Medication administration wku nursing[1].txt

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Medication administration wku nursing[1].txt
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NUR105 western Kentucky notes
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    • author "Leslie"
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    • fileName "Medication administration wku nursing"
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    • Each drug has three names
    • The chemical, generic, and trade name
  1. The chemical name provides
    The exact description of medications composition
  2. The generic name is
    From the manufacturer who first develops the drug and assigns the name, and then it is listed in the US pharmacopeia
  3. The trade name is also known
    As known as the brand or proprietary name. this is the name that the manufacturer markets the medication
  4. The marker picks the generic name so that it is
    Easy to spell and to remember
  5. The three different classifications of drugs
    The effect of medication on body system, the symptoms the medication relieves, the medications desired effect
  6. forms medications can be in
    Solid, liquid, other oral forms: topical, parenteral, forms for installation into body cavities
  7. Types of medication action- therapeutic effect
    Expected or predicted physiological response. Why we are giving it.
  8. Types of medication action- side effect
    Predictable and Unavoidable secondary effect, they are usually produced at the therapeutic dose
  9. Types of medication action- adverse effect
    Unintended undesirable and often unpredictable. can be immediate but also can .take weeks or months to develop. Often adverse effects are severe enough that they are discontinued by the manufacturer.
  10. Types of medication action- toxic effect
    Accumulation of medication in the bloodstream or develop after a prolonged intake of a medication or because person takes more than therapeutic dose. A type of adverse effect that is predictable
  11. 2 reasons why medication may accumulate in bloodstream
    Impaired Metabolism or excretion.
  12. Type of medication action- Idiosyncratic reaction
    Rare unpredictable response at a normal dose. Overreaction or under reaction or different reaction from normal. It is a type of adverse effect
  13. Type of medication action allergic reaction
    It is a type of adverse effect. Unpredictable response to medication. In this case the medication acts as an antigen in checkers the release of antibodies in the body . Allergic responses may differ per individual
  14. Three types of adverse effects
    Toxic. idiosyncratic. Allergic.
  15. List all six types of medication action
    Therapeutic. Side effect. Adverse. Idiosyncratic. Allergic. Toxic.
  16. This drug often causes a high amount of allergic reaction
    Antibiotics
  17. Severe life threatening reaction to the medication where they get sudden construction of the bronchials. Thier airway gets obstructed. Edema of pharynx and larynx. Severe wheezing and shortness of breath. It is a medical emergency that requires immediate medical attention.
    Anaphylactic reaction
  18. Can either increase or decrease the actions of one or both of the drugs involved and can be either beneficial or harmful
    Medication interaction
  19. What is polypharmacy
    The use of many different drugs (prescription or over the counter) concurrently in treating a patient. (Often they have several health problems)
  20. What is increased when a person experiences polypharmacy
    Medication interaction. adverse effects. or even effects of the medication to food
  21. Synergistic effect
    Effect of two medications combined is greater than the effects of the medication when given separately. can be positive or negative
  22. Established a government agency (fda) to approve all new drugs and determine that the drug was safe with humans . to make sure drugs were free of impurities. And To make sure drugs contain what they say they contain
    Food, drug, and Cosmetic Act of 1938
  23. amendment of 1952. specified the criteria for prescription medications and over the counter medications
    Durham-humphrey amendment
  24. Kefauver-harris amendment of 1962
    Established the FDA as responsible for approving drugs official names (generic)
  25. Established schedule of drugs. Categorizing them according to their potential for abuse. Made it illegal to possess a controlled substance without a legal prescription for it
    Comprehensive drug abuse and Control Act of 1970
  26. Schedule 1 drugs
    Often your street drugs. Not considered legitimate for medical use. Examples being heroin LSD and peyote
  27. Schedule 2 drugs
    Consider to have strong potential for abuse but also have a legitimate medical use. Examples being morphine opium cocaine
  28. Schedule 3 drugs
    Drugs and less potential for abuse than schedule 2 or 1, or addiction and have a use for medical purpose . being short acting barbituates and amphetamines. Example is anabolic steroids
  29. Schedule 4 drugs
    Medically useful category of drugs that have left potential for abuse then schedule 3, 2, or 1 . Examples -diazepam, valium, or xanax
  30. schedule 5 drugs
    Very little chance of addiction. Examples being antidiarrheals, antitussives (cough syrup with codeine)
  31. Controlled substances must be kept locked in a secure place and:
    have a special inventory with an ongoing record. wasting. counting for reconciliation of drug each shift, must be seperate from other medications
  32. Wasting includes
    Keeping a record of how much was thrown out. And having a witness record how much you threw out and they must sign that they witnessed it
  33. The 6 steps of pharmacokinetics
    • The study of how medications:
    • enter the body
    • are absorbed and distributed into cells, tissues, and organs
    • reach the site of action
    • alter physiological function
    • are metabolized
    • and exit the body
  34. Four processes included when considering pharmacokinetics
    Absorption. Excretion. Distribution. metabolism.
