Pharma Test 2 Flashcards
(42 cards)
5 rights
Right med/dose/route/time/patient
10 rights of medication
Med/dose/route/time/patient/documentation/assessment of pt/education/evaluation/refusal
3 checks of med administration
1.at the drawer while taking meds out
2.after you pour meds
3.as you put back the med/at clients bedside
How to take out narcotics
Locate keys/instructor, unlock narc drawer, obtain med and verify the count
Check label to MAR (1st check) then sign for med on count sheet. ask coworker to cosign, prepare med (2nd check) place it back (3rd check) and ensure drawer is locked and keys are returned
How to waste narcotics
If you must use a portion of a dose have someone (instructor) watch you discard the excess meds and co-sign the waste on the narc count sheet
What does the nurse need to know about the medications they administered
Medication purpose, dosage, route of administration, and side effects
Standard precautions gloves
Hand washing is done before and after pt contact and before and after wearing gloves and anytime hands are visibly soiled. Wear gloves handling blood or fluids mucous membranes or non intact skin
Standard precautions re capping needles
Recapping is avoided and if necessary use a 1 handed scoop
Enteral medications procedure
-check 1 retrieve med from cart
-check 2 after prepping med, label
-check 3 in pt room
-administer med, check it’s gone
-evaluate effectiveness
Factors to determine needle gauge
Determined by type of injection. Syringe and needle determined by volume of med degree of accuracy and type of med
Ampoules how to draw up
Glass containers that usually contain a single dose. May be scored to allow easier breakage, move all solution from neck of ampoule cover neck with gauze and break away from you. Use blunt fill needle, withdraw med to desired volume and do not allow the needle tip or shaft to touch the rim of the ampoule
Vials how to draw up
A single or multi dose container with a rubber seal at the top, is a pressurized closed system. Must inject air into the container to permit withdrawal of solution, contain liquid or dry form of med. meds that are unstable in solution are packaged dry and reconstituted
Minimizing injection discomfort
Use sharp beveled needle in smallest suitable length and gauge. Position client as comfortable to reduce muscular tension, select proper site and landmark, ask client questions to divert attention, insert quickly and smoothly to minimize pulling hold steady while needle remains in tissue, inject slowly, 1ml/sec and hold 10 seconds
Intradermal sites
Inner forearm and scapula used for Mantoux and allergy
Intradermal route admin
Injection is made into the dermal layer of skin just below epidermis, blood supply is less and drug absorption occurs slowly
Swab area with alcohol dry stretch skin with non dominant hand insert needle at 5-15 degrees inject slowly and remove, a small wheal will appear
Subcut layer to inject into
Injected into loose CT between dermis and muscle
Subcut route administrations
Refer to rotation chart, choose correct needle, draw up med, prepare client, avoid areas with rash edema or bruising, clean skin, pinch skin, needle in, use non dominant hand to support and inject with dominant slowly, withdraw slowly, withdraw needle and apppy gentle pressure 30-60 sec after
Short acting insulin
Regular humulin r, color is clear,
onset of 30-60 mins
Peak 2-3hrs
Duration 6.5 hr
Rapid acting
Lispro, color is clear
Onset 10-15 mins
Peak 1-2hr
Duration 3.5-4.75
Intermediate acting
Novolin NPH humulin N humulin L. Color is cloudy
Onset 1-3hrs
Peak 4-10hrs
Duration 18hrs
Mixed insulin
Humulin 30/70 color is cloudy
Used when large doses are required
Drawing up 2 insulins
Always use insulin syringe, draw up short acting first then long acting (cloudy to clear)
Roll bottles in hand, no shake. Determine volume of long acting insulin (cloudy), draw out the same amount of air in syringe, inject into cloudy solution. Draw air into syringe for units of clear insulin. Insert needle and push air, turn bottle over carefully and withdraw required volume ensuring tip of the needle is in the solution. Remove needle
Intramuscular route
Injection deep into muscle mass, age and muscle mass are factors to consider when giving, provides faster absorption than Subcut as muscles have greater vascularity.
Vastus lateralis
The vastus lateralis is a large muscle located on the outer (lateral) side of the thigh, specifically within the anterior compartment, and is part of the quadriceps group.
