N200_Medication_.txt

is to protect the health of the people by ensuring that medications are safe and effective. Currently the FDA ensures that all medications undergo vigorous testing before they are sold.

conform to federal legislation but also have additional controls such as alcohol and tobacco.

individual policies to meet federal and state regulations.

define the scope of a nurse’s professional functions and responsibilities.

provides an exact description of the medication’s composition and molecular structure

manufacturer who first develops the medication, which becomes the official name

the manufacturer has trademarked the medication’s name

indicates the effect of the medication on a body system, the symptoms the medication relieves, or the medication’s desired effect

determines its route of administration

is the study of how medications enter the body, reach their site of action, metabolize, and exit the body

refers to the passage of medication molecules into the blood from the site of administration

• a. route of administration
• b. ability of the medication to dissolve
• c. blood flow to the site of administration
• d. body surface area
• e. lipid solubility

• a. circulation
• b. membrane permeability
• c. protein binding

occurs under the influence of enzymes that detoxify, degrade, and remove biologically active chemicals, mostly in the liver

the kidneys; when renal function declines, a client is at risk for medication toxicity

is the expected or predictable physiological response to a medication

are the unintended, secondary effects a medication predictably will cause

are severe responses to medication

develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion

unpredictable effects in which a client overreacts or underreacts to a medication or has a reaction different from normal

are predictable responses to a medication

allergic reactions that are life-threatening and characterized by sudden constriction of bronchiolar muscles, edema of the pharynx and larynx, and severe wheezing and shortness of breath

when one medication modifies the action of another medication

The combined effect of the 2 medications is greater than the effect of the medications when given separately

constant blood level within a safe therapeutic range

highest serum concentration

is the time it takes for excretion processes to lower the serum medication concentration by half

time it takes after a medication is administered for it to produce a response

time it takes for a medication to reach its highest effective concentration

minimum blood serum concentration of medication reached just before the next scheduled dose

time during which the medication is present in concentration great enough to produce a response

blood serum concentration of a medication reached and maintained after repeated fixed doses

• a. oral
• b. buccal
• c. sublingual

• a. intradermal
• b. subcutaneous
• c. intramuscular
• d. intravenous

administered in the epidural space via a catheter, usually used for post-op analgesia

a catheter that is in the subarachnoid space or one of the ventricles of the brain

infusion of medication directly into the bone marrow, commonly used in infants and toddlers

into the peritoneal cavity such as chemotherapeutic agents, insulin, and antibiotics

directly into the pleural space, commonly chemotherapeutics

directly into the arteries

injection of a medication into a joint

• a. directly applying a liquid or ointment
• b. inserting a medication into a body cavity
• c. instilling fluid into a body cavity
• d. irrigating a body cavity e. spraying

injection directly into the cardiac tissue

They are readily absorbed and work rapidly because of the rich vascular alveolar capillary network present in the pulmonary tissue

• a. metric
• b. apothecary
• c. household

given mass of solid substance dissolved in a known volume of fluid or a given volume of liquid dissolved in a known volume of another fluid

if the order is given verbally to the nurse by the provider

is carried out until the prescriber cancels it by another order or until a prescribed number of days elapse

a medication that is given only when a client requires it

a medication that is given only once at a specified time

single dose of a medication to be given immediately and only once

is used when a client needs a medication quickly but not right away; nurse has up to 90 minutes to administer

• a. unit dose
• b. automated medication dispensing systems (AMDS)

inaccurate prescribing, administration of the wrong medicine, giving the medication using the wrong route or time interval, and administering extra doses or failing to administer a medication

• a. verify
• b. clarify
• c. reconcile
• d. transmit

• a. the right medication
• b. the right dose
• c. the right client
• d. the right route
• e. the right time
• f. the right documentation

• a. be informed of the medication’s name, purpose, action, and potential undesired effects
• b. refuse a medication regardless of the consequences
• c. have qualified nurses or physicians assess a medication history
• d. be properly advised of the experimental nature of medication therapy and give written consent
• e. receive labeled medications safely without discomfort
• f. receive appropriate supportive therapy g. not receive unnecessary medications h. be informed if medications are a part of a research study

• a. history
• b. history of allergies
• c. medication data
• d. diet history
• e. client’s perceptual coordination problems
• f. client’s current condition
• g. client’s attitude about medication use
• h. client’s knowledge and understanding of medication therapy
• i. client’s learning needs

1. anxiety

2. health maintenance, ineffective

3. health-seeking behaviors

4. deficient knowledge

5. noncompliance

6. disturbed visual sensory perception

7. impaired swallowing

8. effective therapeutic regimen management

9. ineffective therapeutic regimen management

health beliefs, personal motivations, socioeconomic factors, and habits

• a. will verbalize understanding of desired effects and adverse effects of medications
• b. will state signs, symptoms, and treatment of hypoglycemia
• c. to monitor blood sugar to determine if medication is appropriate to take
• d. establish a daily routine that will coordinate timing of medication with meal times

