Chapter 34_ Medication Administration.txt

Card Set Information

Author:
nursedgm87
ID:
238642
Filename:
Chapter 34_ Medication Administration.txt
Updated:
2013-10-03 23:52:30
Tags:
Med admin
Folders:

Description:
nursing med admin
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user nursedgm87 on FreezingBlue Flashcards. What would you like to do?


  1. To safely and accurately administer medications, the nurses need knowledge related to 8 elements. What are these 8 elements?
    • 1 - pharmacology
    • 2 - pharmacokinetics
    • 3 - growth development
    • 4- human anatomy
    • 5- pathophysiology
    • 6- psychology
    • 7 - nutrition
    • 8- mathematics
  2. How is the dosage calculated for every medications given to children?
    By weight
  3. True or False? The elderly people are more sensitive to medication, especially types that act on the brain.
    True
  4. Drugs usually have 3 types of name to identify them. What are these types of names?
    • 1-trade
    • 2-generic
    • 3 - chemical
  5. When you look up the characteristics of a drug you don't know in your drug book, you're trying to find out about the classification of said drug. What are these 3 characteristics?
    • 1 - effects on the body
    • 2-symptoms relieved
    • 3- desired effect
  6. What are the 6 medication forms that can be given to a patient?
    • 1-solid
    • 2-liquid
    • 3-other oral forms (sl)
    • 4-topical
    • 5-parenteral (iv-im-sc)
    • 6 - instillation
  7. What does standing order mean?
    Don't need physician's permission to give some types of medication, like Tylenol.
  8. What does pharmacokinetics study? (3)
    • How medication
    • 1-enters the body
    • 2-are absorbed and distributed into cells, tissues or organs
    • 3-alters physiological functions
  9. What happens during absorption of medications in the body?
    Passage of medication molecules into the blood from the site of administration
  10. Place the 4 routes of medication administration from the fastest acting to the slowest acting.
    • 1-iv
    • 2-im
    • 3-sc
    • 4-po
  11. True or False? Pills that are covered by a plastic coat dissolve fasterthe than pills that don't have this plastic coating.
    False
  12. What happens during the distribution of medications in the body?
    After absorption, distribution occurs within the body to tissues, organs, and to specific sites of action
  13. Distribution of medications in the body depends on 3 elements. What are these elements?
    • 1-circulation
    • 2-membrane permeability
    • 3 - protein binding
  14. True or False? Medications are metabolized into a less potent or an inactive form.
    True
  15. Biotransformation occurs under the influence of enzymes. What are the 3 the things these enzymes do?
    • 1-detoxify
    • 2-degrade
    • 3- remove active chemicals
  16. In which organ of the body does most of the biotransformation occurs?
    In the liver
  17. Medications are excreted through... (5)
    Kidneys, liver, bowel, lungs, exocrine glands
  18. Through which organ are medications mostly excreted?
    Kidneys
  19. Quick Quiz! The nurse who is caring for a patient who has kidney disease secondary to diabetes will need to make a detailed assessment when administering medications. This is a result of a potential for problems with which medication process? A. Absorption B. Biotransformation C. Distribution D. Excretion
    B. Biotransformation
  20. What are the 6 types of medication action?
    • 1-Therapeutic effect (expected, predictable)
    • 2-Side effect (unintended secondary effect)
    • 3-Adverse effect (severe, negative response to medication e.g heart dysrhythmias
    • 4-Toxic effect (medication accumulation in the bloodstream)
    • 5 -Idiosyncratic reaction (over or under reaction to a medication)
    • 6 - Allergic reaction (unpredictable response to a medication)
  21. When do medication interactions occur?
    When one medication modifies the action of another
  22. When does a synergistic effect occurs?
    When the combined effect of two medications is greater than the effect of the medications given separately (calcium with vitamin D)
  23. What's the onset of a medication?
    Time it takes for a medication to produce a response
  24. What's the peak of a medication?
    Time at which a medication reaches its highest effective concentration
  25. What's the trough of a medication?
    Minimum blood serum concentration before next scheduled dose
  26. What's the duration of a medication?
    Time medication takes to produce greatest result
  27. What's the plateau of a medication?
    Blood serum concentration reached and maintained
  28. When giving a medication orally, 3 types of oral medications can be given. What are they?
    • 1-Oral (swallowing)
    • 2-Sublingual (atikan or nitro)
