Medication Administration Competency Flashcards
(45 cards)
acetaminophin
Trade Name: Tylenol
Route: oral
Therapeutic effects: analgesia, antipyresis
Indications: treatment of mild pain, fever
Contraindications: previous hypersensitivity; severe hepatic impairment or active liver disease
Side Effects/Adverse Reactions: agitation in children; hepatotoxicity in higher doses; renal failure in higher doses and chronic use
Nursing considerations: Assess pain type, location, and intensity prior to and 30-60 mins following administration; assess fever and presence of associated signs (diaphoresis, tachycardia, and malaise); and assess overall health status and risk of developing hepatotoxicity.
Patient teaching: Take exactly as directed and do not exceed recommended amount (may lead to hepatotoxicity, renal, or cardiac damage. Avoid alcohol and concurrent usage with salicylates or NSAIDs for more than a few days. Ensure caregivers know how to determine correct dosage for a child and how to measure.
acetylsalicylic acid (ASA)
Trade Name: Aspirin
Route: Oral
Therapeutic Effects: antipyretic; nonopioid analgesic.
Indications: Fever, mild to moderate pain, prophylaxis of transient ischemic attacks and MI, inflammatory disorders (RA, OA)
Contraindications: hypersensitivity; bleeding disorders or thrombocytopenia; may increase risk for children of Reye’s syndrome.
Side Effects: dyspepsia, epigastric distress, nausea.
Nursing Considerations: Assess pain and limitation of movement (type, location, intensity) before and after the peak of administration. Assess fever and noted associated signs (diaphoresis, tachycardia, malaise, chills).
Patient Teachings: Take with full glass of water and remain upright for 15-30 mins. Avoid alcohol to minimize gastric irritation. Avoid taking w/ acetaminophen or NSAIDs for more than a few days unless directed by clinician to prevent analgesic nephropathy.
alprazolam
Trade Name: Xanax
Route: Oral
Therapeutic Effects: Anti-anxiety agent, benzodiazepine, Schedule IV drug.
Indications: Generalized anxiety disorder, panic disorder, anxiety associated with depression.
Contraindications: Hypersensitivity; severe uncontrolled pain; pre-existing CNS depression.
Side Effects: Dizziness, drowsiness, lethargy, paradoxical excitation, physical or psychological dependence, tolerance.
Nursing Considerations: Assess degree and manifestations of anxiety and mental status (orientation, mood, behavior) prior to and periodically during therapy. Assess pt for drowsiness, light-headedness, and dizziness (should disappear as therapy progresses). Prolonged high dose therapy may lead to dependence. Assess Geri patients for fall risks.
Patient Teaching: Take meds as directed and do not skip or double up (if missed, take w/in 1 hr or just take next regular dose). Do not take more than is prescribed or share with others. May cause dizziness or drowsiness so wait to see effect before driving etc.
amlodipine
Route: oral
Therapeutic effects: antihypertensive
Indications: Hypertension, angina pectoris, vasospastic (Prinzmetal’s) angina.
Contraindications: Hypersensitivity, systolic BP <90 mmHg
Side Effects: Dizziness, fatigue, bradycardia, hypotension
Nursing Considerations: Monitor BP and pulse before therapy, during dose titration, and after therapy. For Angina, assess location, duration, intensity, and precipitating factors of pain. Monitor intake/output ratios and daily weight - assess for heart failure.
Patient Teaching: Take meds as directed and take missed doses w/in 12 hrs or just go to next dose. Teach pt to monitor pulse and to contact clinician if <50 bpm. And teach pt and family proper technique for monitoring BP (weekly).
atorvastatin calcium
Trade Name: Lipitor
Aka: HMG-CoA Reductase Inhibitors
Route: Oral
Therapeutic Effects: Lipid-lowering agent; HMG-CoA Reductase Inhibitors
Indications: adjunctive management of primary hypercholesterolemia and mixed dyslipidemias. Primary prevention of cardiovascular disease for patients with multiple risk factors for coronary heart disease or type 2 diabetes.
Contraindications: Hypersensitivity, active liver disease, avoid during pregnancy/lactation.
Side Effects: abdominal cramps, constipation, diarrhea, flatus, heartburn, rashes.
Nursing Considerations: Obtain dietary history (fat consumption). Evaluate serum cholesterol and triglyceride levels before initiating, after 4-6 wk of therapy, and periodically thereafter.
Patient Teaching: take meds as directed. Avoid more than 200 mL of grapefruit juice. Meds should be in conjunction with diet restrictions (fat, cholesterol, carbs, alcohol), exercise, cessation of smoking. F/u exams to monitor effectiveness and side effects important.
dextromethorphan
Trade name: Robitussin, Vicks
Route: Oral
Therapeutic Effects: Allergy, cold, cough, antitussive.
