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NCLEX-RN (4) Pharmacology > Med Administration > Flashcards

Flashcards in Med Administration Deck (73)
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What is the medication administration record (MAR)?

The MAR is a record of all the medications that the client takes.


What is a medication reconciliation ("med rec")?

The "med rec" is the list of medications that the HCP reviews when the client is:

  • admitted
  • discharged
  • transferred to another unit


When should the nurse ask the client about medication allergies?

Ask if the client has any med allergies:

  1. at the admission assessment when getting data about what medications the client takes
  2. before giving medications


What are the 5 medication rights?

  1. right client
  2. right medication
  3. right dose
  4. right time
  5. right route


What are the 3 additional medication rights?

  1. right reason
  2. right documentation
  3. client has the right to refuse the med


What information is included on an ID wrist band?

The ID wrist band includes:

  • full name
  • birthday
  • medical record number


What information is included on an allergy wrist band?

The allergy wrist band includes allergies to:

  • meds
  • substances
  • foods


What are some client identifiers for medications and treatments?

Client identifiers:

  1. client name
  2. birthday
  3. medical record number
  4. phone number
  5. social security number


How many client identifiers are required before giving medication or a treatment?

Two client identifiers are required:

Client name and one more identifier such as:

  • birthday
  • medical record number
  • phone number
  • social security number


What should NOT be used to identify a client when giving meds or a treatment?

Never use the room number or crib number to identify a client.


How should medication doses be written?

Medication doses should be written:

  • with a preceding zero e.g. 0.5 mg (NOT .5 mg)
  • ​no trailing zeros e.g. 10 mg (NOT 10.0 mg)


What are 4 unacceptable medication abbreviations?

4 unacceptable medication abbreviations:

  1. do not write U: write "unit" instead
  2. do not write IU: write "international unit" instead
  3. do not write anything with a q or Q: write "every day" or "every other day" instead
  4. do not write MS: write "morphine sulfate" or "magnesium sulfate" instead


What are high alert meds?

When there is a high risk of death or injury if the med is given improperly such as IV push or IV meds

Heparin IV, potassium IV, and insulin are examples of high alert meds.


What is a side effect of a medication?

Side effects are unintended effects of a medication but are more likely to be expected.


How should side effects be managed?

Side effects are managed by:

  • having the nurse teach the client how to deal with that side effect
  • provide safety measures when taking the medication


What is an adverse effect (reaction) of a medication?

Adverse effects (reactions) are unexpected and severe side effects of a medication.


How should adverse effects (reaction) be managed?

Adverse effects (reactions) are managed by:

  • holding the medication and notifying the HCP
  • possible life-saving interventions


What are some common side effects of medications?

Common side effects of meds:

  • mild nausea or diarrhea - take med with food
  • sedation - use caution when driving or using big machines
  • orthostatic hypotension - sit at the side of the bed for a few minutes before getting up

Immediate Complication

What are 3 adverse effects (reactions) of medications?

3 adverse effects (reactions):

  1. anaphylactic shock or difficulty breathing
  2. rash
  3. significant changes in vital signs or level of consciousness

Notify the HCP immediately.

Fill in the answer

1 gram (g) = _____ milligram (mg)

1 gram (g) = 1000 milligram (mg)

Fill in the answer

1 microgram (mcg) = _____mg

1 microgram (mcg) = 0.001 mg

Fill in the answer

1 kilogram (kg) = ___ g

1 kilogram (kg) = 1000 g

Fill in the answer

1 kilogram (kg) = ___ pounds (lbs)

1 kilogram (kg) = 2.2 pounds (lbs)

Fill in the answer

1 liter (L) = ___ mL

1 liter (L) = 1000 mL

Fill in the answer

1 teaspoon (tsp) = ___ mL

1 teaspoon (tsp) = mL

Fill in the answer

1 Tablespoon = ___ mL

1 Tablespoon = 15 mL

Fill in the answer

1 ounce (oz.) = ___ mL

1 ounce (oz.) = 30 mL

Fill in the answer

1 cup = __ oz.

1 cup = 8 oz.


What does giving a medication "PO" mean?

PO means to give the med by mouth and have the client swallow the med. 


What is a sublingual medication?

Sublingual med is administered under the tongue.


What is a buccal medication?

A buccal med is placed in the cheek.


What types of meds should NOT be crushed?

Do not crush:

  • enteric-coated
  • buccal
  • sublingual
  • ER (extended-release)
  • SR (sustained-release)
  • iron pills

These meds are designed to be released over a long period of time and will affect absorption.


How are crushed medications given?

Crushed meds can be sprinkled over apple sauce or another very soft food and administered with a spoon. 


What is an otic medication?

Otic meds are administered in the ear.


How are otic medication given in a client < 3 years old?

Pull the ear DOWN and back to give otic meds.


How is an otic medication given in a client > 3 years old?

Pull the ear UP and back to give otic meds.


What is an optic medication?

Optic meds are administered in the eye.


Where on the eye is the eye drop placed?

Place eye drop in the lower conjunctival sac.


How long is pressure placed on the inner canthus after administering an eye drop?

Place pressure on the inner canthus for 1-2 minutes.

This prevents systemic absorption.


How long should the client wait in between different eye drop medications?

Wait 3-5 minutes between different eye drop medications.


How is eye ointment administered?

Eye ointment is administered by squeezing a thin layer from inner to outer canthus.