    • 3-Buccal (behind the cheek)
  29. When you are administering parenteral medication, what 4 types of medication are concerned?
    • 1-intradermal (tuberculosis, allergy test)
    • 2-subcutaneous (heparin, fragmin, insulin) 4 to 5 cm away from umbilicus
    • 3 - intravenous (between wrists and elbow, in the hand, in the foot)
    • 4 - intramuscular (vaccine, different sites include deltoid 3-4 fingers down shoulder, vastus lateralis, dorsogluteal upper outer quadrant method because you don't want to hit ciatic nerve that runs in line with your butt crack, ventre gluteal feel front hip and where humerus attaches to your hip)
  30. What's a topical medication?
    Creams on skin (wear gloves)
  31. What's an intraocular medication?
    Eyedrops
  32. What's an inhalation medication?
    Puffers (bronchodilators, asthma)
  33. A.C.
    Before meal
  34. P.C.
    After meal
  35. BID
    2x a day
  36. TID
    3x a day
  37. QID
    4x a day
  38. HS
    Bedtime
  39. G or gm
    Gram
  40. Gr
    Grain
  41. Gtts
    Drops
  42. Kg
    Kilogram
  43. L
    Liter
  44. LBS
    Pounds
  45. Meq
    Milliequivalent
  46. Mcg
    Microgram
  47. Mg
    Milligram
  48. Ml
    Milliliter
  49. PRN
    As needed
  50. Stat
    Immediately
  51. H
    Hour
  52. Cap
    Capsule
  53. Tab
    Tablet
  54. Neb
    Nebulizer
  55. IM
    Intramuscular
  56. Supp/Ir
    Suppository intrarectal
  57. PO
    By mouth
  58. SC/SQ
    Subcutaneous
  59. SL
    Sublingual
  60. IN
    Intranasal
  61. IV
    Intravenous
  62. ID
    Intradermal
  63. i/ii/iii
    1/2/3
  64. Q5min
    Every 5 minutes
  65. QH
    Every hour
  66. QAM
    Every morning
  67. QD
    Every day, write daily instead
  68. Q2h
    Every 2 hours
  69. QHS
    Every night
  70. For which abbreviations do you need to write the full word?
    • Unit
    • Write full drug name
    • Daily
    • Left eye, right eye, both eyes
    • At
    • Greater than, more than, less than, lower than
  71. Who's the prescriber?
    Can be physician, nurse practitioner, or pharmacist only in some provinces
  72. What's the prescriber 's role?
    Must document diagnosis, condition, or need for each medication
  73. How can orders be given?
    Written, verbal, by phone
  74. Which elements must be found on an order for it to be valid?
    • Date
    • Time
    • How the order was given (if phone or verbal)
    • Name of the prescriber
    • Name of the nurse underneath
    • Drug name
    • Dose
    • Route of medication (PO)
    • Frequency of administration of drug (daily)
  75. What are the 6 types of orders seen in acute care agencies?
    • 1-Routine - administered until the dosage is changed or another medication is prescribed
    • 2-PRN
    • 3-Single (one time)
    • 4-Stat
    • 5-Now - given within 90 minutes
    • 6-Prescription - taken outside hospital
  76. What's the pharmacist's role in medication administration? (4)
    • 1-Recalculate the dose prescribed by physician and make sure it's safe
    • 2-Prepare prescription
    • 3-Make sure there's enough meds
    • 4-Call physician if they don't understand reading
  77. Which elements must highly be taken into consideration by a nurse regarding her numerous roles? (8)
    • 1-knowing what medication are prescribed
    • 2-the therapeutic and non therapeutic effects
    • 3-the medications associated nursing implications
    • 4-determining if medication is safe to administer based on physical assessment data
    • 5-knowing why the patient needs the medication
    • 6-determining if the patient requires supervision with the administration and education
    • 7-monitoring the effects of the drug
    • 8-reporting and documenting administration and effects
  78. Medication errors occurs as a result of... (4)
    • 1-neglecting to check dose calculations
    • 2-administering unfamiliar medication
    • 3-neglecting to administer an ordered medication
    • 4-failing to comply with the 10 rights of medication administration, or failing to perform necessary assessments before medication administration
  79. True or False? Additional system issues leading to medication errors include distraction, illegible orders, transcription errors, and inappropriate use of abbreviations.
    True
  80. True or False? Acknowledgement of errors doesn't demonstrate accountability meaning that an accident report doesn't protect you and the hospital if a mistake is made.
    False
  81. How long after a mistake is made by the nurse does an accident report has to be written?
    24 hours
  82. Which elements must an accident report include? (4)
    • -patient identification information
    • -location and time of incident
    • -accurate and factual description of what occurred and what was done
    • -nurse's signature
