Assisting Ms. Periwinkle: Medication & Care
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Questions and Answers

Which of the following electrolyte imbalances might be indicated by symptoms such as confusion, muscle cramps, and nausea?

  • Reduced magnesium levels (correct)
  • Elevated potassium levels
  • Elevated sodium levels
  • Reduced calcium levels

A client is prescribed 650 mg of Tylenol, but the available tablets are 325 mg each. After noticing the discrepancy, what is the MOST appropriate action for the healthcare provider?

  • Administer two tablets and proceed as usual.
  • Report the discrepancy to the nurse and clarify the order. (correct)
  • Administer one tablet and document the discrepancy later.
  • Administer one and a half tablets to reach the prescribed dose

When administering multiple puffs of an inhaled medication, what is the generally recommended waiting period between puffs, and why?

  • 2 minutes, to prevent over-medication.
  • 5 seconds, to ensure quick administration.
  • 30-60 seconds, to maximize medication absorption in the lungs. (correct)
  • No waiting period is needed; administer puffs consecutively.

What is the MOST important reason for disposing of a used nitroglycerin patch in a designated medication disposal container?

<p>To avoid accidental exposure and absorption of the medication by others. (C)</p> Signup and view all the answers

You are about to remove a nitro patch from a patient. What observation is MOST critical during this procedure?

<p>Any signs of skin irritation, rash, or redness. (C)</p> Signup and view all the answers

A patient refuses to have a prescribed topical cream applied after a bath, stating that the treated area has cleared up, and the redness is gone. What is the MOST appropriate next step?

<p>Document the refusal and notify the nurse. (A)</p> Signup and view all the answers

Ms. Periwinkle's care plan now includes a DOT for medication assistance. Considering her age, arthritis, angina, CKD, and new asthma diagnosis, which factor MOST significantly influences drug action and requires careful monitoring?

<p>The effect of polypharmacy (multiple medications) and potential drug interactions. (D)</p> Signup and view all the answers

A patient exhibits tremors and a rapid heart rate. Which of the following is the MOST appropriate initial action?

<p>Assess for potential medication side effects or signs of toxicity. (B)</p> Signup and view all the answers

What is the PRIMARY reason for healthcare providers to wear gloves when removing a nitroglycerin patch?

<p>To avoid absorbing the medication through the skin. (A)</p> Signup and view all the answers

Ms. Periwinkle uses a Salbutamol (Ventolin) MDI with a spacer for her asthma. What is the MOST important reason to provide oral care after administering the MDI?

<p>To prevent potential fungal infections or thrush (oral candidiasis). (B)</p> Signup and view all the answers

You are assisting Ms. Periwinkle with applying her Fucidin cream for intertrigo in the crease of her left breast. What is the MOST important infection control measure to follow during this procedure?

<p>Wearing non-sterile gloves during the application and using a gloved finger. (C)</p> Signup and view all the answers

Ms. Periwinkle's daughter removes her Nitro patch every evening, as it's only worn for 12 hours. What is the PRIMARY reason for this specific application schedule?

<p>To minimize the risk of developing a tolerance to the medication. (D)</p> Signup and view all the answers

You observe that Ms. Periwinkle is having increased difficulty opening her medication bottles and is unsure if she's taking the correct pills due to blurry vision. Besides reporting this to your supervisor, what immediate action can you take to ensure her medication safety?

<p>Read the labels to her each time she takes her medication, ensuring she understands which medication she is taking. (A)</p> Signup and view all the answers

Ms. Periwinkle is prescribed Furosemide (Lasix). Which potential side effect of this medication warrants careful monitoring due to her age and existing CKD?

<p>Electrolyte imbalances and dehydration. (D)</p> Signup and view all the answers

Prior to assisting Ms. Periwinkle with her medications, you review the DOT and MAR (Medication Administration Record). What is the MOST critical reason for this review immediately before medication assistance?

<p>To double-check for any recent changes in medication orders or dosages. (D)</p> Signup and view all the answers

Ms. Periwinkle takes Acetaminophen (Tylenol) for pain. Considering her existing health conditions, what is the MOST important consideration regarding its administration?