  35. in order for drugs to be considered therapeutic they must follow the 6 steps of pharmacokinetics . true or false
    True
  36. passage of medication molecules into the blood from the site of administration
    Absorption
  37. factors that influence absorption
    The route of administration. Ability to dissolve. blood flow to site of administration. Body surface area. lipid solubility.
  38. What has the fastest and slowest absorption rate
    Topical has the slowest. IV has the fastest because it goes directly into the bloodstream
  39. Would a larger body surface equal faster or slower absorption
    Faster
  40. Which is easier to absorb lipid soluble or water soluble medications
    lipid soluble (cell membranes made up of lipids and lipids are attracted to lipids)
  41. Occurs after absorption. Occurs within the body to tissues, organs, and specific sites of action
    Distribution
  42. Distribution depends on
    Physical and chemical properties of the medication. Unique physiology of the person taking it.
  43. The speed of distribution will depend on how vascular areas are. List some highly vascular and less vascular areas.
    High vascular organs such as the heart, liver, and brain will deliver medications quicker. It is more slowly distributed in muscle, fat, and skin
  44. The blood brain barrier only allows what type of soluble medicine to pass to the brain and cerebral spinal fluid
    Liquid soluble
  45. what three aspects of a person's physiology changes how fast distribution occurs
    Circulation (vascularity), membrane permeability (lipid versus water soluble), protein binding
  46. What allows both water soluble and lipid soluble agents to pass. Considered a nonselective membrane.
    Placenta
  47. Serum protein that a majority of meds bind to partially. Once they bind to it they can't be pharmacologically active (no therapeutic effect)
    Albumin
  48. Once attached to albumin. The part that is not attached and remains free is considered the:
    Active form of the medication . It is amount that will produce the therapeutic response (more exposed=more distribution)
  49. Once distributed to its specific site Medications are metabolized into what type of form?
    less potent or inactive form
  50. Metabolism can also be known as
    Biotransformation
  51. Biotransformation occurs
    Under the influence of enzymes that detoxify, breakdown, and remove active chemicals
  52. Main organ where biotransformation occurs
    Liver
  53. What other organs play a role in biotransformation
    Kidneys. blood. Intestines. And lungs
  54. This individual has a decrease in liver function. that occurs with aging. Or maybe they have liver disease such as cirrhosis or hepatitis makes the medication be metabolized ( slower or faster)
    slower
  55. Medications excreted through
    The kidneys which is the main one, the bowels, lungs, and exocrine glands
  56. Will help promote excretion of medication in the average normal adult
    drinking 2 liters of water a day
  57. Determines the organ of excretion
    Chemical makeup of medication
  58. Laxative s and enemas increase excretion through the
    Feces !
