Medication Administration

Question 1

What are the 3 names for drugs

Answer 1

generic
official - name by which drug is identified in the official publications US Pharmacopeia
trade name

Question 2

What are ways drugs can be classified

Answer 2

effect on body systems
chemical composition
clinical indication/therapeutic action

Question 3

What is pharmacokinetics

Answer 3

the effect of the body on the drug - mvmt of drug molecules in the body in relation to the drugs absorption, distribution, metabolism, and excretion

Question 4

Are acidic drugs well absorbed?

Answer 4

Yes; basic drugs remain ionized/insoluble in acid environments

Question 5

Elixir

Answer 5

medication in a clear liquid containing water, alcohol, sweeteners, and flavor

Question 6

Enteric coated

Answer 6

a tablet or pill coated to prevent stomach irritiation

Question 7

Extended release, and what are other names for it

Answer 7

preparation of a med that allows for slow and continuous release over a predetermined period; aka 
CR/CRT (controlled release) 
SR (slow/sustained release)
SA (sustained action)
LA (long acting)
TR (time release)

Question 8

What is a loading dose

Answer 8

dose that is larger than normal - usually given when a pt is in acute distress and maximum therapeutic effect is desired as quickly as possible

Question 9

What is a maintenance dose

Answer 9

lower dosage that becomes the usual or daily dosage

Question 10

Therapeutic Range

Answer 10

the concentration of the drug in the blood serum that produces the desired effect with out causing toxicity

Question 11

Peak Level

Answer 11

highest plasma concentration - should be measured when absorption is complete

Question 12

Half-life

Answer 12

amount of time it takes for 50% of the blood concentration of a drug to be eliminated from the body…monitoring this ensures that therapeutic ranges are obtained without reaching toxic levels

Question 13

Distribution

Answer 13

after drug is absorbed: depends on blood flow to the tissues, the drugs ability to leave the bloodstream and the drug’s ability to enter cells.

**Binding to plasma proteins = unequal distribution/prevents drug from reaching intended site of action

Question 14

What are 3 factors that affect distribution

Answer 14

binding of drug to plasma proteins = unequal distribution
blood brain barrier= prevents toxins and poisons from reaching the brain
placenta = NOT A BLOOD BARRIER - blood freely flows across it and can drugs can affect the fetus

Question 15

Metabolism of a drug

Answer 15

aka biotransformation is the change of a drug from its original to its new for

Question 16

What is the primary site for drug metabolism

Answer 16

liver

Question 17

Excretion

Answer 17

the process of removing a drug or its metabolites from the body

**kidneys excrete most drugs; lungs = primary route of excretion for gaseous substances; bile in GI tract

Question 18

Where should adverse reactions to medications be reported

Answer 18

MEDWATCH or a national database

Question 19

MedWatch

Answer 19

safety information and voluntary adverse events reporting program, sponsored by the U.S. Food and Drug Administration, which also provides up-to-date information about medication errors and potential or actually medical product problems and errors

Question 20

For a drug to be an adverse effect it must

Answer 20

life threatening action
requires intervention to prevent death/impairment
leads to death/hospitalization/disability/congenital deformity

Question 21

What are the 3 red drugs

Answer 21

Insulin (need 2 licensed prof to dbl check)
Any anticoagulants
IV narcotics

Question 22

What are CPOEs and what do they allow

Answer 22

Computer-generated pharmacy order system
allows prescriber to enter medication sorters in a standard format + guide the prescriber in complete, accurate, and appropriate ordering

**prevents guess handwritten orders

Question 23

stat order

Answer 23

single order, but carried out immediately

Question 24

What is needed on the medication order

Answer 24

Patient name
Date and time order is written
Name of drug
Dosage of the drug
Route by which the drug is to administered
Frequency of administration of the drug
Signature of the person writing the order

Question 25

What are the terms used to describe route administration

Answer 25

Oral Parenteral (SubQ,Intramuscular, Intradermal) Topical Pulmonary

Question 26

What is the nurse responsible for when checking the medication order

Answer 26

checking that the medication order was transcribed correctly from the original to the MAR; if it was not you must rewrite the order correctly Nurse must also check the dosage 2X and 1 x more right before injection

Question 27

A drug is ordered that would potentially interact with another medication the patient is taking...what should you do?