  83. True or False? Accident report is not a permanent part of the medical record and not referred to in the record.
    True
  84. What's the main use of an accident report?
    Used to track incident patterns and to address quality improvement and risk management issues as necessary
  85. True or False? Disclosure of error to the patients or family member isn't a necessary procedure to do.
    False
  86. Quick Quiz! Nurses are legally required to document medications that are administered to patients. What, specifically, are they mandated to document? A. The rationale for administration B. The medications before administration C. The medications after administration D. The prescriber 's rationale for prescription.
    C. The medications after administration
  87. Why is it important to document the medications given to the patient after administration?
    Because if you write it before, u could forget to give it, it could be refused by patient. It's as if you lied.
  88. What are the patient's 10 rights?
    • Right medication
    • Right dose
    • Right patient
    • Right route
    • Right time and frequency
    • Right documentation
    • Right reason
    • Right to refuse
    • Right to patient education
    • Right evaluation
  89. Which elements do you assess in a patient before administering a medication? (9)
    • Medical history
    • History of allergies
    • Medication data
    • Diet history
    • Perceptual or coordination problems
    • Current condition
    • Attitude toward medication use
    • Knowledge and understanding of medication therapy
    • Patient's learning needs
  90. Quick Quiz! If a nurse experiences a problem reading a prescriber 's medication order, what would be the most appropriate action? A. Call the prescriber to verify the order B. Call the pharmacist to verify the order C. Consult with other nursing staff to verify the order D. Withhold the medication until the prescriber makes rounds.
    A. Call the prescriber to verify the order
  91. True or False? It's never important to circle the time a medication was given to a patient and put your initials next to the circle.
    False
  92. What's polypharmacy?
    A patient with many prescribed medications
  93. Why is it important to be aware if a patient is self-prescribing medications? Example a patient takes his neighbors meds because the said neighbor says it works fine for him so it should be fine for your patient.
    Because it could alter the effects of the other meds he's already taking.
  94. Give examples of over the counter medications...
    Ibuprofen, acetaminophen, gravol, vitamin D
  95. What's considered a misuse of medication?
    • Not taking meds at an appropriate time
    • Taking half of a pill
  96. What kind of attitude does a patient have when we say that he is not compliant regarding his medication therapy?
    Patient is not taking meds at all or patient is not taking his antibiotics for at least 7 to 10 days.
  97. A patient that is not taking his antibiotics until the end is more at risk of...?
    Becoming resistant to this kind of antibiotics
  98. Quick Quiz! A postoperative patient is receiving morphine sulphate via a patient-controlled analgesia (PCA) system. The nurse assesses that the patient's respirations are depressed. How would this result of the effects of the morphine sulphate be classified? A.Allergic B.Toxic C.Therapeutic D.Idiosyncratic
    B.Toxic
  99. Which class of medication induces respiratory depression almost every time that a patient receives it?
    Narcotics, mostly dilaudid and morphine.
  100. What does dysphagia mean?
    Difficulty to swallow
  101. True or False? It's possible that a patient with dysphagia dies when given a toast because toast will (or can) go onto his lungs.
    True
  102. Which 4 steps must be followed when administering an oral medication?
    • -Presence of GI alterations (antacids)
    • -Ability to swallow (dysphagia)
    • -Use of gastric suction (feces coming through mouth, you don't give medications PO, if patient needs this pill, crush it and give it through naso gastric tube, irrigate)
    • -Positioning (Sitting)
  103. Which 3 steps must be followed when administering an topical medication?
    • -Use gloves or applicators
    • -Preparation of skin (not on hair, wound, mole, dry skin)
    • -Thickness of cream (Thick cream won't change anything)
  104. Which 3 steps must be followed when administering an nasal instillation medication?
    • -Assessment of nares
    • -Patient instruction and self-administration
    • -Head tilt backwards
  105. Which 4 steps must be followed when administering an eye instillation medication?
    • -Drops/ointments
    • -Assessment of eyes
    • -Asepsis (eyes=mucous membranes=sterile technique)
    • -Inner eye to outer eye, then press on eye for medication to go through the membrane and into the bloodstream
