ORAL MEDICATIONS

Question 1

medication

Answer 1

substance used in diagnosis, treatment cure, relief of prevent health alteration
medication may be prescription, non-prescription, complementary/herbal preparation

Question 2

acute care - RN roles

Answer 2

ensure pt. prepared to administer meds when discharged
educate pt. about meds & side effects
ensure med regimes are ‘fit for purpose’, practice & sustainable
assesses effects of meds in restoring/maintaining health

Question 3

Aus national med policy

Answer 3

maximise indiv. benefit from med regime

achieve safe, effective & appropriate use of meds & optimise medicinal use

Question 4

quality use of medicines

Answer 4

aus response -> National Medicines Policy

wise -> ensuring best treatment plan

necessary -> ensuring when meds are needed, theyre carefully selected, managed, monitored & reviewed

safe & effective -> minimising misuse, overuse & underuse while achieving goals of therapy by delivering beneficial changes in health outcomes

Question 5

medication team

Answer 5

prescriber
nurse
pharmacists

Question 6

medication management cycle

Answer 6

working together in all aspects to prevent an error
prescriber -> prescribe/issue med
pharmacist -> review medicine order, issue of med, education patient
nurse -> distribute/storage of med, adminster/monitor med response, transfer of verified info, educate patient

Question 7

RNs role in meds

Answer 7

RN’s prescribing/administering meds are accountable for knowing meds prescribed, therapeutic/non-therapeutic effects & patients need for med

provides education to patient & family about med & effects

assesess patients need for med before dose

evaluates therapeutic & non-therapeutic effects of medication & clinical outcomes

Question 8

errors in medication cycle

Answer 8

ordering, transcribing, dispensing, administering

O-> wrong dose, drug, route/form, allergy/drug interaction

T -> dose, route, patient, time, drug

D -> dose, route, patient, time, incorrect labelling/drug ID, primary catch for allergy/drug interaction

A -> patient, dose, drug, time/omitted, route, frequently involves infusion pump

Question 9

pharmacokinetics

Answer 9

study how medication enters body, moves through body & leaves body

Question 10

pharmacodynamics

Answer 10

process in which med interacts with body cells to produce biological response

Question 11

therapeutic effect

Answer 11

desired result or action of med

Question 12

absorption

Answer 12

passage of a drug from administration site to bloodstream

Question 13

distribution

Answer 13

process of delivering mediation to tissues, organs & the specific site of action

Question 14

metabolism

Answer 14

process by which drug is altered to less active form to prepare for excretion

Question 15

excretion

Answer 15

process removes less active drug or its metabolites

Question 16

adverse drug reaction

Answer 16

harmful unintended reaction to medicines that occur at doses normally used for treatment

Question 17

medication interactions

Answer 17

when drug action is modified by presence of certain food/herb or other medication

Question 18

antagonism

Answer 18

occurs when drug effect is decreased by taking the drug with another substance

Question 19

drug incompatibility

Answer 19

mixing medications in solution that causes precipitation or combining drug with another that causes adverse chemical reaction

Question 20

diversity considerations

Answer 20

pregnancy -> extreme risk to developing foetus
infants -> require smaller doses
older adults -> increased side effects
gender -> drug actions differ based on hormone levels & distribution of body fat
genetics -> affecting drug metabolism & influence dosage needs
cultural factors -> herbal med may affect action of prescribed meds

Question 21

pharmacodynamics

Answer 21

drugs half life -> expected time it takes for blood conc. to measure half of original drug dose due to drug elimination

onset of action -> time body takes to respond to drug after administration

plasma plasma level -> indicated highest serum (blood) concentration

trough -> lowest serum level of medication

Question 22

side effects

Answer 22

predictable but unwanted & sometimes unavoidable reactions to medications

Question 23

toxic effects

Answer 23

result from medication overdose or the buildup of medication in the blood due to impaired metabolism & excretion

Question 24

allergic reactions

Answer 24

unpredictable immune responses to medications

Question 25

routes of administration

Answer 25

Oral Routes -> oral, sublingual, buccal Parenteral Routes -> subcutaneous, intradermal, intravenous, intramuscular, epidural, intrathecal, intraosseus, intraperitoneal, intradermal, intraarterial Topical Routes -> skin, mucous membranes, inhalation, introcular

