Chapter 7

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  1. what are the six rights of drug administration?
    • right person
    • right drug
    • right dose
    • right time
    • right route
    • right documentation
  2. ...agents used in the diagnosis, or prevention of disease.
  3. ...measures to decrease your risk of exposure to blood and body fluids.
    standard precautions
  4. ...a condition free of pathogens.
  5. to one area.
  6. ...throughout the body.
  7. of all forms of life.
  8. ...careful handling to prevent contamination.
    medically clean
  9. ...cleansing agent that destroys or inhibits pathogenic organisms and is also toxic to living tissue.
  10. ...cleansing agent that destroys or inhibits pathogenic organisms but is not toxic to living tissue.
  11. routes of drug administration?
    • -percutaneous
    • -pulmonary
    • -enteral
    • -parenteral
  12. ...medications applied to and absorbed through the skin or mucous membranes.
    percutaneou (topical medications)
  13. percutaneous routes?
    -transdermal (this route promotes slow, steady absorption)

    -mucous membrane (this route absorbs medications at a moderate to rapid rate)
  14. mucous membrane medication sites?
    • -tongue
    • -cheek
    • -eye
    • -nose
    • -ear
  15. sublingual...
    beneath the tongue
  16. buccal...
    between the cheek and gums
  17. ocular medication...
    drug administered through the mucous membranes of the eye
  18. nasal medication...
    drug administered through the mucous membranes of the nose
  19. aural medication...
    drug administered through the mucous membranes of the ear and ear canal
  20. inhalation...
    drawing of medication into the lungs along with air during breathing
  21. injection...
    placement of medication in or under the skin with a needle and syringe
  22. nebulizer...
    inhalation aid that disperses liquid into aerosol spray or mist
  23. metered-dose inhaler...
    handheld device that produces a medicated spray for inhalation
  24. pulmonary medication mechanisms?
    • -nebulizer
    • -metered-dose inhaler
    • -endotracheal tube
  25. endotracheal medications?
    • -lidocaine
    • -epinephrine
    • -atropine
    • -naloxone (narcan)

    ...may have to increase dose 2-2.5 times and dilute.
  26. enteral drug administration...
    the delivery of any medication that is absorbed through the gastrointestinal tract
  27. enteral routes...
    • -oral
    • -gastric tube
    • -rectal
  28. oral drug administration...
    the delivery of any medication that is taken by mouth and swallowed into the lower gastrointestinal tract
  29. hepatic alteration...
    change in a medication's chemical composition that occurs in the liver
  30. suppository...
    medication packaged in a soft, pliable form, for insertion into the rectum
  31. enema...
    a liquid bolus of medication that is injected into the rectum
  32. parenteral drug administration...
    drug administration outside of the gastrointestinal tract

    injected into circulatory system or tissue...most rapid drug delivery and absorption
  33. syringe...
    plastic tube in which medication can be drawn up, stored, and injected
  34. hypodermic needle...
    hollow metal tube used with the syringe to administer medications

    parts: hilt, shaft, and bevel
  35. types of medication packaging...
    • -glass ampules
    • -single and multidose vials
    • -nonconstituted drug vials
    • -prefilled syringe
    • -intravenous medication fluids
  36. ampule...
    breakable glass vessel containing liquid medication

    1-5ml, least expensive, single dose
  37. vial...
    plastic or glass container with a self-sealing rubber top

    single/multidose, vacuum
  38. nonconstituted drug vial/mix-o-vial...
    vial with two containers, one holding a powdered medication and the other holding a liquid mixing solution

    extends shelf life
  39. prefilled/preloaded syringe...
    syringe packaged in a tamper-proof container with the medication already in the barrel

    prefilled decreases dosage error
  40. medicated solution...
    parenteral medication packaged in an IV bag and administered as an IV infusion

    (infusion-liquid medication delivered through a vein)
  41. parenteral routes...
    • -intradermal injection
    • -subcutaneous injection
    • -intramuscular injection
    • -intravenous access
    • -intraosseous infusion
  42. intradermal injection...
    within the dermal layer of the skin

    small amount, very slow rate of absorption, no systemic distribution
  43. subcutaneous injection...
    relating to the layer of loose connective tissue between the skin and muscle

    small amount, slow sustained absorption prolongs drug affects on body, some systemic distribution
  44. intramusclar injections...
    deposits medications into muscle

    extremely vascular and permits systemic delivery at a moderate rate
  45. intramusclar injection sites...
    • -deltoid
    • -dorsal gluteal
    • -vastus lateralis
    • -rectus femoris
  46. intravenous access (cannulation)...
    surgical puncture of a vein to deliver medication or withdrawl blood
  47. types of intravenous access...
    -peripheral venous access (surigcal puncture of a vein in the arm, leg, or neck