<p>Monitoring for potential liver toxicity, especially given her age and other medications. (A)</p> Signup and view all the answers

Which factor most significantly increases the risk of medication errors for an elderly individual with weak vision and arthritis?

<p>Difficulty reading labels and manipulating medication containers. (B)</p> Signup and view all the answers

A resident is prescribed both Acetaminophen and Tylenol. Why are two names associated with the same medication?

<p>One is the <em>generic name</em>, a standard identifier, and the other is the <em>trade/brand name</em> given by the manufacturer. (A)</p> Signup and view all the answers

Furosemide (Lasix) is classified as a diuretic. What is its primary action in the body?

<p>Increasing urine output and reducing fluid retention. (A)</p> Signup and view all the answers

What is the primary action of Salbutamol (Ventolin) in treating respiratory conditions like asthma and COPD?

<p>Relaxing and widening the airways to ease breathing. (D)</p> Signup and view all the answers

When assisting a resident with Acetaminophen (Tylenol), which observation would necessitate immediate reporting to a healthcare professional?

<p>Signs of jaundice or dark urine. (D)</p> Signup and view all the answers

Why is it important to encourage fluid intake and monitor for dehydration when a resident is taking Furosemide (Lasix)?

<p>To counteract the fluid loss caused by the diuretic effect of the medication. (D)</p> Signup and view all the answers

What is the most important reason for offering a resident a cup of water to rinse their mouth after using a Salbutamol (Ventolin) inhaler?

<p>To prevent throat irritation and reduce the risk of fungal infections. (B)</p> Signup and view all the answers

A resident taking Furosemide (Lasix) reports muscle cramps and weakness. Which electrolyte imbalance is most likely indicated by these symptoms?

<p>Low potassium levels (hypokalemia). (A)</p> Signup and view all the answers

Flashcards

Generic Name

The non-proprietary name of a medication.

Trade/Brand Name

The brand name given by the drug manufacturer.

Acetaminophen (Tylenol) Classification

Pain reliever and fever reducer.

Acetaminophen (Tylenol) Action

Reduces pain and fever.

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Diuretic Classification

A type of drug that increases urine output.

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Furosemide (Lasix) Action

Increases urine output, reduces fluid retention, decreases blood pressure.

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Bronchodilator Classification

Medication that relaxes and widens the airways.

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Salbutamol (Ventolin) Action

Relaxes airway muscles, making breathing easier.

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Medication Assistance (DOT)

Assisting a client with their prescribed medications, involving tasks listed in the

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Acetaminophen (Tylenol)

650 mg, used for pain relief.

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Furosemide (Lasix)

40 mg, Used to treat fluid retention (edema) and high blood pressure.

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Salbutamol (Ventolin) MDI

A bronchodilator used to relieve bronchospasm.

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Spacer

A type of administration of medication in which a device is used to increase the ease of administering medication.

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Nitro Patch

Applied for chest pain.

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Fucidin Cream

Topical antibiotic cream used to treat skin infections.

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Age-related Pharmacokinetics

Changes to how the body processes drugs due to age.

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Liver Toxicity Signs

Signs like tremors or fast heart rate may point to liver issues.

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Electrolyte Imbalance Symptoms

Electrolyte imbalances can cause confusion, fatigue, muscle cramps, or nausea.

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Tylenol Dosage Calculation

You should take 2 tablets from the blister pack.

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Medication Discrepancy Reporting

Report the discrepancy to the nurse to ensure patient safety and correct orders.

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Inhaler Puff Interval

Wait at least 30 seconds between puffs to maximize medication delivery.

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Nitro Patch Removal & Disposal

Slowly peel off the patch while wearing gloves, check for skin irritation, and dispose in a medication disposal container.

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Handling Medication Refusal

Respect the patient's refusal, inform the nurse, and document the refusal on the MAR.

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MAR Documentation

Use the MAR legend to accurately record medication administration or refusal.