• a. client’s full name
• b. date and time that the order is written
• c. medication name
• d. dose
• e. route of administration
• f. time and frequency of administration
• g, signature of provider

the name of the medication, dose, route, and the exact time of administration and site

1. a. Determine the client’s ability to swallow.

b. Assess the client’s cough.

c. Determine the presence of a gag reflex.

d. Prepare oral medications in the form that is easiest to swallow.

e. Allow the client to self-administer medications if possible.

f. If the client has unilateral weakness, place the medication in the stronger side of the mouth.

g. Administer pills one at a time, ensuring that each medication is properly swallowed before the next one is introduced.

h. Thicken regular liquids or offer fruit nectars if the client cannot tolerate thin liquids.

i. Avoid straws because they decrease the control the client has over volume intake, which increases the risk of aspiration.

j. Have client hold cup and drink from cup if possible.

k. Time medications to coincide with mealtimes or when the client is well-rested and awake if possible.

l. Administer medications using another route if risk of aspiration is severe.

decongestant spray or drops

• a. avoid instilling any eye medication directly onto the cornea
• b. avoid touching the eyelids or other eye structures with eye droppers or ointment tubes
• c. use medication only for the client’s affected eye
• d. never allow a client to use another client’s eye medications

vertigo, dizziness, nausea

suppositories, foam, jellies, or creams

exerting local effects (promoting defecation) or systemic effects (reducing nausea)

delivers a measured dose of medication with each push of a canister often used with a spacer

hold dry, powdered medication and create an aerosol when the client inhales through a reservoir that contains the medication

1. Draw medication from ampule quickly; do not allow to stand open.

2. Avoid letting needle touch contaminated surface.

3. Avoid touching length of plunger or inner part of barrel.

4. Prepare skin, use friction and a circular motion while cleaning with an antiseptic swab, and start from the center and move outward.

• a. the client’s size and weight
• b. type of tissue into which the medication is to be injected

contain single doses of medications in a liquid

is a single dose or multidose container with a rubber seal at the top (closed system)

• a. do not contaminate one medication with another
• b. ensure that the final dose is accurate
• c. maintain aseptic technique

rate of action (rapid, short, intermediate, and long-acting); each has a different onset, peak, and duration of action

• a. need to maintain their individual routine when preparing and administering their insulin
• b. do not mix insulin with any other medication or diluents
• c. never mix insulin glargine or insulin detemir with other types of insulin
• d. inject rapid-acting insulin mixed with NPH within 15 minutes before a meal
• e. do not mix short-acting and lente insulins unless the blood glucose levels are currently under control with this mixture
• f. do not mix phosphate-buffered insulins with lente insulins

• a. use a sharp beveled needle in the smallest suitable length and gauge
• b. position the client as comfortably as possible to reduce muscle tension
• c. select the proper injection site
• d. divert the client’s attention from the injection
• e. insert the needle quickly and smoothly
• f. hold the syringe while the needle remains in tissues
• g. inject the medication slowly and steadily

the outer posterior aspect of the upper arms, the abdomen (below the costal margins to the iliac crests), and the anterior aspects of the thighs

0.5 to 1 ml

• 25-gauge, 5/8 inch needle inserted at a 45-degree angle
• or a ½ inch needle inserted at a 90-degree angle

90 degrees

3 ml into a large muscle

2 ml

1 ml

lacks major nerves and blood vessels; rapid absorption; frequently used in infants, older children, and toddlers (immunizations)

deep site away from nerves and blood vessels, less chance of contamination, easily identified landmarks, preferred site for medications

easily accessible but muscle not well developed, use small amounts, not used in infants or children, potential for injury to radial and ulnar nerves, immunizations for children, recommended site for hepatitis B and rabies injections

minimizes local skin irritation by sealing the medication in muscle tissue

skin testing, injected into the dermis where medication is absorbed slowly

• a. as mixtures within large volumes of IV fluids
• b. injection of a bolus or small volume of medication
• c. piggyback infusion

• a. fast-acting medications must be delivered quickly
• b. constant therapeutic blood levels

• a. most dangerous method because there is not time to correct errors
• b. a bolus may cause direct irritation to the lining of blood vessels

• a. it reduces risk for rapid-infusion by IV push
• b. allows for administration of medications that are stable for a limited time in solution
• c. it allows for control of IV fluid intake

a small (25-250 ml) IV bag connected to short tubing lines that connects to the upper Y port of a primary infusion line

small (25-100 ml) IV bag connected to a short tubing line to the lower Y port of a primary infusion

small (50-150 ml) containers that attach below the primary infusion bag

battery-operated and allows medications to be given in very small amounts of fluid (5-60 ml)

cost-saving, convenience, increased mobility, safety, and comfort for the client

Pharmacokinetics

• Most drugs must enter the systemic circulation to have a therapeutic effect
• ** absorption refers to the passage of medication molecules into the blood from the site of administration

Produce a response

Buccal is wrong, this is an oral route

• B-the vial of NPH
• **if mixing rapid- or short-acting insulin with intermediate or long-acting insulin, take insulin syringe and aspirate volume of air equivalent to the dose of insulin to be withdrawn from the long-acting insulin first