    -central venous access (surgical puncture of the internal jugular, subclavian, or femoral vein
  48. peripherally inserted central catheter (PICC)...
    line threaded into the central circulation via a peripheral site

    long-term use
  49. intravenous fluid...
    chemically prepared solution tailored to the body's specific needs

    keep vein patent, replace body lost fluids
  50. four types of intravenous fluids...
    • -colloids
    • -crystalloid
    • -blood
    • -oxygen-carrying fluids
  51. colloids...
    intravenous solutions containing large proteins that cannot pass thru capillary membranes

    remain in circulatory system longer, attract water, increase intravascular volume
  52. crystalloid...
    intravenous solutions that contain electrolytes but lack the larger proteins

    prehospital uses, three types..isotonic, hypertonic, hypotonic
  53. isotonic...
    state in which solutions on opposite sides of a semipermeable membrane are in equal concentration
  54. hypertonic...
    state in which a solution has a higher solute concentration on one side of a semipermeable membrane than on the other side
  55. hypotonic...
    state in which a solution has a lower solute concentration on one side of a semipermeable membrane than on the other side
  56. three types of IV solutions....
    -lactated ringers (isotonic solution, containing sodium chloride, potassium chloride, calcium chloride and sodium lactate in water

    -normal saline solution (isotonic solution, containing 0.90% sodium chloride in water

    -5% percent dextrose in water (hypotonic solution, used to keep vein patent and supply calories needed for cellular metabolism)
  57. blood...
    most desirable fluid for blood replacement, hemoglobin in blood carries oxygen, O-negative is universal
  58. microdrip tubing...
    administration tubing that delivers a relatively small amount of fluid

  59. macrodrip tubing...
    administration tubing that delivers a relatively large amount of fluid

  60. administration tubing...
    flexible, clear plastic tubing that connects the solution bag to the IV cannula
  61. drip camber...
    clear plastic chamber that allows visualization of the drip rate
  62. drip rate...
    pace at which the fluid moves from the bag into the patient

    • macrodrip=10gtts=1ml
    • microdrip=60gtts=1ml
  63. blood tubing...
    administration tubing that contains a filter to prevent clots or other debris from entering the patient
  64. three types of IV cannulas (intravenous cannulas)...
    • -over-the-needle catheter
    • -hollow-needle catheter
    • -plastic catheter inserted thru a hollow needle
  65. over-the-needle catheter...
    semiflexible catheter enclosing a sharp metal stylet
  66. hollow-needle catheter...
    stylet that does not have a teflon tube but is itself inserted into the vein and secured there
  67. catheter inserted thru the needle (intracatheter)...
    teflon catheter inserted thru a large metal stylet
  68. venous constricting band...
    flat rubber band used to impede venous return and veins easier to see

    never leave longer than 2 min
  69. extravasation...
    leakage of fluid or medication from the blood vessel that is commonly found with infiltration
  70. IV troubleshooting...
    • -constricting band still on
    • -edema at puncture site
    • -cannula abutting wall/valve
    • -administration set closed
    • -IV bag height too low
    • -completely filled drip camber
  71. IV access complications...
    • -pain
    • -local infection
    • -allergic reaction
    • -catheter shear
    • -inadvertent arterial puncture
    • -air embolism
    • -necrosis
    • -anticoaulants
  72. pyrogen...
    foreign protein capable of producing fever

    abrupt onset of fever (100-106), within one half to one hour of IV
  73. embolus...
    foreign particle in blood (catheter shear)
  74. circulatory overload...
    an excess in intravascular fluid volume
  75. thrombophlebitis...
    inflammation of the vein

    common in long-term intravenous therapy, redness and edema at the puncture site
  76. thrombus...
    blood clot, can form if IV access injures the vessel wall
  77. air embolism...
    air in the vein

    improper flushing of tubing
  78. necrosis...
    the sloughing off of dead tissue
  79. anticoagulant...
    drug that inhibits blood clotting

    aspirin, Coumadin, heparin
  80. heparin lock...
    peripheral IV port that does not use a bag of fluid
  81. saline lock...
    peripheral IV cannula with a distal medication port used for intermittent fluid or medication infusions, saline is injected into the device to maintain it's patency
  82. venous access device...
    surgically implanted port that permits repeated access to central venous circulation
  83. blood tube...
    glass container with color-coded, self sealing rubber top

    vacuum packed, contain anticoagulants
  84. vacutainer...
    device that holds blood tubes (multi-draw needle)

    Luer sampling needle screws on the end
  85. hemoconcentration...
    elevated numbers of red and white blood cells

    caused from leaving constricting band on too long
  86. hemolysis...
    the destruction on red blood cells

    caused by vigorously shaking blood tube, using too small of needle, too forcefully aspirating blood in or out of syringe
  87. intraosseous (IO)...
    infusion involved inserting a rigid needle into the cavity of a long bone or into the sternum

    initiate IO line only after 90 sec or three unsuccessful attempts of peripheral IV
  88. intraosseous access complications...
    • -fracture
    • -infiltration
    • -growth plate damage
    • -complete insertion
    • -pulmonary embolism
    • -infection
  89. contraindications to intraosseous placement...
    • -fracture to the tibia or femur
    • -osteoporosis
    • -establishment of peripheral IV line
  90. desired dose...
    specific quantity of medication needed
  91. concentration...
    weight per volume
  92. dosage on hand...
    the amount of drug available in a solution
  93. volume on hand...
    the available amount of solution containing a medication
  94. unit...
    predetermined amount of medication or fluid
  95. infusion rate...
    speed at which a medication is delivered intravenously
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Chapter 7
Chapter 7
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