Med Admin and Safe Injection

Question 1

what is MAR?

Answer 1

medication administration record

Question 2

if its due its?

Answer 2

blue

Question 3

if its green its?

Answer 3

given

Question 4

if its pink its?

Answer 4

not given

Question 5

ADS

Answer 5

automatic dispensing system

Question 6

where is medication by central pharm located?

Answer 6

in patient drawer

Question 7

where are meds metabolized?

Answer 7

liver

Question 8

where are meds excreted?

Answer 8

kidneys

Question 9

what should we do with pt in liver or kidney failure?

Answer 9

make sure meds are metabolized and excreted properly

Question 10

adverse effects?

Answer 10

side effect
*determine whether effect is severe enough to stop meds

Question 11

if side effects outweigh benefits?

Answer 11

switch meds

Question 12

opioids for pain
meds are working but pt is constipated
give laxative for constipation
do benefits outweigh effects?

Answer 12

yes

Question 13

anti seizure meds given
pt gets steven johnsons and skin is falling off
benefits outweigh effects?

Answer 13

no

Question 14

mild allergic reaction example behavior?

Answer 14

itching

Question 15

example behavior of anaphylactic reaction

Answer 15

stop breathing

Question 16

toxic

Answer 16

nursing failure due to lack of knowledge
ex. meds to be pushed over 4 minutes and the nurse pushes over 40 seconds

Question 17

idiosyncratic

Answer 17

opposite of anticipated effect

Question 18

therapeutic range

Answer 18

concentration of drug in blood that produces desired effect without causing toxicity

Question 19

peak level

Answer 19

the point where drug is at its highest
*draw blood 1 hour after first full dose

Question 20

trough level

Answer 20

the point where drug is at its lowest concentration
*indicates rate of elimination
*draw blood 1 hour before next dose

Question 21

half life

Answer 21

amount of time it takes for 50% of blood concentration of drug to be eliminated from body

Question 22

what is medication reconciliation?

Answer 22

meds taken at home vs taken at hospital

Question 23

PTA meds

Answer 23

prior to administration

Question 24

pregnancy and lactation

Answer 24

meds can transfer to baby

Question 25

why is it important to ask about allergies?

Answer 25

not always in charts

Question 26

why is asking about at home meds important?

Answer 26

dietary supplements, herbal/natural remedies homeopathic can interfere with pharmaceuticals

Question 27

older adult drug responses

Answer 27

decreased: gastric motility total body water lipid content in skin liver function kidney function adverse CNS effects altered peripheral vascular tone

Question 28

check ____ before giving anti-hypertensives?

Answer 28

BP

Question 29

check for what in prep for giving meds?

Answer 29

gloves water

Question 30

verbal order require?

Answer 30

mandatory read back *repeat back all info: pt name, dx, med, dose, etc *they say it, you say it, they say it again to confirm

Question 31

proper order for med?

Answer 31

pt name and DOB, drug, dose, time, route

Question 32

what is one equipment decision we can make

Answer 32

size of syringe

Question 33

standing orders

Answer 33

written in chart stand until discontinued

Question 34

PRN

Answer 34

as needed *usually pain meds

Question 35

STAT

Answer 35

immediately

Question 36

5 medication rights

Answer 36

patient med dose route time

Question 37

1 of 3 checks?

Answer 37

remove meds from med cart

Question 38

2 of 3 checks?

Answer 38

compare med to MAR

Question 39

3 of 3 checks?

Answer 39

rechecking to EMR/MAR at bedside PRIOR to administration

Question 40

do not open meds until?

Answer 40

confirmation pt is taking all

Question 41

what is the time window for meds given MORE frequently than Q6? (Q1-5)

Answer 41

administer within 30 minutes before or after scheduled time

Question 42

what is the time window for meds given LESS frequently than Q6? (Q6-12)

Answer 42

administer within 60 minutes before or after scheduled time

Question 43

time window for meds daily, weekly, or monthly?

Answer 43

admin with in 2 hours before or after scheduled time

Question 44

if you are unable to give a med on time, the next dose is given using the _____

Answer 44

half time rule

Question 45

what type of medication is oral?

Answer 45

enteral

Question 46

enteral means?

Answer 46

it enters the GI tract

Question 47

are injections enteral?

Answer 47

no, parenteral

Question 48

SR?

Answer 48

sustained release

Question 49

XL

Answer 49

extended release

Question 50

CR

Answer 50

controlled release

Question 51

can you crush meds that have a coating?

Answer 51

no *coating affects release- if compromised the full dose will be delivered all at once

Question 52

what does an enteric coating ensure?

Answer 52

that the med does not break down in the stomach *reducing irritation and absorption in stomach lining

Question 53

sublingual meds?

Answer 53

dissolve under tongue *no water

Question 54

brown/orange syringes for?

Answer 54

oral only

Question 55

topical meds?

Answer 55

lotions/creams/ointments powders patches eye/nose/ear drops suppositories

Question 56

what do we write on transdermal patches?

Answer 56

date, time, initials *before applying

Question 57

where do we put transdermal patches

Answer 57

hair free areas *upper outer arm, upper back, upper chest, side of chest

Question 58

why do we wear gloves when applying patches?

Answer 58

so skin doesn't absorb meds

Question 59

pt looks ____ when giving eyedrops

Answer 59

up

Question 60

aim the eyedrops where?

Answer 60

conjunctival sac

Question 61

after delivering eyedrops, place tissue?

Answer 61

in inner corner for 30 seconds so med does not drain down duct

Question 62

important when giving an inhaler?

Answer 62

giving a spacer

Question 63

what is the one and only campaign?

Answer 63

ONE needle ONE syringe ONE time

Question 64

single use devices?

Answer 64

needles and syringes

Question 65

intradermal test example?

Answer 65

TB

Question 66

IM admin sites

Answer 66

deltoid ventral gluteal vastus lateralis *do not use dorsal gluteal

Question 67

you can put ____ in muscle than skin

Answer 67

more medication

Question 68

IM needle? degree? how much med?

Answer 68

angle: 90, sometimes 72 length: 5/8-1.5 gauge: 20-25 amount: up to 3 mL in large muscles *gentle pressure NOT massage

Question 69

intradermal needle?

Answer 69

angle: low (5-15 degrees) length: short (1/4-1/2) gauge: 25, 27 amount: less than 0.5 mL

Question 70

SUBQ needle?

Answer 70

angle: 45-90 length: 3/8-5/8 gauge: 25-30 amount: 1 mL

Question 71

amount for deltoid vs ventrogluteal

Answer 71

up to 1 mL for deltoid up to 3 mL for ventrogluteal *smaller muscle=less volume

Question 72

when do you pinch SUBQ

Answer 72

if thin arms to access SUBQ area

Question 73

should you massage an injection site?

Answer 73

no- it increases circulation and absorption affecting medicine

Question 74

______ sites for frequent injections?

Answer 74

rotate *can create knots in skin if you don't

Question 75

SUBQ injection sites?

Answer 75

backs of arm 2 in around belly button front of thighs above butt scapular region

Question 76

why do we go 2 in around belly button?

Answer 76

so we don't hit the rectus abdominus muscle

Question 77

once needle is in skin, do we continue pinching skin?

Answer 77

no

Question 78

what is the z track method?

Answer 78

pull skin to side after removing needle to avoid med uptake

Question 79

why do we not use dorsal gluteal

Answer 79

sciatic nerve and artery

Question 80

always before giving meds?

Answer 80

ID patient and check allergies