Indications: symptomatic relief of coughs (viral upper respiratory tract infections) - particularly for chronic nonproductive cough.
Contraindications: Hypersensitivity, patients taking MAO inhibitors or SSRIs, chronic PRODUCTIVE coughs.
Side effects: dizziness and sedation, nausea
Nursing considerations: Assess frequency and nature of cough, lung sounds, and amount and type of sputum produced. Unless contraindicated, maintain fluid intake of 1500-2000 mL to decrease viscosity of bronchial secretions.
Patient Teachings: Instruct pt to cough effectively (sit up, take deep breaths before cough). Minimize exposure to irritants/humidifier. May cause dizziness - avoid driving etc until known response.
diphenhydramine
Trade name: Benadryl, Unisom
Route: oral
Therapeutic Effects: allergy, cold, cough, antihistamine, antitussive
Indications: relief of allergic symptoms caused by histamine relief. Mild nighttime sedation.
Contraindications: Hypersensitivity; acute attacks of asthma; geriatrics - anti cholinergic effects (delirium, confusion, dizziness, dry mouth)
Side Effects: drowsiness, dizziness, headache, paradoxical excitation (esp children)
Nursing Considerations: Assess degree/nature/frequency of allergic rhinitis, cough, related symptoms. Maintain fluid intake of 1500-2000 mL to decrease viscosity of bronchial secretions.
Patient Teachings: take meds as directed. Take precautions w/ drowsiness. May cause dry mouth (oral rinses, sugarless gum or candy).
docusate sodium
Trade name: Colace
Route: Oral
Therapeutic effects: laxative, stool softener
Indications: prevention of constipation
Contraindications: hypersensitivity, abdominal pain, nausea, vomiting.
Side effects: throat irritation, mild cramps, diarrhea, rashes.
Nursing considerations: assess for abdominal distention, presence of bowel sounds, and unusual pattern of bowel function. Assess color, consistency, and amount of stool produced.
Patient Teaching: only for short term therapy. Use w/ increasing bulk of diet, fluid intake, mobility. Don’t use laxatives when abdominal pain, nausea, vomiting, or fever is present.
famotidine
Trade name: Pepcid
Route: oral
Therapeutic effects: antiulcer agent, histamine H2 antagonist
Indication: short term relief of active duodenal ulcers and benign gastric ulcers or maintenance therapy once healed. Management of GERD, treatment of heartburn, acid indigestion, and sour stomach.
Contraindications: Hypersensitivity
Side effects: confusion, dizziness, drowsiness, constipation.
Nursing considerations: assess for epigastric or abdominal pain and frank or occult blood in stool, emesis, or gastric aspirate.
Patient teachings: take as directed. Smoking interferes with effectiveness. Avoid foods and alcohol that cause GI irritation and increase fluid, fiber, exercise. May cause drowsiness or dizziness.
ferrous sulfate
Iron supplements, 30% elemental iron
Route: oral
Therapeutic effects: antianemics, iron supplement
Indications: prevention/treatment of iron-deficiency anemia
Contraindications: evidence of iron overload, anemia not due to iron deficiency
Side effects: nausea, constipation, dark stools, diarrhea, epigastric pain.
Nursing considerations: assess nutritional status and dietary history to determine cause of anemia and need for teaching. Monitor hemoglobin, hematocrit, and reticulocyte values prior to and every 3 weeks after during the first 2 months of therapy, and periodically after.
Patient teachings: explain purpose of iron therapy; follow high iron diet. Stools may become dark green or black, but harmless. Comply with medication regimen.
furosemide
Route: oral
Therapeutic effects: diuretic
Indications: edema due to heart failure, hepatic impairment, renal disease, hypertension
Contraindications: hypersensitivity; hepatic coma; anuria
Side effects: dehydration, hypocalcemia, hypochloremia, hypokalemia; hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis
Nursing considerations: assess fluid status (monitor daily weight, intake, and output ratios and location of edema, lung sounds, skin turgor, and mucous membranes). Notify clinician if thirst, dry mouth, lethargy, weakness, hypotension, or oliguria occurs. Monitor BP and pulse before and after drug administration. Monitor Rx refills for compliance.
Patient Teachings: take as directed, no double dosing. Change positions slowly to minimize orthostatic hypotension and be mindful of things that lead to dehydration (alcohol, exercise in hot weather, etc). If gain more than 3 lbs in one day contact clinician.
gabapentin
Route: Oral
Therapeutic effects: analgesic adjunct, therapeutic anticonvulsant, mood stabilizer.
Indications: partial seizures (adjunct treatment - IR only), postherpetic neuralgia, restless leg syndrome.