Answer 27

All medications the patient is taking should be verified before administration NEVER guess an order

Question 28

How are children's medications typically calculated

Answer 28

by weight

Question 29

What is the most common FORM of medication error

Answer 29

omitted dose

Question 30

What is most common CAUSE of medication error

Answer 30

Transcription

Question 31

Three Checks for medication

Answer 31

1- When the nurse reaches for the container or unit dose package 2- After retrieval from the drawer and compared with the MAR/compared with the MAR immediately before pouring from a multi dose container 3- When giving unit dose to the patient

Question 32

After administering the medication the nurse should

Answer 32

remain with the patient and make sure that the medication is taken Record the medication administration

Question 33

Contraindications to administering oral meds

Answer 33

vomiting NPO difficulty swallowing unconscious

Question 34

What are the Rights to Ensuring Correct Administration of Medications

Answer 34

``` Right Patient Right Drug Right Dose/Preparation Right Route Right time Right documentation ```

Question 35

What is the single most preventable cause of patient injury

Answer 35

Medication error | they are responsible for about 25% of cases against general practitioners

Question 36

Medication Errors can be

Answer 36

Prescribing Dispensing Administration

Question 37

Prescribing Errors include

Answer 37

incorrect drug dose strength, rout, quantity failure to comply with legal requirements for prescription adverse patient effects incorrect dosage calculations incorrect frequency

Question 38

Dispensing errors

Answer 38

occur at any stage during the dispensing process from the receipt of the prescription in the pharmacy through to the supply of a dispensed product to the patient

Question 39

dispensing errors include

Answer 39

wrong strength/product | wrong computerized labeling/transposition error (wrong dose, drug, patient)

Question 40

Administration errors when

Answer 40

there is a discrepancy between the drug therapy received by the patient and the drug therapy intended by the prescriber

Question 41

Drug administration errors largely involve

Answer 41

erros of omission

Question 42

What are other types of drug administration errors:

Answer 42

wrong administration technique administration of expired drugs wrong preparation administered wrong landmark

Question 43

ss

Answer 43

1/2

Question 44

1 qt

Answer 44

4 cups

Question 45

1 pt

Answer 45

2 cups

Question 46

8oz

Answer 46

1/2 pt = 1 cup

Question 47

IX ss | X ss

Answer 47

9 1/2 | 10 1/2

Question 48

What time refers to

Answer 48

what time IS it, has it been signed for as given, and is it a time-limited drug

Question 49

What is the only reason you would not discard of a medication from stock supply after a patient refused it

Answer 49

CONTROLLED DRUGS | Unopened unit doses may be returned to drawer

Question 50

What happens to the medications a patient is taking if they go in for an operation

Answer 50

ALL medication orders are discontinued and new orders must be written post operatively by physician

Question 51

If a patient is an ambulatory risk, what must the nurse do when administering medications

Answer 51

Face patients and remain with them until they swallow

Question 52

Where are controlled substances stored

Answer 52

double locked in a stationary cupboard at all times | They must be signed for on a registry or computer at the time they are removed from cupboard

Question 53

What are "time limited" drug classifications

Answer 53

controlled substances antibiotics anticoagulants steroids

Question 54

Pregnancy category X

Answer 54

cannot give the medication

Question 55

Pregnancy category A

Answer 55

safe to be given to pregnant lady

Question 56

What are things you need to remember for liquid medication administrations

Answer 56

solution vs. suspension (adequately shake a suspension) pour away from the label hold the medicine cup at eye level read the bottom of meniscus wipe "drip" off top of bottle before replacing the cap

Question 57

Once a medication is prepared it must

Answer 57

remain in your sight until administered

Question 58

When administering an ampule medication

Answer 58

Break ampule away from you (if you cut self, discard ampule) Use a filter needle to remove the medication from the vial Then discard needle and replace it with the correct one

Question 59

If you are to mix insulin which insulin do you draw first

Answer 59

short acting followed by your intermediate acting

Question 60

What are Sub Q injection sites

Answer 60

``` abdominal (2 finger length from umbilicus) Vastis lateralis Behind arm Sub Scapular "Buffin" Top (right over the butt) ```

Question 61

What are the IM injection sites

Answer 61

Venterogluteal Vastis Lateralis Deltoid

Question 62

What injection site is no longer used for IM injections and why

Answer 62

Dorsogluteal site - risk for damaging the cystic nerve

Question 63

What is the only recommend IM site for newborns

Answer 63

Vastis lateralis