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Study Notes

  • Assisting Ms. Periwinkle, who has arthritis, angina, CKD, and a fungal rash under her left breast, is emotionally taxing due to the special connection you share.
  • Ms. Periwinkle takes several pills in the morning, and you're careful not to dislodge her heart medication patch during baths.
  • Ms. Periwinkle has grown weaker, has difficulty opening medication bottles, and her vision has become blurry.
  • She has been diagnosed with asthma, uses an inhaler and has difficulty depressing it due to arthritis.
  • You report your observations to your supervisor leading to a change in care plan including a DOT for medication assistance.
  • You must assist Ms. P with 650 mg of Acetaminophen (Tylenol), 40 mg of Furosemide (Lasix), Salbutamol (Ventolin) MDI and spacer.
  • You must also apply her Nitro patch each morning, and apply a thin layer of Fucidin prescription cream to the crease in her left breast after her bath and document the administration on the MAR.

Special Considerations

  • Her daughter removes the Nitro patch each evening because it is only needed for 12 hours.
  • Use a gloved finger to apply Fucidin Cream.
  • Provide oral care after MDI administration

Drug Action Factors

  • Age may slow metabolism, increasing the risk of side effects and toxicity.
  • Kidney function issues (CKD) and impaired liver function (common in elderly) can slow drug metabolism.
  • Multiple medications (polypharmacy) increase toxicity risks.
  • Poor vision and arthritis can increase medication errors.
  • Fungal rash under the breast can affect absorption.

Generic and Trade Names

  • Acetaminophen (Tylenol).
  • Furosemide (Lasix).
  • Salbutamol (Ventolin).

Drug Classifications and Actions

  • Acetaminophen (Tylenol) is a pain reliever and fever reducer used to reduce pain and fever.
  • Furosemide (Lasix) is a diuretic that increases urine output, reduces fluid retention (edema), and decreases blood pressure.
  • Salbutamol (Ventolin) is a bronchodilator that provides airway relaxation and widening to relieve bronchospasms in conditions like asthma and COPD, making breathing easier.

Medication Responsibilities

  • Acetaminophen (Tylenol), 650 mg: assist with correct dose and watch for signs of nausea, jaundice, and dark urine, which can indicate liver toxicity; document at MAR.
  • Furosemide (Lasix): assist with correct morning dose to prevent nighttime urination, encourage fluid intake, monitor for dehydration, low blood pressure, dizziness, electrolyte imbalances, and document in MAR.
  • Salbutamol (Ventolin): using the metered-dose inhaler (MDI) with a spacer. Assist to press the inhaler. Offer water to rinse the mouth to prevent throat irritation, observe for side effects like tremors and fast heart rate, and document in MAR.

Observations

  • Observe for signs of nausea, jaundice, and dark urine, which indicate liver toxicity.
  • Observe for side effects like tremors and fast heart rate.
  • Observe for electrolyte imbalances (confusion, fatigue, constipation, muscle cramps or weakness, nausea, vomiting, numbness in limbs).

Dosage

  • If the Tylenol in the blister pack is 325 mg instead of the required 650 mg, administer two tablets and report the discrepancy to the nurse.

Inhaler timing

  • Wait at least 30 seconds between Ventolin puffs, up to 60 seconds.

Nitro Patch

  • Remove the old Nitro patch carefully with gloves, observe the skin for rash, redness, or irritation, and dispose of the used patch in a medication disposal container.

Refusal

  • For a patient who refuses the cream, do not force it; instead, tell the nurse about the refusal and note it in the MAR.

MAR Documentation

  • 650 mg of Acetaminophen (Tylenol), Administered at 0700, PL.
  • 40 mg of Furosemide (Lasix), Administered at 0700, PL.
  • Salbutamol (Ventolin) MDI and spacer, Administered (2 puffs) at 0700, PL.
  • Nitro patch applied each morning at 0700, PL.
  • Fucidin prescription cream application refused after bath at 0700, PL.

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Description

Assisting Ms. Periwinkle involves careful medication administration, including Tylenol, Lasix, and Ventolin, as well as applying a Nitro patch and Fucidin cream. Report observations to supervisors for care plan adjustments. Special attention is needed due to her arthritis, angina, CKD, asthma and fungal rash.

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