Contraindications: hypersensitivity
Side effects: confusion, depression, dizziness, drowsiness, ataxia
Nursing considerations: monitor closely for notable changes in behavior that could indicate emergence or worsening of suicidal thoughts or behavior. Seizures - note the location, duration, and character. Postherpetic neuralgia and neuropathic pain - assess, COLDSPA.
Patient teachings: take only as directed - if on 3x/day, no more than 12hrs between doses. Take missed doses ASAP; if less than 2 hrs until next dose, take the dose immediately and then take the next dose 1-2 hours later, then resume regular schedule. Do not discontinue abruptly; may cause increased frequency of seizures. May cause dizziness or drowsiness. Contact clinician if change in mood.
guaifenesin
Route: oral
Therapeutic effects: allergy, cold, cough, expectorant
Indications: coughs associated with viral upper respiratory tract infection.
Contraindications: hypersensitivity
Side effects: dizziness, headache, nausea, diarrhea
Nursing considerations: Assess lung sounds, frequency and type of cough, and character of bronchial secretions periodically. Maintain fluid intake of 1500-2000 mL/day to decrease viscosity of secretions.
Patient teachings: Effective coughing - sit up, deep breaths, then cough. Might cause dizziness - driving safety. Limit irritants, hard candy to alleviate discomfort.
hydrochlorothiazide
Route: oral
Therapeutic effects: antihypertensive, diuretic
Indications: management of mild to moderate hypertension. Treatment of edema associated with: heart failure, renal dysfunction, cirrhosis, glucocorticoid therapy, estrogen therapy.
Contraindications: hypersensitivity, anuria.
Side effects: hypokalemia, dehydration, hypovolemia.
Nursing considerations: monitor BP, intake, output, and daily weight and assess feet, legs, and sacral area for edema daily. Assess pt, esp if takes digoxin, for anorexia, nausea, vomiting, muscle cramps, paresthesia, and confusion. Notify clinician if these signs of electrolyte imbalance occur (digoxin also potassium depleting). If hypokalemia occurs, considerations may be given to potassium supplements or decrease dose of diuretic.
Patient Teachings: Take med same time each day, no double dosing. Pt monitor weight biweekly. Slowly change positions - orthostatic hypotension (might be worse with alcohol). Weekly BP.
ibuprofen
Route: oral
Therapeutic effects: antipyretic, antirheumatic, nonopioid analgesic, nonsteroidal anti-inflammatory agent.
Indications: treatment of mild to moderate pain, fever, inflammatory disorders, dysmenorrhea.
Contraindications: Hypersensitivity, history of recent MI, severe heart failure.
Side effects: headache, constipation, dyspepsia, vomiting.
Nursing considerations: assess pain/range of motion prior to and 1-2 hours after administration. Monitor fever. Assess for GI bleeding, renal dysfunction, and hepatic impairment.
Patient Teachings: take w/ full glass of water and remain upright for 15-30 mins after. Avoid alcohol, aspirin, acetaminophen. Do not take more than 10 days for pain or 3 days with a fever without consulting clinician.
levothyroxine
Route: oral
Therapeutic effects: hormone - thyroid preparation
Indications: thyroid supplementation in hypothyroidism. Treatment or suppression of euthyroid goiters. Adjunctive treatment for thyrotropin-dependent thyroid cancer.
Contraindications: hypersensitivity, recent MI, hyperthyroidism.
Side effects: usually only seen when excessive doses cause iatrogenic hyperthyroidism.
Nursing Considerations: assess apical pulse and BP prior to and periodically during therapy. Assess for tachyarrhythmias and chest pain.
Patient Teachings: take meds every day, same time, take missed dose ASAP unless almost time for next dose. If more than 2-3 doses missed, notify clinician. Does not cure hypothyroidism - it provides a supplement and therapy is for life. Contact clinician: headache, nervousness, diarrhea, excessive sweating, chest pain increased pulse rate, palpitations.
lisinopril
Route: oral
Therapeutic effects: antihypertensive, ACE inhibitor
Indications: Management of hypertension, reduction of risk of death or developing heart failure following MI.
Contraindication: hypersensitivity; history of angioedema with previous use of ACE inhibitors.
Side effects: hypotension, cough, taste disturbances.
Nursing considerations: hypertension - monitor BP and pulse frequently during initial dose and periodically during therapy. Assess patient for signs of angioedema.
Patient teachings: Take meds as directed; take missed dose ASAP; do not double up. Avoid salt substitutes or foods containing high levels of potassium or sodium. Take care with orthostatic hypotension contributors and potential dizziness.
loratadine
Trade Name: Claritin
Route: Oral
Therapeutic effects: antihistamine
Indications: relief of symptoms of seasonal allergies; management of chronic idiopathic uticaria; management of hives.
