exam week 10 part 2`

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  1. what are the ten rights of medication administration?
    • Right Medication
    • Right Dose
    • Right Time
    • Right Route
    • Right Client
    • Right Documentation
    • Right Education
    • Right to Refuse
    • Right Assessment
    • Right Evaluation
  2. first 5 rights of medication administeration
    • Right Medication
    • Right Dose
    • Right Time
    • Right Route
    • Right Client
  3. 2nd 5 rights of med administration
    • Right Documentation
    • Right Education
    • Right to Refuse
    • Right Assessment
    • Right Evaluation
  4. What are the 3 medication preparation checks
    • compare label on med to MAR
    • check expiration date
    • 1 when you get med out
    • 2 when placing into cup(pouring, drawing up, placing package in cup)
    • 3 when putting the medication away
  5. you should leave medication ______ until ______
    • in package
    • until you hand it to client
  6. Medication Preparation
    • Know the Drug (if don't look it up)
    • Check medical administration record (MAR)
    • Verify Route
    • Organize self and supplies
    • only prepare meds for 1 client at a time
    • check expiration date
    • never leave meds unattended
    • always lock the lock box
    • check ID Bracelet (have client state name/DOB)
  7. what physiological changes occur in the elderly
    • Altered memory
    • Decreased Visual acuity
    • Decreased renal function
    • Less complete and slower absorption from CGI tract
    • increased proportion of fat to lean Body mass
    • decreased liver function
    • decreased organ sensitivity
    • decreased manual dexterity
  8. altered memory in elderly causes
    • did they remember to take meds
    • did they take too many times
  9. decreased renal function in elderly
    resulting in slower elimination of drugs and higher concentrations of drugs in the bloodstream for longer periods of time
  10. when preparing to give a medication you should always know ______
    • why they are getting the med
    • always ask about allergies
  11. 3 checks for injection meds
    • 1 when it is  taken from med cart
    • 2 before withdrawing the medication
    • 3 after drawing medication (putting med away or throwing away package)
  12. steps for preparing med from ampule
    • 3 check
    • hand hygiene
    • make sure med is out of top, open ampule (opener or gauze)
    • top goes in sharps container
    • attach filter needle-draw out dose
    • replace needle with reg needle needed for type or injection you are giving
  13. steps for mixing insulin
    using 1 syringe
    • draw up the amount of air that u are removing from both vials
    • inject air into NPH withdraw needle (do not touch liquid)
    • inject air into reg insulin and withdraw amount needed
    • reinsert needle in NPH and withdraw amount needed
    • be careful to only get amount ordered
  14. steps for intradermal injection
    • prepare med & prepare client explain wheal
    • select site and clean/let dry
    • remove cap, expel air
    • Hold Almost PARALLEL (15*or less) to skin BEVEL UP
    • nondom hand hold and pull taught
    • insert tip, bevel should be visible under the skin
    • inject slowly so wheal appears
    • withdraw at same angle
  15. things that you should never do after intradermal injection
  16. sites for intradermal injections
    • inner lower arm
    • upper chest
    • back beneath scapulae
  17. what is intradermal route most commonly used for
    • allergy testing
    • TB test
  18. Sub Q injections
    sites and angle
    • outer aspects of upper arm
    • anterior aspects of thighs
    • abdomen
    • scapular areas of upper back
    • upper ventrogluteal
    • dorsogluteal areas
    • 45* angle with palm facing to the side or upward
    • 90* palm downward
  19. what are the essential parts of an order
    • client's full name
    • Date, month and year
    • Drug Name, dosage, frequency and route of administration
    • Signature of person writing the order
  20. do not crush meds that are......
    • time released
    • sublingual
    • enteric coated
    • sustained release
  21. when giving med through NG or g-tube or j-tube what precautions should be made before giving
    • if poss have pharmacy switch to liquid
    • if no liquid form check to see if it can be crushed
    • crush and dissolve into at least 30mL warm water
    • check tube placement
    • aspirate stomach contents and measure
  22. when giving meds through NG, Gtube or j-tube
    steps of administer after dissolved in 30mL warm water
    • remove plunger and connect to a pinched tube
    • put 15-30mL of water in syringe barrel to flush
    • raise or lower to adjust the flow
    • pinch or clamp before all water is instilled
    • pour liquid or dissolved med into barrel
    • if giving more than one med give each separately with 15 to 30mL water between each to flush
    • disconnect from suction and keep tubing clamped for 20 to 30 mins to enhance absorption
  23. when giving heparin
    • abdomen at least 2 inches away from umbilical
    • and above iliac crest
    • 90* angle
  24. what types of medications are given Sub Q
    • vaccines
    • pre-op meds
    • narcotics
    • insulin
    • heparin
  25. what kinds of medications are given intramuscular
    • vaccines
    • hep B
    • pneumonia
    • flu
  26. landmarks for deltoid IM
    • four fingers across deltoid starting at acromion process
    • axillary is lower border line
    • give injection in triangle
  27. landmarks for vastus lateralis
    • divide area between greater trochanter and lateral femoral condyle into thirds give injection in middle third of thigh
  28. Landmarks for ventrogluteal
    • pt lays on side knee bent pulled up slightly towards chest
    • nurse uses opposite hand
    • palm over greater trochanter index finger points toward client's head middle finger drops dorsally towards buttocks inject inside triangle
    • Not as much risk, sealed off from the bone contains less fat than Butt, suitable for infants over 7 months
  29. dorsogluteal
    • not recommended because sciatic nerve, major blood vessels and bone
    • if has to be used
    • children over 3 or that have been walking for more than 1 year
  30. what is Z-Track
    • injection given IM
    • use nondominant hand to push subQ away give injection at 90* into the muscle hold needle in for 10 seconds then withdraw and release skin
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exam week 10 part 2`
week 10 part 2
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