Medication Administration

Question 1

IM injection
Size of needle:
Length of needle:
Angle:
Volume of fluid:

Answer 1

25-gauge
1 inch
90 degree
2-5 mL

Question 2

ID injection
Size of needle:
Length of needle:
Angle:
Volume of fluid

Answer 2

27-gauge (TB syringe, Insulin)
5/8 inch
5-15 degree until resistance is felt (you’ll see needle tip)
0.3- 1 mL

Question 3

Purpose of aspiration:

Answer 3

Ensure needle is in the muscle and not in the vascular system

Question 4

SubQ injection:
Size of needle:
Length of needle:
Angle:
Volume of fluid:

Answer 4

25-gauge
1/2 in - 1 in
45-90 degree (pinch skin)
0.5-1.5 mL of water soluble meds

Question 5

IV injection:
Size of needle:
Length of needle:
Angle:
Volume of fluid:

Answer 5

25 degrees

500-1000 mL

Question 6

Flush feeding tubes with __________ between medications:

Answer 6

30-60 mL water

Question 7

Acidic medications are absorbed:

Answer 7

Stomach

Question 8

Basic medications are absorbed:

Answer 8

Small intestines

Question 9

Idiosyncratic:

Answer 9

Reaction opposite to what the effects of the medication normally are, or pt underreacts or overreacts to the med

Question 10

Gaseous and volatile meds are excreted through:

Answer 10

Gas exchange (lungs)

Question 11

Only insulin that can be given IV:

Answer 11

Regular

Question 12

Glargine (lantus) insulin should be given:

Answer 12

By itself

Question 13

When mixing insulin, draw _____ first, then…

Answer 13

Draw regular insulin first
Then NPH (intermediate) insulin

Question 14

Preferred injection site for IM:

Answer 14

Ventrogluteal

Question 15

First accuracy check:

Answer 15

When removing medication from storage unit

Question 16

Second accuracy check:

Answer 16

Compare the patient’s name and name of the medication with the MAR

Question 17

Third accuracy check:

Answer 17

Compare names of medications on labels at the pt’s bedside

Question 18

Critical scheduled meds should be given:

Answer 18

Within 30 minutes before or after scheduled dose

Question 19

Non-critical scheduled meds should be given:

Answer 19

Within 1-2 hours of scheduled dose

Question 20

Highly __________ meds cross the cell membrane easily/absorbed quickly

Answer 20

Lipid-soluble

Question 21

Factors of pharmokinetics:

Answer 21

Absorption
Distribution
Metabolism
Excretion

Question 22

3 methods of distribution of meds in the body:

Answer 22

Circulation
Membrane permeability
Protein binding

Question 23

Sites of metabolism:

Answer 23

Liver, kidneys, blood, intestines, lungs

Question 24

Sites of excretion:

Answer 24

Kidneys, liver, bowel, lungs, exocrine glands

Question 25

Medication dependence: Physical Physiological:

Answer 25

Intense physical disturbance when med is withdrawn | Pt desires med for benefit other than intended effect

Question 26

Trough conc. drawn:

Answer 26

30 min before next dose is due

Question 27

Prescription components Inscription: Signature: Superscription:

Answer 27

Drug name, strength, dose Directions to pt Pt identifiers

Question 28

Medication error steps:

Answer 28

1. assess and examine pt's condition 2. notify HCP 3. once pt is stable, report incident to manager 4. file incident or occurrence report

Question 29

Reconciliation steps:

Answer 29

1. obtain, verify, compare 2. consider and compare 3. reconcile 4. communicate

Question 30

Considered 7th patient right:

Answer 30

Indication

Question 31

Effects of aging on medication metabolism Metabolism:

Answer 31

↓ hepatic blood flow and enzyme activity ↓ metabolism ↓ liver mass ↓ enzyme ability to process drugs -> prolonged drug half-life

Question 32

Effects of aging on medication metabolism Absorption:

Answer 32

↓ gastric emptying rate and GI motility ↓ active transport ↓ absorption capacity of cells

Question 33

Effects of aging on medication metabolism Circulation:

Answer 33

Vascular nerve control is less stable

Question 34

Effects of aging on medication metabolism Excretion:

Answer 34

``` ↓ renal blood flow ↓ renal tubular secretion ↓ glomerular filtration rate ↓ reabsorption ↓ number of nephrons ↓ waste removal ```

Question 35

Effects of aging on medication metabolism Distribution:

Answer 35

``` ↓ lean body mass ↓ total body water ↑ conc. of water-soluble drugs ↑ adipose stores ↓ plasma protein -> reducing sites for protein-bound drugs and raising blood level of free drug ```

Question 36

Effects of aging on medication metabolism Drug-receptor interaction:

Answer 36

Brain receptors more sensitive-> psychoactive drugs more potent

Question 37

Types of enteral tubes:

Answer 37

NG tube, g-tube, j-tube, small-bore

Question 38

Special consideration for enteral tube feeding:

Answer 38

Keep head of bed elevated at 30-45 degrees for 1 hr s/p med admin

Question 39

Tablets and capsules dissolved in:

Answer 39

30 mL warm water

Question 40

Good indicator of enteral tube placement:

Answer 40

Gastric pH is less than 5.0

Question 41

How to check placement of enteral tube:

Answer 41

Observe gastric content and check pH of aspirate content

Question 42

Which inhaler delivers more medication to the lungs?

Answer 42

DPI (dry powder inhaler)

Question 43

Administering meds by irrigation Technique when break in skin: Technique when cavity to be irrigated is not sterile:

Answer 43

Aseptic | Clean

Question 44

When mixing vial and ampule meds...

Answer 44

Vial first | Ampule second

Question 45

When mixing meds from 2 vials...

Answer 45

Use septic technique

Question 46

Zig-zag technique used for which type of injection:

Answer 46

IM

Question 47

Best injection sites for subq:

Answer 47

``` Outer posterior arms Abd below costal margins to iliac crest Anterior thighs Scapular back Upper ventral (side) or dorsal gluteal (butt) ```

Question 48

Best injection sites for IM:

Answer 48

Ventrogluteal Vastus lateralis Deltoid (nothing greater than 2 mL)

Question 49

DO not aspirate when:

Answer 49

Giving immunizations or insulin

Question 50

Most dangerous method for administering medications due to the rapid dose infusion:

Answer 50

IV bolus or push

Question 51

Intrathecal:

Answer 51

Administered through cath surgically placed in subarachnoid space or ventricle of brain

Question 52

Intraosseous:

Answer 52

Infusion of med directly into bone marrow

Question 53

Intraperitoneal:

Answer 53

Administration of intrapleural meds directly into pleural space (chemotherapy)

Question 54

Intraaerterial:

Answer 54

Administration of meds directly into arteries (for pts w/ clots)

Question 55

Best injection sites for insulin:

Answer 55

Upper arm Anterior and lateral thigh Buttocks Abd

Question 56

Factors that influence absorption:

Answer 56

- Route of administration - Ability of med to dissolve - Blood flow to the site of administration - Body surface area - Lipid solubility of med

Question 57

Absorption:

Answer 57

When medication molecules pass into the blood from the site of medication administration

Question 58

Distribution:

Answer 58

How med is distributed within the body to tissues, organs, and specific site of action.

Question 59

Metabolism:

Answer 59

After med reaches site of action, it becomes metabolized into a less active or inactive form that is easier to excrete.

Question 60

Occurs under the influence of enzymes that detoxify, break down, and remove biologically active chemicals:

Answer 60

Biotransformation

Question 61

Main site of biotransformation:

Answer 61

Liver

Question 62

Lie pt in ________ position when inserting vaginal suppository:

Answer 62

Dorsal recumbent

Question 63

Lie pt in ________ position when inserting rectal suppository:

Answer 63

Left side-lying Sims'

Question 64

Sublingual meds act in:

Answer 64

15 min

Question 65

Most oral meds act in:

Answer 65

30-60 min

Question 66

Characteristics of positive TB test:

Answer 66

15 mm area of induration (hard, dense, raised area)

Question 67

Best injection sites for ID (TB test):

Answer 67

Forearm and upper back