Calculate with Confidence-Chapters 17-25 Flashcards

Study Notes

7 Rights for Medication Administration

Right Client
Right Medication
Right Dose
Right Route
Right Time
Right Documentation
Right Programming (for pump delivery)

Medication Order Components

Client's Name
Medication Name
Dosage
Route of Administration
Frequency
Special Instructions
Physician's Signature

Insulin Administration

Always draw up insulin: CLEAR to CLOUDY
Insulin is administered subcutaneously.
Intermediate insulin refers to long-acting types.

Types of Insulin

Rapid-acting Insulin:
- Humalog (lispro): Administer 5 minutes before meals
- Novolog (aspart): Can be given subcutaneously or IV
- Apidra (glulisine): Can be given subcutaneously or IV
Short-acting Insulin:
- Regular (R): Takes 30 minutes to work; can be given subcutaneously or IV, and is clear.
Intermediate Insulin:
- NPH (cloudy).
Long-acting Insulin:
- Lantus: Clear, administered subcutaneously (cannot be mixed)
- Levemir: Clear, not as long-lasting as Lantus, may require 2 doses daily (cannot be mixed).

Insulin Mixing Techniques

Draw up clear, mixable insulin first when mixing with cloudy insulin.
Sequence for mixing involves gently rolling vials, cleansing vial tops, injecting air into the cloudy vial, and withdrawing from the clear vial without shaking.

Insulin Safety

Insulin doses should always be checked by two nurses.
Administer intravenous fluids (IVF) to the correct client at the prescribed rate; monitoring response is critical to avoid mild to fatal reactions.

IV Fluids & Monitoring

IV fluids should be documented on Intake & Output (I&O).
Common IV fluids include:
- 0.9% Normal Saline
- D5W (Dextrose 5% in water)
- Ringer Lactate (RL or LR) (contains electrolytes)
- Potassium Chloride (KCl) additive (in mEq per L)
- 0.45% Sodium Chloride (1/2 NS)
- Dextrose 5% and Lactated Ringer (D5RL)
- D5 in Sodium Chloride (D5NS)
- D5 in 0.45% Sodium Chloride

Infusion Rates and Calculations

IV checks frequency:
- Adults: every 2 hours
- Children: every hour
- Highly concentrated solutions: every hour
IV infusion calculation formulas:
- mL per hour = V infusion
- mL X gtt / minutes = IV flow rate (gtt/min)
- If an infusion exceeds 200 mL, it should be questioned.

Medications and Lab Tests

Coumadin lab test: Prothrombin Time/INR (normal range 2-3); antidote is Vitamin K.
Heparin lab test: Activated Partial Thromboplastin Time (APTT); antidote is protamine sulfate.
Heparin should never be administered via IM route and never pushed.

Weight and Dosage Conversions

2.2 pounds = 1 kilogram
1 pound = 16 ounces
1 inch = 2.5 centimeters
Body Surface Area (BSA) is used for dosage calculations.
Pediatric dosages should use a TB syringe for accuracy (measure in hundredths).

BSA Calculations

BSA calculated from kg and cm: BSA = (weight in kg × height in cm) / 3,600, then square root the result.
BSA calculated from lb and inches: BSA = (weight in lbs × height in inches) / 3,131, then square root the result.
Child dosing from adult dosage: BSA of child (m²) / 1.7 × adult dosage = estimated child's dose.

Heparin Administration

The TB syringe should be used for Heparin dosing.
Calculation examples for Heparin involve unit conversions based on mL and concentrations.

Description

This quiz consists of flashcards covering essential concepts from Chapters 17 to 25 of 'Calculate with Confidence.' Focus on key terms and definitions related to medication administration and order components. Enhance your understanding and retention of critical medication safety principles.