  106. True or False? It's alright to touch the eye with the tip of the tubing when administering an eye ointment or eye drops.
    False
  107. If you have 2 types of eye medications to give to a patient, how long do you have to wait to administer the 2nd medication?
    5 minutes
  108. Which 4 steps must be followed when administering an ear instillation medication?
    • -Assessment of ear canal
    • -Warming of solution (when solution was in the fridge)
    • -Straightening of ear canal (back down kids and back up adults)
    • -Side lying position for 2-3 minutes
  109. Why does an ear medication taken in a fridge needs to be warmed up before going into the ears?
    Because cold in the ears will make the patient dizzy and disoriented
  110. Which 3 steps must be followed when administering a vaginal instillation medication?
    • -Suppositories, foams, creams
    • -Use glove and applicator
    • -Patient positioning (dorsal recumbent), comfort, and hygiene
  111. Which 3 steps must be followed when administering a rectal instillation medication?
    • -Suppositories (coat suppositories with lube)
    • -Use of gloves
    • -Patient positioning (sim's for at least 5 min so it doesn't come out), comfort, and hygiene.
  112. How deep (ideally) must a rectal suppository be inserted?
    About 4 cm
  113. Why do you want your patient to lie on his left side while you're administering a suppository?
    Because that's the direction and side your intestine is designed
  114. What is the advantage of using a spacer when using puffer medications?
    You can take a few deep breaths instead of taking a giant one because medication is contained in the empty space and inhaled at a comfortable rate by the patient.
  115. Which types of patients use the spacer more frequently than others?
    Children and elderly adults (or any adult that cannot take one big deep breath)
  116. How long do you have to wait to administer a 2nd dose of the same puffer medication?
    Wait one minute
  117. How long do you have to wait to administer a 2nd dose of a different kind of puffer medication?
    Wait 5 minutes
  118. In which situation is irrigation a necessary procedure?
    When there's an open wound
  119. True or False? Irrigating an open wound isn't an aseptic procedure.
    False
  120. Which 3 types of medication solutions are used to wash out (irrigate) a body cavity?
    • -Sterile water
    • -Saline
    • -Antiseptic (baxedin-bactine, iodine, alcohol not used anymore)
  121. What is the difference between an ampule and a vial?
    • -Ampule=break tip to get med
    • -Vial=open vial cap
  122. What is a bolus injection?
    Rapid injection of a drug, medication or other substance directly into a blood vessel. Given IV.
  123. A butterfly catheter is given...
    S/C
  124. Butterfly catheters are mostly given to...
    Children, palliative patients,patients that take a lot of meds, blood work
  125. How long is a butterfly catheter good for?
    A week
  126. If you're doing a piggy back IV with 2 bags, which bag will you place the highest? the lowest?
    The bag you want to infuse first will be higher than the 2nd bag
  127. What are the 4 types of insulin that can be given to a patient?
    • -Short acting
    • -Rapid acting
    • -Intermediate acting
    • -Long acting
  128. What kind of wrist movement do you use when giving an intramuscular injection?
    Wrist flick
  129. What kind of movement do you make when you have to mix insulin?
    You mix as if you were rubbing wood to make a fire (rolling it in the palm of your hands)
  130. Long acting insulin always appear to be...
    Cloudy
  131. If you have a short acting insulin, you know that...
    The insulin will act quickly on the patient
  132. Insulin is measured in...
    Units
  133. The insulin syringes are made to solely administer insulin. Why?
    Because insulin syringes are in units, you do not need to make any conversion
  134. When preparing yourself to administer insulin to a patient, you know that you always put the.......... before the ..........
    Clear, Cloudy
  135. When giving an intramuscular injection, how long do you take to inject the liquid and how long after injecting the liquid do you have to remove the needle from the skin?
    Take between 5-10 seconds to inject liquid, leave needle 5 seconds in the skin after being done injecting the liquid
  136. What can you find on the MAR?
    • -Drug order is written on the patient’s chart
    • -Medication order is transcribed to a Medication Administration Record (MAR)
    • -MAR’s contain Name, Room #, Bed #, Drug Name, Dose, and Times and Method of Administration
  137. What are the steps in order to appropriately administer insulin in a patient?
    Requires check by 2 licensed personnel