Contraindications: hypersensitivity
Side effects: drowsiness or dizziness. Rare - confusion, dry mouth, GI upset.
Nursing considerations: assess allergy symptoms before and periodically during therapy. Assess lung sounds - 1500-2000 mL liquids to decrease viscosity of secretions.
Patient teachings: take as directed; may cause drowsiness or dizziness; if dry mouth use good oral hygiene, sugarless gum/candy, rinsing mouth
losartan
Route: oral
Therapeutic effects: antihypertensive, angiotensin II receptor antagonist
Indications: management of hypertension; treatment of diabetic nephropathy in patients with type 2 diabetes and hypertension.
Contraindications: hypersensitivity; concurrent use with aliskiren in patients with diabetes or moderate to severe renal impairment.
Side effects: dizziness, hypotension
Nursing considerations: assess BP (lying, sitting, standing) and pulse periodically during therapy; monitor refills for adherence; assess for signs of angioedema.
Patient teachings: keep taking meds even if feeling well and take doses at same time each day. Avoid salt substitutes containing potassium or food containing high levels of potassium or sodium. Avoid sudden changes in position, use of alcohol, hot weather, standing for long periods bc of orthostatic hypotension. Be cautious of dizziness. If swelling occurs, call clinician.
metformin
Route: oral
Therapeutic effects: antidiabetic
Indications: management of type 2 diabetes mellitus; may be used with diet, insulin, or sulfonylurea oral hypoglycemics.
Contraindications: hypersensitivity, metabolic acidosis including diabetic ketoacidosis, severe renal impairment.
Side effects: abdominal bloating, diarrhea, nausea, vomiting.
Nursing Considerations: when combined with sulfonylureas, observe for signs and symptoms of hypoglycemic reactions. If pt who has been on metformin develops illness - assess for ketoacidosis or lactic acidosis and if present, discontinue immediately and treat acidosis.
Patient Teachings: Take every day at the same time; control hyperglycemia but does not cure diabetes. The treatment is usually long term. Stick with prescribed diet, medication, and exercise to prevent hyper/hypoglycemic episodes. Keep sugar/sweets with you at all times in case hypoglycemic episode occurs.
metropolol
Route: Oral
Indications: Hypertension, angina, prevention of MI and decreased mortality in pt with recent MI, management of stable symptomatic heart failure due to ischemic, hypertensive, or cardiomyopathic origin.
Contraindications: uncompensated heart failure, pulmonary edema, cardiogenic shock, bradycardia, heart block, bad SA node
ADEs: fatigue, weakness, bradycardia, hypotension
Nursing Implications/Teachings: Take meds as directed (don’t skip or double up), abrupt withdrawal may cause arrhythmia, hypertension, or myocardial ischemia. Check pulse daily and BP biweekly. Change positions slowly to minimize orthostatic hypertension.
ondansetron
Route: oral
Indication: prevention of nausea and vomiting associated with highly or moderate emetogenic chemo; prevents nausea and vomiting associated with radiation; prevention and treatment of postoperative nausea and vomiting.
Contraindications: hypersensitivity; allergy to aspartame; congenital long QT syndrome; concurrent use of apomorphine
ADEs: headache, dizziness, drowsiness, torsade de pointes, constipation/diarrhea
Nursing Considerations/Teachings: Take meds as directed. Notify HCP if symptoms of irregular heart beat, serotonin syndrome, or involuntary movement of eyes, face, or limbs occur.
oxycodone
Route: Oral
Indications: moderate to severe pain; pain severe enough to require daily, round the clock long term treatment for which alternatives are inadequate
Contraindications: hypersensitivity; significant respiratory depression; paralytic ileus; acute or severe asthma
ADEs: confusion, sedation, dizziness, orthostatic hypotension, constipation, respiratory depression; psychological/physical dependence, tolerance.
Nursing Implications/Teachings: OD on opioids can cause death - make sure to clarify all orders and have a 2nd practitioner check order and dose calculations. Do not confuse with long acting oxycontin. Explain therapeutic value of med and to only take as needed, potential for abuse. Should be discontinued gradually. May be administered with food or milk to minimize GI irritation. May cause drowsiness. Avoid alcohol or CNS depressants.
potassium
Route: oral
Indications: treatment/prevention of potassium depletion arrhythmias due to digoxin toxicity.
Contraindications: hyperkalemia, severe renal impairment, untreated Addison’s
ADEs: confusion, restlessness, weakness, arrhythmias, ECG changes, paralysis
Nursing Implications/Teachings: Advise sources of dietary potassium; instruct to report dark, tarry, bloody stools, weakness, unusal fatgiue, tingling of extremities to HCP. F/u is important.