Question 26

dosage calcs

Answer 26

Tablets -> dose required = amount to be administered stock strength Liquids -> dose required x volume = amount administered stock strength

Question 27

benefits of EMMS

Answer 27

fewer prescribing errors lower dispensing errors through med orders, automation & barcode scanning reduced admin errors through clearer info less omission/commission errors in care through improved info transfer improved med adherence & minimised misuse, overuse & underuse of meds

Question 28

medication errors

Answer 28

any event that could cause/lead to incorrect administration to prescribers orders may occur when RN fails to follow routine procedures

Question 29

preventable errors

Answer 29

use of incorrect drug prescribing errors administration errors incorrect drug

Question 30

legal/valid orders

Answer 30

written/printed in ink / entered in EMMS signed by prescriber & contact number full name of recipient, medication, dosage, route, frequency reason for administration detail the number of times drug may be dispensed or time between repeated administrations

Question 31

reason for med

Answer 31

RN must assess if reason for med is valid medicine needs to be assessed as being appropriate for patient in current state RN must assess patient for particular med & evaluate if its been given for right reasons if no reason is apparent, contact prescriber

Question 32

5 rights of medication

Answer 32

``` right med / right reason right dose right patient right route right time / frequency ```

Question 33

Drug Scheduling

Answer 33

``` Schedule 1-intentionally blank. Schedule 2- Pharmacy Medicine Schedule 3- Pharmacist Only Medicine prescription. Schedule 4- Prescription Only Medicine Schedule S4 appendixD: require storage and security (NSW) Schedule 5- Poisons of a hazardous nature Schedule 6-Poison Schedule 7 – Dangerous Poison Schedule 8- Controlled Drug substances which should be available for use but require restriction Schedule 9- Prohibited Substance ```

Question 34

Prescribing rules

Answer 34

drugs in S4/8 must be prescribed by medical officer in emergencies, verbal order is permitted by must be written up in 24hrs NP's can prescribe from predetermined formulae