  59. The therapeutic range
    Occurs between the minimum effective concentration and the toxic concentrations . It is the range the medication producing the desired response
  60. The plasma level of a medication below which the therapeutic effect of the medication occurs
    Minimum effective concentration
  61. Tyelon, acetaminophen, N-acetyl-para-aminophenol. Which drug name is which?
  62. Medication dose responses
    Onset, trough, plateau, peak, duration, biological half-life
  63. Types of typical allergic reactions
    Rash, hives, itching
  64. Minimum blod serum concentration before next scheduled dose
    Trough
  65. Time it takes for a medication to produce a response
    Onset
  66. Point at which blood serum concentration is reached and maintained
    Plateau
  67. Idiosyncratic reactions occur most often to what people
    Children
  68. Point at which blood serum concentration is reached and maintained
    Plateau
  69. Time at which a medication reaches its highest effective concentration
    Peak
  70. Time medication takes to produce greatest result
    Duration
  71. Time for serum medication concentration to be halved
    Biological half-life
  72. Professionals that can prescribe medication
    Physician, nurse practitioner, or physician's assistant
  73. Medication orders can be prescribed 3 ways
    Written, verbal, or given by telephone
  74. Every medication order needs to include:
    • Patient's name
    • Order date
    • Medication name
    • Dosage
    • Route
    • Time of administration
    • Drug indication
    • Prescriber's signature
  75. Standing orders
    Carried out until canceled by prescriber
  76. PRN or As needed
    Given only if patient needs it
  77. One-Time orders
    Given one time at a specific time
  78. STAT order
    Single dose immediately
  79. Now Orders
    Specific one time order, quickly (within 30min) but not STAT
  80. Two types of Distribution Systems
    Unit Dose and Automated Medication Dispensing System
  81. Uses a portable cart that contains a drawer for each client's medications for a 24 hour period
    Unit Dose (distribution system)
  82. Each nurse has a security code and must select medication or bioidentification(finger print)
    Automated medication dispensing system
  83. Assessment for medication administration
    • Patient Hx
    • Allergies
    • Medication Hx
    • Diet HX
    • Perceptual or coordination problem
    • Current condition
    • Attittude about medication use
    • Knowledge/Understanding of medication Therapy
  84. Tips for administration of medications safely
    • Avoid distractions and follow same routine
    • Administer only meds that you prepare, and never leave prepared meds unattended
    • Know meds you are giving
    • Keep controlled meds secure
    • Use only clearly labeled meds
    • Don't use cloudy liquid meds or ones that changed colors
    • Calculate accurately
  85. When considering liver disease why is it important to give smaller doses
    Often kidneys unable to excrete medications quickly so it may build up to toxic effects
  86. Considering the therapeutic range when is it the best time to give another dose
    At minimum effective concentration
  87. Six rights of medication administration
    Medication, dose, patient, route, time, documentation
  88. As a nurse you must validate the written medication order with the?
    MAR (medication adminstration record)
  89. Once you check the MAR and physician's order, ou must validate the medication by?
    Comparing the label on medication with MAR three times
  90. Difference between plateau and peak
    Basically same thing
  91. IV antibiotics (gentamycin and vancomiosen)
    If in toxic levels can cause hearing loss and damage kidneys. Very important to recognize therapeutic range(peak or trough)
  92. Time at which to administer another dose
    30 mins after trough so that second dose doesn't take medication into toxic range
  93. Checking the medication to MAR three times: (the three safety checks)
    • While removing from drawer or shelf
    • As you remove the amount from container
    • At the beside before administrating
  94. The half life of a medication in 8hrs, 16hrs, 24hrs, and 32hrs. What is percentage left
    50%, 25%, 12.5%, 6.25%
  95. If given a patient 2 grams of medicine after 12hrs, 24hrs, 36hrs, 48hrs how many mgs are left
    1gram, 500mg, 250mg, 125mg
  96. Never cut/crush time released meds that say
    ER, ST, CR
  97. Acceptable identifers include
    Patient's name, identification number assigned by the health care facility, patient's date of birth
  98. How to apply opthalmic ointment
    Ask patient to look at ceiling, hold ointment applicator above lower lid margin and apply a thin stream of ointment evenly along the inner edge of lower eyelid on the conjunctiva from the inner canthus to the outer canthus, patient close the eye (not firmly) and roll eye behind closed eyelid
  99. Otic medications: How to place patient
    Side lying position
  100. For otic medications straighten ear canal by (children vs adults)
    Pull auricle down and back for children, upward and outward for adults
  101. Try to wait how long between different inhaled medications
    2 to 5 mins
  102. Opthalmic administeration:with dominant hand resting on patient's forehead, hold filled medication eye dropper or opthalmic soultion where?