    What do you assess before giving or drawing up?

    Insulin classifications

    Regular insulin is clear and fast acting

    Other insulin is cloudy – such as NPH

    • Order for drawing two insulin in one syringe:
    • 1) inject air into cloudy (long lasting) vial.
    • 2) inject air into clear vial (fast acting).
    • 3) Turn over and draw clear into syringe.
    • 4) Turn over and draw cloudy into syringe.
    • 5) Check total amount before administering.
  138. Which elements do you need to look out for when you are administering different types of medications (prescriptions) to a patient?
    • -Medications must be compatible
    • -Total dose must be within accepted limits
    • -Care must be taken to not contaminate one medication vial with another medication
    •             – Change needles
    • -Ensure that the final dose is accurate
    •            –  Insulin
  139. What are the steps that must be followed before administering an oral medication to a patient?
    ·Prepare medication for only one client at a time

    ·Compare order with medication available

    ·Calculate drug dose

    ·Prepare medications

    ·Keep unit dose in wrapper

    ·Don’t touch pills

    ·Liquids at eye level

    ·Fill till bottom of meniscus is at desired mark

    ·Narcotics: need 2 RNs to verify Rx.
  140. What are the steps to be followed (before-during-after) when administering an intradermal injection to a patient?
    ·Necessary to see injection sites for changes of color

    ·Lightly pigmented, free of lesions, as hairless as possible

    ·Decreased blood supply = increased absorption time

    ·TB syringe Angle – 5º- 15º
  141. For which purpose(s) are intradermal injections are usually used for?
    Mostly skin testing like TB
  142. Which 3 assessment can be made while a nurse is (in the present moment) administering an Rx?
    ·Understanding of the patient perception of why they are taking the medication

    ·Ability to self administer

    ·Swallowing…change form, thick liquids
  143. What are the steps to be followed when administering a subcutaneous injection to a patient?
    • ·Small amount of injectable material
    • – usually 0.5 – 1 ml fluid

    ·25-27 Gauge needle; ¼ - 5/8 inch in length

    ·90º angle.

    ·Absorption slower than IM route

    ·EBP shows no need to aspirate (unless heparin)
  144. Which size of needles will be used when administering subcutaneous injections?
    25-27 Gauge needle; ¼ - 5/8 inch in length
  145. Which angle will be used when administering a subcutaneous injection?
    90º angle
  146. What are the steps to be followed when administering a intramuscular injection to a patient?
    ·Faster absorption that SC due to increased vascularity

    ·Assess integrity of muscle prior to injection

    ·Injecting medications into the blood is a risk of this route

    ·Needle ½ - 3 inches in length, dependent on amount of adipose tissue and patient size.

    ·Gauge~24ish.

    ·90º angle, < 3 ml injectable amount
  147. Which size of needle will you use for an intramuscular injection?
    Gauge~24ish
  148. Which angle will be used when administering an intramuscular injection to a patient?
    90º angle, < 3 ml injectable amount
  149. Which angle will be used when administering an intradermal injection to a patient?
    5º- 15º
  150. Which size of needle will you use for an intradermal injection?
    1ml syringe 25-29 gauge 1/4-5/8" length needle
  151. 1-3 ml syringe 25-32 gauge 1/2-5/8" length needle
    S/C syringe/needle
  152. 0.5 - 3 ml syringe 20-25 gauge 5/8-3" length needle (depends on site, med, pt. size)
    Intramuscular syringe/needle range
  153. 0.5ml-1 ml 23-25 gauge 5/8-1" length needle
    Deltoid syringe/needle
  154. 1-3ml 20-23 gauge 1.5-3" length needle
    Dorsogluteal syringe/needle
  155. 1-5ml 20-23 gauge 1.5-2.5" length needle
    Ventrogluteal syringe/needle
  156. 1-3ml 21-25 gauge 5/8-1.5" length needle
    Vastus Lateralis syringe/needle
  157. 5 ml (large amounts require large muscle)
    Max volume injected into a muscle
  158. 1ml
    Max volume that can be injected into Deltoid
  159. Abdomen, upper-outer arms, upper-outer thighs, & upper back are sites for _____.
    subcutaneous injections
  160. 3ml syringe at least 1.5" needle, 3" required for obese patients. Which method will be used?
    Z Track syringe/needle
  161. Dorsogluteal or Ventrogluteal are appropriate, large muscle, injection sites for _____.
    Z-Track injections
  162. A volume of up to _____ can be administered with Z-Track injections
    3 ml
  163. After you've injected all of the med into the ventrogluteal muscle using the Z-Track technique, be sure to ___.
    release the skin simultaneously with needle withdrawal
  164. What are the steps required in order to perform the Z track technique
    Always wash hands. Sterile procedure.