Question 35

accountable medications

Answer 35

S4D, S8 S4/SD4 drugs are liable to abuse

Question 36

register of S8 drugs

Answer 36

``` record patients name prescribed drug/dose doctors name date/time of administration balance of ampoules/tablets/capsules or liquids in supply ```

Question 37

RN's accountability

Answer 37

responsible for own actions required by law to be knowledgeable of meds must be knowledgeable about restricted drugs must sign chart after administration document reason why med wasnt given

Question 38

fatal errors

Answer 38

giving med prepared by someone else signing med given by someone else not checking correctly 5 rights 3 times trade vs generic name leaving medication by bedside & not watching them be consumed administering med from unlabelled container administering med where order is incorrect

Question 39

caplet

Answer 39

solid dosage form for oral use, shaped like capsule & coated for ease of swallowing

Question 40

capsule

Answer 40

solid dosage for oral use, medication in powder/liquid/oil form & encased in gelatine shell, capsule coloured to aid in product identification

Question 41

elixir

Answer 41

clear fluid containing water and/or alcohol, designed for oral use, usually has sweetener added

Question 42

enteric-coated tablet

Answer 42

oral use coated with materials that don’t dissolve in stomach, coatings dissolve in intestine, where medication is absorbed

Question 43

extract

Answer 43

concentrated medication form made by removing active portion of medication from its other components e.g. fluid extract is medication made into solution from vegetable source

Question 44

glycerite

Answer 44

solution of mediation combined with glycerine for external use, contains at least 50% glycerine

Question 45

intra-ocular disc

Answer 45

small flexible oval consisting of 2 soft outer layers & a middle layer containing medication, when moistened by ocular fluid, releases medication for up to a week

Question 46

liniment

Answer 46

preparation usually containing alcohol, oil or soapy emollient that is apples to skin

Question 47

lotion

Answer 47

medication in liquid suspension applied external `

Question 48

ointment

Answer 48

semi-solid, external applied preparation, usually containing one or more medications

Question 49

paste

Answer 49

semi-solid prep, thicker & stiffer than ointment, absorbed through skin more slowly than ointment

Question 50

pessery

Answer 50

solid dosage form mixed with gelatine & shaped into form of pellet for insertion into vagina, melts when it reaches body temp, releasing medication for absorption

Question 51

pill

Answer 51

solid dosage form containing one or more medications, in globule, avoid or oblong shape, true pills are rarely used because they have been replaced by tablets

Question 52

solution

Answer 52

liquid prep that may used orally, parenterally or externally, can also be instilled into body organ or cavity e.g. bladder irrigations, contains water with one or more dissolved compounds, must be sterile for parenteral use

Question 53

suppository

Answer 53

solid dosage form mixed commonly with gelatine or wax & shaped into form of pellet for insertion into rectum, melts when reaches body temp, releasing medication for absorption

Question 54

suspension

Answer 54

finely divided drug particles dispersed in liquid medium, when suspension is left standing, particles settle to bottom of container, commonly an oral medication & not given intravenously

Question 55

syrup

Answer 55

medication dissolved in conc. sugar, may contain flavouring to make medication more palatable

Question 56

tablet

Answer 56

powered dosage form compressed into hard disks or cylinders

Question 57

tincture

Answer 57

alcohol or water - alcohol medication solution

Question 58

transdermal disc/patch

Answer 58

medication contained within semi-permeable membrane disc or patch which allows medications to be absorbed trough skin slowly over long period

Question 59

troche / lozenge

Answer 59

flat, round dosage form containing medication, flavouring, sugar & mucilage, dissolves in mouth to release medication

Question 60

in the morning

Answer 60

mane

Question 61

night

Answer 61

nocte

Question 62

twice a day

Answer 62

bd

Question 63

three times a day

Answer 63

tds

Question 64

four times a day

Answer 64

qid

Question 65

when required

Answer 65

prn

Question 66

immediately

Answer 66

stat

Question 67

extended/sustained release coated drug

Answer 67

extends release over time reduces number of doses

Question 68

sublingual

Answer 68

place medication under tongue until tablet dissolves. Blood telesales under tongue are very close to surface

Question 69

buccual

Answer 69

place between cheek & teeth until dissolved

Question 70

3 checks (5 rights)

Answer 70

1st -> prior to disposing med 2nd -> after dispensing med 3rd -> immediately prior to administering med to pt.

Question 71

right medication check

Answer 71

check selected med against order (check MIMS) | check 3 times -> when selecting, when removing, when returning

Question 72

right patient

Answer 72

check pt. ID band ask their name & DOB check name & patient ID against med chart

Question 73

common abbreviations

Answer 73

``` subcut -> subcutaneous IM -> intramuscular IV -> intravenous PICC -> peripherally inserted central catheter PEG -> percutaneous enteral gastronomy PO -> oral subling -> sublingual PR -> per rectum PV -> per vagina NEB -> nebuliser MA -> metered aerosol NG -> nasogastric ```

Question 74

reasons for nurse not administering

Answer 74

must be recorded if pt. refuses, prescriber must be notified if med withheld, reason must be documented in medical notes if med not available, person administering has to notify pharmacy, obtain supply or contact prescriber its appropriate to withhold if theres known adverse drug reaction withhold if pt is pre-operative, NBM or fasting

Question 75

telephone medication order

Answer 75

person receiving order must be authorised due to misinterpretation, orders must be read back to prescriber with numbers, figures & words prescriber should repeat to second person administration must be recorded on med chart in telephone order section

Question 76

loss of S4 / S8 drug

Answer 76

report to nurse in charge complete incident report immediately record balance in drug register with witness highlighting deficit note to hospital director & director of pharmacy/nursing director of pharmacy notify NSW ministry of health

Question 77

eye drop method

Answer 77

clean patients eyes prevent accidental contact of eye dropper with eye structure when administering medications that cause systemic effects apply gentle pressure with finger & clean tissue on clients nasolacrimal duct for 30-60 seconds apply thin stream of ointment evenly along inner edge of lower eyelid on conjunctive from the inner cants to the outer canthus

Question 78

ear drops method

Answer 78

children (3 & under) -> pull auricle down & back | adult -> pull auricle upwards & outwards