Medication Administration

Question 1

areas the nurse needs to assess to determine the need for and potential response to medication therapy

Answer 1

-6 rights
-history
-history of allergies
-medication data
-diet history
-patient’s perceptual coordination problems
-patients current condition
-patients attitude about medication use
-patient’s knowledge and understanding of medication therapy
-patient’s learning needs

Question 2

what are the 6 rights?

Answer 2

client- 2 ID’s
route
drug
dose
time
documentation- no doc didn’t happen

PDDRTD- patient do drugs round the day

Question 3

what is an antipyretic

Answer 3

fever reducer

Question 4

what if a med is thought to be incorrect

Answer 4

ask provider, pharmacy

Question 5

what is the nurses role in med admin

Answer 5

assessment b4 & after, med history, exam, manage side effects, education, administration, compliance with orders

Question 6

what are the routes of admin

Answer 6

PO, SL, Buccal, topical, resp inhalant, SQ, IM, ID, irrigations/instillations

Question 7

Types of oral meds

Answer 7

capsule, pill, tablet, time-release, elixir, extract, fluid extract, spirits, syrup, tincture, powder, solution, suspension

Question 8

what are side effects?

Answer 8

unintended & predictable

Question 9

what are adverse reactions?

Answer 9

harmful
unintended
not predicted
often need to be discontinued
life threatening

Question 10

client states they do not recognize the pills you gave them. what do you do?

Answer 10

double check info

Question 11

What are instillations

Answer 11

eye drops/ointments, ear drops, nasal sprays

Question 12

What are kinds of parenteral injections?

Answer 12

ID, SQ, IM, IV

Question 13

sites for injections

Answer 13

deltoid, vastus laterals, rectus femoris, ventrogluteal, Dorsogluteal (not recommended)

Question 14

what angle for IM injection?

Answer 14

90

Question 15

what angle for SQ injection?

Answer 15

90 or 45

Question 16

what angle for ID injection?

Answer 16

15

Question 17

How do you admin ID meds?

Answer 17

• Forearms or upper back
• Spread skin taut
• Max 0.1 mL dose (1 mL syringe)
• 26 – 28 gauge needle
• 3/8 inch needle
• 5 - 15° angle, bevel up
• Inject slowly

Question 18

What are SQ sites?

Answer 18

anterior thigh, no more than 2 inches to belly button, biceps, triceps, lats

Question 19

where to admin IM in delt?

Answer 19

2-3 fingerbreadths below acromion process

Question 20

where to admin IM in ventrogluteal?

Answer 20

Between anterior superior iliac spine, and iliac crest.

Question 21

where to admin IM in rectus femoris?

Answer 21

Anteromedial thigh
Adults only, for when can’t get to other sites

Question 22

where to admin IM in vastus lateralis?

Answer 22

Midlateral thigh
Preferred site for infants

Question 23

form of the medication determines its

Answer 23

route of administration

Question 24

absorption is

Answer 24

passage of medication molecules into the blood from the site of administration

Question 25

therapeutic effect

Answer 25

expected or predictable physiological response to a medication

Question 26

idiosyncratic effect

Answer 26

unpredictable effects in which a patient overreacts or underreacts to a medication or has a reaction that is different from normal

Question 27

angle of insertion for an intramuscular injection

Answer 27

length depends on subcutaneous tissue depth 1/2 inch-1.5 adult 5/8 for pedi 90 degree angle

Question 28

angles that should be used when administering a subcutaneous injection, and needle size

Answer 28

25-27 GA, 3/8-5/8 inches 45-90 degree angle

Question 29

angles that should be used when administering a ID injection, and needle size

Answer 29

5-15

Question 30

seven potential nursing diagnoses used during the administration of medications

Answer 30

-anxiety -ineffective health maintenance -readiness for enhanced immunization status -deficient knowledge -noncompliance -effective therapeutic regimen management -impaired swallowing

Question 31

*identify the components of medication orders

Answer 31

patients full name -date and time that the order is written -medication name -dose -route of adminstration -signature of provider

Question 32

failure to instill ear drops at room temperature causes

Answer 32

vertigo -dizziness -nausea

Question 33

factors that must be considered when selecting a needle for an injection

Answer 33

patient's size and weight -type of tissue into which the medication is to be injected

Question 34

*best sites for subcutaneous injections

Answer 34

-the outer posterior aspect of the upper arms -the abdomen (below the costal margins to the iliac crests) -the anterior aspects of the thighs

Question 35

*maximum amount of water-soluble medication given by the subcutaneous route

Answer 35

0.5-1mL

Question 36

*maximum volume of medication for an IM injection in well-developed adult

Answer 36

2-5 mL in large muscle

Question 37

*ventrogluteal injection site

Answer 37

deep site away from nerves and blood vessels; preferred site for medications for adults; children and infants for large volumes and viscous and irritating solutions

Question 38

*vastus lateralis injection site

Answer 38

for adults and children, muscle is thick and well developed; anterior lateral aspect of the thigh

Question 39

*deltoid injection site

Answer 39

easily accessible but muscle not well developed; use small amounts; not used in infants or children; potential for injury to radial and ulnar nerves; immunizations for children; recommended site for hep B and rabies injections