    1. Place gloved fingers on the skin surface and pull the overlying skin and subcutaneous tissue approximately 2.5-3.5 cm (1 to 1 ½ inches) laterally to the side.

    2. Holding the skin taut with the nondominant hand, insert the needle at a 90 degree angle at the spot where the finger was initially placed before displacing the skin laterally.

    3. Aspirate for blood return with the dominant hand only (practice of nurse makes this step easy). If there is no blood return on aspiration, inject the drug slowly, followed by the air. Air clears the clears the needle of the medication and prevents tracking of the medication through the subcutaneous layers upon needle withdrawal. (Air-lock technique)

    4.Wait for 10 seconds before withdrawing the needle to allow the medication to disperse evenly.

    5. Slowly remove the needle.

    6. Release the skin taut. A zigzag needle track is created (by sliding of the tissue planes across each other) preventing the escape of medication from the muscle tissue.
  165. What are the appropriate sites for subcutaneous injections?
  166. What are the appropriate sites for intramuscular injections?
  167. What are the appropriate sites for intradermal injections?
  168. The nurse is having difficulty reading a physician's order for a medication. The nurse knows that the physician is very busy and doesn't like to be called. What should the nurse do?
    A. Call a pharmacist to interpret the order. B. Call the physician to have the order clarified.
    C. Consult the unit manager to help interpret the order.
    D. Ask the unit secretary to interpret the physician's handwriting.
    B. Call the physician to have the order clarified
  169. The client has an order for 2 tablespoons of milk of magnesia. The nurse converts this dose to the metric system. How much should the nurse give to the client?
    A. 2 ml
    B. 16 ml
    C. 30 ml
    D. 5 ml
    C. 30 ml
    (this multiple choice question has been scrambled)
  170. Most medication errors occur when the nurse does which of the following?
    A. Cares for too many clients
    B. Fails to follow standard precautions/routine practices
    C. Administers unfamiliar medications
    D. Is responsible for administering numerous medications
    B. Fails to follow standard precautions/routine practices
    (this multiple choice question has been scrambled)
  171. A client is to receive cephalexin (keflex) 500 mg PO. The pharmacy has seen 250 mg tablets. How many tablets does the nurse give? A. 0.5 tab
    B. 1 tab
    C. 1.5 tab
    D. 2 tabs
    D. 2 tabs
  172. When identifying a new client before administering medications, the nurse asks the client to state his name. The client does not give the correct name. The nurse asks again, and the client states yet another name. What is the nurse's next action? A. Laugh at the client and tell him to quit kidding
    B. Give the medications without further questioning
    C. Investigate the client's mental status before administering any further medications
    D. Look at the client's identification bracelet to correctly identify the client. Reorient the client to person, place and time and report client confusion to the primary health care professional
    D. Look at the client's identification bracelet to correctly identify the client. Reorient the client to person, place and time and report client confusion to the primary health care professional
  173. The nurse is taking an antibiotic to administer to a client. The client asks what the medication is and why he should take it. What should the nurse tell the client.
    A. Explain that because of the limits placed on nursing students, the client will have to speak with his assigned nurse about this
    B. Tell the client that information about medications is confidential and cannot be shared
    C. Inform the client that only the client's physician can give this information
    D. Provide the name of the medication and a description of its desired effect
    D. Provide the name of the medication and a description of its desired effect
    (this multiple choice question has been scrambled)
  174. The nurse is administering a sustained-release capsule to a new client. The client insists that he cannot swallow pills. Which is the best course of action?
    A. Ask the physician to change the order
    B. Crush the pill with a mortar and pestle
    C. Hide the capsule in a piece of solid food D. Open the capsule and sprinkle over pudding
    A. Ask the physician to change the order
    (this multiple choice question has been scrambled)
  175. The nurse selects the route for administering medication according to which following protocol?