What is the order of administration for eye drops and eye ointment?

Give eye drops first, then eye ointment second for better absorption.


What is the order of administration for inhalers?

Order of administration for inhalers:

  1. bronchodilator first to open the airways
  2. steroid is given second to decrease inflammation


What are the steps to using an inhaler?  

Steps to using an inhaler:

  1. Use the bronchodilator first, then the steroid
  2. remove cap and hold inhaler upright
  3. shake inhaler
  4. tilt head back and breathe out
  5. press down on inhaler to release medicine
  6. breath in slowly for 3-5 seconds
  7. hold breath for 10 seconds
  8. wait 1 minute in between puffs

Click HERE to view a video on how to use an inhaler.


What is a spacer for an inhaler?

A spacer is placed in between the mouth and inhaler to prevent throat irritationbad taste in the mouth and to disperse medication better.


What sized needle is used for an intramuscular (IM) shot?

Use a large bore needle for IM shot: 18 gauge


What is the Z-track method for IM shots?

Z-track method is for giving IM shots that prevent leaking of medicine out of the skin.


What are the steps for giving an IM shot with the Z-track method?

Steps for IM shot with Z-track method:

  1. pull skin laterally (to the side)
  2. inject needle at 90 degree angle
  3. aspirate to make sure a blood vessel wasn't entered
  4. inject the med
  5. remove the needle
  6. release the skin


Where is a transdermal (skin patch) medication placed?

Transdermal (skin patch) medications are placed in areas:

  • that are NOT hairy
  • that are NOT in a skin fold


Before placing the skin patch on the skin, what is written on the patch?

Before placing the skin patch on the skin write:

  • date
  • time
  • nurse initials


What are 4 common skin patch medications?

4 common skin patch medications:

  1. nicotine
  2. birth control
  3. nitroglycerin
  4. fentanyl


How is a topical skin medication administered?

To apply a topical skin medication:

  • assess area for improvement or worsening
  • wash area
  • apply a thin film of ointment or cream
  • possible dressing covering the area


How are intravenous (IV) meds administered?

  1. IV push: dilute with normal saline and manually push over about 5 minutes into a vein
    • always check to see if the medication is diluted and how fast to push it in
  2. IV piggyback: place on a pump and above the main bag of IV fluids
    • given over 15 minutes or up to several hours depending on what is appropriate for the particular med


In regards to IV fluids, what needs to be checked before an IVPB medication is given?

Check to see if the medication in the IVPB is compatible with the main bag of IV fluids. 



What is done before and after an IV medication is given?

Flush the IV line with normal saline before and after IV meds.


What is the advantage of using a central venous access device (CVAD) to administer meds?

Advantage of using a CVAD to administer meds:

  • more meds at once can be given through the different lumens
  • higher concentrations of meds can be given



How should nasogastric meds be administered: one at a time or all the medications crushed at once?

Give nasogastric meds crushed and given one at a time with a flush of normal saline or water in between each medication.

Do this in case there is a reaction with one of the meds.


How often is the pH of gastric secretions checked when giving meds through an NG tube?

Check the pH before every med administration.

There is no need to check the pH before giving several meds in a row.


What should the pH of gastric secretions be before NG tube med administration?

Gastric secretions: pH equal or < 5

If it is > 5, hold the meds and get an x-ray to assess for possible tube dislodgement.


What is aspirated before NG tube med administration?

The amount of gastric secretions are aspirated before NG tube administration to assess if the client is digesting the NG tube feeding and meds.

Complete the sentence

If the gastric secretions are > than _______, hold the NG tube feeding.

In general, if the gastric secretions are > than 100 mL, hold the NG tube feeding.

HCP/hospitals have different policies for when to hold feedings or meds.


What 2 meds are tube feedings held for two hours before and two hours after administration?

warfarin and phenytoin

Feeding formula prevents these two meds from being absorbed.


Can needles be recapped?

Never recap a dirty needle!

It's OK to put the cap back on a needle if it hasn't been used on a client yet. Otherwise, put the dirty needle into the sharps container.

Complete the sentence

The smaller the size (gauge), the ________ the needle or IV catheter.

The smaller the size (gauge), the BIGGER the needle or IV catheter.


What is a 16 gauge IV catheter used for?

Giving blood and rapid fluid administration.


What is an 18 gauge IV catheter or needle used for?

  • for IM shots
  • giving blood
  • rapid fluid administration


What is a 20 gauge IV catheter or needle used for?


It is used for smaller veins:

  • possibly for giving blood
  • giving meds
  • IV fluids


What is a 22 gauge IV catheter or needle used for?

giving meds and IV fluids


What is a 24 gauge IV catheter or needle used for?

A very small IV catheter or needle for pediatric clients.


What is a 25-30 gauge IV catheter or needle used for?

Subcutaneous needle used to give insulin and heparin.



In which population are most medications contraindicated?

Most meds are contraindicated with pregnant clients.


Which 2 groups have a higher risk of medication toxicity?

There is a higher risk of med toxicity with:

  1. children
  2. older adults

These groups have decreased kidney function making it difficult for medications to be metabolized.


What labs are commonly checked before giving medications?

  1. BUN and creatinine
    • many meds are nephrotoxic
  2. ALT and AST
    • many meds are hepatoxic
  3. Electrolytes
    • many meds affect levels

​Get a baseline of lab and vital sign measurements before med administration due to side effects and adverse reactions.