    1 to 2 cm(1/2 to 3/4 inch) above conjunctiva sac
  103. Repeat putting a opthalmic drop in if?
    Client blinks or closes eye or if the drop lands on outer lid margins
  104. After a opthalmic drop is instilled, make sure to do what?
    Gently close eye
  105. Transdermal Medications
    Are applied topically to skin, disk holds the medicated ointment to the skin, may stay in place as little as 12 hrs to 7days, rotate site of new patches
  106. Types of parenteral medication
    Subcutaneous, Intramuscular(IM), Intradermal (ID), Intravenous(IV), Insulin
  107. Parts of the syringe
    Plunger, barrel, needle hub(or hit): needle including shaft, lumen, bevel
  108. Two types of syringes used:
    Luer-Lock, slip tip
  109. Syringe used for IM and subcutaneous
    1 to 3mL
  110. Syring used for certain IV meds
    3 to 5mL
  111. Syringe used for insulin
    Only used for insulin! Each mL contains 100 units of insulin
  112. Disposal of sharps includes:
    Use puncture proof container, never throw in waste can, never bend or break before disposal, never recap except under specific circumstances (use 1 scoop method), use safety devices on needle, dispose needle end first in SHARPS container
  113. Length of needle determined by:
    Patients size, weight, and route of administration
  114. Only time you can recap a needle
    It is a clean needle. Such as you have drawn up medications and now have to take to patients room
  115. Tuberculin syringes hold how many mL
    1
  116. Medications can come supplied in for needles?
    Ampule, vial, and prefilled cartridge
  117. Glass container that usually holds a single dose of a drug
    Ampule
  118. When preparing to use ampule
    Hold upright, tap top of ampule, above neck. (To make sure all medication in bottom portion), break ampule at neck, break the neck of the glass away from your body using a gauze.
  119. Withdraw medication from ampule in upright position, using what type of needle?
    Filter needle (dispose afterwards and change to needle for injection)
  120. Intraocular Disk application
    Wear gloves! Gently press fingertip against disk so it adheres to your finger, with other hand gently pull back the client's lower eyelid away from eye. Ask patient to look up. Place disk in conjunctival sac so that it floats on tha sclera between the iris and lower eyelid.
  121. Glass bottle with sealed rubber cap: range from single to multidose
    Vial
  122. Preparation of medications from vials
    Pierce rubber top with needle, if not first person to use make sure to clean stopper with alcohol wipe, inject air prior to withdrawl medicine (equalizes pressure).
  123. Rule for injecting air into vial
    Add the same amount of air as the amount of medication you remove
  124. If medication dispensed of powder it must be...
    Reconstituted
  125. Date and initial any vial that?
    You open and is going to be used more than once
  126. The smaller the gauge of the needle the...the diameter
    Larger
  127. Mixing of medications using on syringe: 2 vials
    Total volume is appropriate for injection site. 2 vials(draw up air equal to both meds: inject air vial 1 then vial 2)(withdraw med from vial 2 the vial 1)
  128. Mixing of Medications using one syringe: vial and ampule
    Draw up air equal to volume from vial: ampules do not require injection of air
  129. Bleb
    Raised area after intradermal administration injection
  130. Z track method: when you might use it?
    For IM injections: medications that are irritating to tissues or stain the tissues may require it
  131. Oral medication types
    Tablets. Tablets with interventions. Liquid. Liquid - less than 5 mL. Sublingual. Buccal

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