    A. Hospital policy
    B. The prescriber 's orders
    C. The type of medication ordered
    D. The client's size and muscle mass
    B. The prescriber's orders
    (this multiple choice question has been scrambled)
  176. A client is receiving an intravenous push medication. If this type of drug infiltrates into the outer tissues, what will the nurse do?
    A. Not worry about this because vesicant filtration is not a problem
    B. Follow facility policy or the drug manufacturer's directions. Notify the prescriber if necessary
    C. Apply a warm compress to the infiltrated site
    D. Continue to let the IV run
    B. Follow facility policy or the drug manufacturer's directions. Notify the prescriber if necessary
    (this multiple choice question has been scrambled)
  177. If a client who is receiving intravenous fluids develop tenderness, warmth erythema, and pain at the site, what does the nurse suspect? A. Sepsis
    B. Phlebitis
    C. Infiltration
    D. Fluid overload
    B. Phlebitis
  178. A nurse administering medications has many responsibilities. Among these responsibilities is a knowledge of pharmacokinetics. Which statement is the best description of pharmacokinetics?
    A. The study of how medications enter the body, reach their site of action, metabolize, and exit the body
    B. The method by which a medication, after absorption, is moved within the body to tissues, organs, and specific sites of action
    C. The degree to which medications bind to serum proteins, which affects distribution
    D. The passage of medication molecules into the blood from the site of administration
    A. The study of how medications enter the body, reach their site of action, metabolize, and exit the body
    (this multiple choice question has been scrambled)
  179. When the nurse delivers a medication to a client, who has the ultimate responsibility for the medication that is being administered?
    A. The client taking the medication
    B. The nurse administering the medication C. The pharmacist providing the medication D. Both the prescriber and the nurse administering the medication
    D. Both the prescriber and the nurse administering the medication
  180. To better control the client's blood glucose level, the physician orders a high regular insulin dosage of 20 units of U-500 insulin. The nurse has only a U-100 syringe. How many units will be given?
    A. 4
    B. 5
    C. 10
    D. 20
    A. 4
    (this multiple choice question has been scrambled)
  181. The nurse is administering an intramuscular injection. Why is the Z-track method a suggested method for IM injections?
    A. It is easier for the nurse to use
    B. It allows for repeated injections into the same site
    C. It minimizes local skin irritation by sealing the medication in the muscle tissue.
    D. It does not require the nurse to aspirate before injecting the medication
    C. It minimizes local skin irritation by sealing the medication in the muscle tissue.
    (this multiple choice question has been scrambled)
  182. What is the best nursing practice for administering a controlled substance (e.g. narcotics) if part of the medication must be discarded?
    A. The nurse documents on the medication administration record
    B. The nurse discards the unused portion and documents on the control inventory form C. The nurse does not discard any controlled substance to prevent environmental contamination
    D. The nurse documents on the medication administration record and the control inventory form and has a second nurse witness the medication being discarded
    D. The nurse documents on the medication administration record and the control inventory form and has a second nurse witness the medication being discarded
  183. When administering medications, it is essential for the nurse to have an understanding of basic arithmetic to calculate doses. The physician has ordered 250 mg of a medication that is available in a 1-g amount. The vial reads 2ml-1g. What dose would the nurse give?
    A. 1 ml
    B. 0.25 ml
    C. 0.5 ml
    D. 2.5 ml
    C. 0.5 ml
    (this multiple choice question has been scrambled)
  184. While the nurse is administering medication, the client says, ''This pill looks different from what I usually take.'' What is the best action for the nurse to take?
    A. Recheck the medication order, taking along the medication
    B. Ignore the statement because the client has a history of confusion
    C. Tell the client that pill manufacturers often change the color of pills
    D. Leave the medication at the bedside and recheck the order
    A. Recheck the medication order, taking along the medication
