report a part of the patient's medical record?
no, to legally protect the nurse and healthcare agency, incident reports do not become a part of a patient's medical record.
155
accurate medication reconciliation requires consulting with...
the patient, family caregivers, other clinicians, pharmacists, and other members of the healthcare team
156
if a nurse experiences a problem reading a physician's medication order, the most appropriate action would be to:
A. call the physician to verify order
B. call the pharmacist to verify order
C. consult with other nursing staff to verify
D. withhold the medicationuntil physician makes rounds
A
157
what kind of skills are required for medication administration?
psychomotor skills
158
what kind of **attitudes** do nurses need to have while administering medications(2)?
1) responsibility and accountability
2) take your time; be disciplined
159
what makes medication administration a complex responsibility(4)?
1) patient attitudes
2) knowledge
3) physical and mental status
4) responses to medication
160
who sets the standards of medication administration(2)?
1) healthcare agencies
2) the nursing profession
161
what limits a nurse's ability to administer medications in certain units of the acute care setting?
agency policy
162
what are the seven rights of medication administeration?
1) Right Medication
2) Right Dose
3) Right Patient
4) Right Route
5) Right Time
6) Right Documentation
7) Right Reason
163
how can you ensure you are giving the right medication?
compare new medication orders to the medication administration record(MAR) or the electronic medication record (eMAR)
164
how can you ensure you are giving the right dose?
have another nurse check your conversion work
165
how can you ensure your are giving medication to the right patient?
make sure to use at least 2 patient identifiers before administration
166
what do you do if you get an order that does not designate a route of administration?
consult the prescriber
167
what should you do if the specified route is not the recommended route?
contact the prescriber immediately
168
a medication order is required every time you administer a medication. what should you do if any question arises about a medication order because it is incomplete, illegible, vague, or not understood?
contact the prescribing healthcare provider before administration of the medication
169
when should you document that you have given a medication?
only after you have given it. NEVER BEFORE!!
170
because of the potential risks related to medication administration, a patient has the following rights(8):
1) to be informed about a medication
2) to refuse a medication
3) to have a medical history
4) to be properly advised about experimental nature of medication
5) to receive labeled medications safely
6) to receive appropriate supportive therapy
7) to not receive unnecessary medications
8) to be informed if medications are part of a research study
171
do not become defensive if...
a patient refuses medication therapy (they have a right to refuse)
172
before administering medication, nurses need to check a patients history including:
1) allergies
2) medications
3) diet history
4) patient's perceptual or coordination problems
5) contraindications for medication being administered
173
if a patient has allergies to medications or food, inform other members of the healthcare team. why food?
because many medications have ingredients also found in food sources
174
nurses should review the medication they are administering including:
1) action
2) purpose
3) normal dosage
4) routes
5) side effects
6) nursing implications for administering and monitoring
175
when it comes to a patient's diet and medication administration, nurses need to teach patients...
to avoid foods that interact with their medications
176
why do nurses need to assess patients' perceptual, fine-motor, and coordination limitations?
because it can limit patients ability to self-administer. will need to find out if they have someone that can help them
177
why do nurses assess physical and mental status before administering medication?
they affect whether a med is given and how it is administered
178
why do nurses assess a patients attitudes about medication?
1) they can sometimes reveal dependance or drug avoidance
2) cultural beliefs about western medicine can interfere with medication adherence
179
why do nurses assess patients literacy regarding medication administration?
serious errors can occur when patients don't understand info about their meds
180
what are no interruption zones(NIZs)?
designed to reduce distractions and interruptions during medication administrations
181
if a patient is unable to afford medications what should you do?
make a referral to community resources
182
some patients take meds incorrectly or not at all because...
they do not understand their medications
183
to make sure patients understand their medications...
make sure you teach them about their medication in the language they are most comfortable speaking
184
what do you need to document after you have administered a medication(4)?
1) name of the med
2) dose
3) route
4) exact time of administration
5) if injected, chart the location of injection
185
what do you chart if a patient refuses a medication or is undergoing tests or procedures that result in a missed dose?
explain reason dose was missed
186
what is polypharmacy?
the use of multiple medications at the same time; OTCs and supplements included
187
what do all children require before receiving medications?
special psychological preparation; parents are great resources for determining best way to give a medication; explain the procedure using comprehendible words
188
all older adults require...
special considerations during medication administration
189
what can cause polypharmacy?
1) taking OTCs frequently
2) lack of knowledge about meds
3) incorrect beliefs about meds
4) visiting different HCP to treat different illnesses
190
**Drug-receptor interaction**
describe the considerations with medications and older people
brain receptors become more sensitive, making psychoactive drugs more potent
191
**Metabolism**
describe the considerations with medications and older people(4)
1) liver mass shrinkst
2) hepatic blood flow and enzyme activity decline
3) metabolism drops 1/2-2/3 the rate of a young adult
4) enzymes lose ability to process some drugs causing prolonged half-life
192
**Absorption**
describe the considerations with medications and older people(2)
1) gastric emptying rate and gastrointestinal motility slow
2) absorption capacity of cells and active transport mechanism declines
193
**Circulation**
describe the considerations with medications and older people(3)
1) Vascular nerve control less stable
2) antihypertensives may overshoot causing hypotension
3) Digoxin may cause bradycardia
194
**Excretion**
describe the considerations with medications and older people
1) kidney function declines
2) blood flow and waste removal slows
3) renally secreted drugs have increased half-life
4) antidiabetic drugs among other stay in system longer
195
**Distribution**
describe the considerations with medications and older people
1) lean body mass falls
2) adipose stores increases
3) total water declines raising the concentration of water-soluble drugs (e.g. digoxin) which can cause heart dysfunction
4) plasma protein diminishes, reducing sites available for protein-bound drugs and raising levels of free drug
196