    (this multiple choice question has been scrambled)
  185. The client is a 40 year old man who weighs 72.7 kg and is 175.26 cm tall. The order is for 5 ml of a medication to be given as a deep intramuscular injection. What size of syringe and gauge and length of needle should the nurse use for best practice?
    A. Two 3 ml syringes, 20 to 23 gauge, 3.8 cm needle
    B. Two 3 ml syringes, 23 gauge, 1.27 cm needle
    C. One 5 ml syringe, 20 to 23 gauge, 2.5 cm needle
    D. Two 2 ml syringes, 25 gauge, 2.5 cm needle
    A. Two 3 ml syringes, 20 to 23 gauge, 3.8 cm needle
    (this multiple choice question has been scrambled)
  186. A site that was a traditional location for intramuscular injections in the past is no longer recommended because its use carries risk of striking the underlying sciatic nerve or major blood vessel. What is the name of this site? 
    A. Vastus lateralis
    B. Ventrogluteal
    C. Dorsogluteal
    D. Plexor
    C. Dorsogluteal
    (this multiple choice question has been scrambled)
  187. The following orders were written by a prescriber. Which order is written correctly?
    A. Aspirin 2 tablets prn
    B. Zolpidem (Ambien) 5 mg PO at bedtime prn
    C. Levothyroxine (Synthroid) 0.05 mg 1 tablet
    D. Haloperidol (Haldol) 0.5 tablet at bedtime
    B. Zolpidem (Ambien) 5 mg PO at bedtime prn
    (this multiple choice question has been scrambled)
  188. What category of drug is Warfarin (Coumadin)?
    Oral anticoagulant
  189. For what health problems is Warfarin (Coumadin) prescribed?
    • -Prevent myocardial infarction, pulmonary embolism
    • -Cerebral vascular accident (stroke)
  190. What important client-family teaching is required when a patient on Warfarin is discharged from the hospital and going back home?
    • Monitor for:
    • -Bruising
    • -Bleeding (shaving, brushing teeth, flossing)
    • -Report tarry stools (black) or bloody stools
    • -Blood in urine
    • -Vomit that has the appearance of coffee grounds
  191. What category of drug is furosemide (Lasix)?
    Ŀoop diuretic
  192. For what health related problems is furosemide (Lasix) prescribed?
    • -Decrease edema
    • -Treat hypertension
  193. What important client-family teaching is required when a patient on furosemide (Lasix) is discharged from the hospital and going back home?
    -Promote adequate intake of potassium at home
  194. What category of drug is Fluoxetine Hydrochloride (Prozac)?
    - Antidepressant, SSRI (selective serotonin reuptake inhibitor)
  195. For what health related problems can Fluoxetine (Prozac) drug be prescribed?
    Major depressive disorder, obsessive-compulsive disorder (OCD), bulimia nervosa
  196. What important client-family teaching is required when a patient on Fluoxetine (Prozac) is discharged from the hospital and going back home?
    • -Do not take if on Pimozide, Thioridazine
    • -Do not take if allergic to Prozac
    • -Do not take if one has been on MAO inhibitor (14 days)
    • -Do not take in pregnancy
    • -Do not stop suddenly to take medication
    • -Take exactly as prescribed
    • -Store at room temperature
    • -Keep out of reach of children
    • -Liquid: use a special measuring spoon or medecine cup
  197. What category of drug is Amoxicillan?
    -Antibiotic
  198. For what health related problems can Amoxicillin be prescribed?
    -Treatment of skin, respiratory, GI, GU infections, otitis media, gonorrhea
  199. What important client-family teaching is required when a patient on Amoxicillin is discharged from the hospital and going back home?
    • -Allergies (penicillin type meds)
    • -Report any kind of allergies, go to emergency ASAP if allergic reaction
    • -Take all capsules
    • -Can be given before or after food
    • -Reduced doses for elderly people because their kidney function is decreased
    • -Store in a cool dry place
  200. What category of drug is Cefaclor?
    -Antibiotics (Cephalosporin)
  201. For what health related problems can Cefaclor be prescribed?
    -Respiratory (bronchitis, pneumonia), middle ear infections, urinary tract infection
  202. What important client-family teaching is required when a patient on Cefaclor is discharged from the hospital and going back home?
    • -Allergies not frequent but if allergic reaction, go to the emergency ASAP
    • -Side effects (stomach/abdominal pain, persistent nausea/vomiting, yellowing eyes/skin, dark urine, new signs of infection, easy bruising/bleeding, change in amount of urine, mental/mood changes such as confusion)
    • -Shake bottle before using
    • -Take full medication

What would you like to do?

Home > Flashcards > Print Preview