Calculate with Confidence-Chapters 17-25 Flashcards
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Which of the following are the 7 Rights of Medication Administration? (Select all that apply)

  • Right Dose (correct)
  • Right Client (correct)
  • Right Time (correct)
  • Right Equipment
  • Right Medication
  • Right Documentation (correct)
  • Right Route (correct)
  • Right Drug (correct)
  • What does VOLUME represent in medication administration?

    What's in the bottle

    Match the components required for a medication order:

    Name of Client = 1 Medication = 2 Dosage = 3 Route = 4 Frequency = 5 Special Instruction = 6 MD Signature = 7

    Insulin should always be drawn up in the order of cloudy to clear.

    <p>False</p> Signup and view all the answers

    How is insulin administered?

    <p>Subcutaneously</p> Signup and view all the answers

    Which of the following insulins are classified as long-acting? (Select all that apply)

    <p>Lantus</p> Signup and view all the answers

    What should a nurse always use when administering insulin?

    <p>Insulin syringe</p> Signup and view all the answers

    What is Normal Saline?

    <p>0.9 NS</p> Signup and view all the answers

    What is the antidote for Coumadin?

    <p>Vitamin K</p> Signup and view all the answers

    Which syringe should be used for Heparin?

    <p>TB syringe</p> Signup and view all the answers

    When calculating IV infusion if more than ____________ you should question it.

    <p>200 mL</p> Signup and view all the answers

    What is the formula for calculating BSA (Body Surface Area) from kilograms and centimeters?

    <p>BSA = weight (kg) x height (cm) / 3600</p> Signup and view all the answers

    Convert 2.2 lbs to kilograms.

    <p>1 kg</p> Signup and view all the answers

    What is the normal range for PT/INR when monitoring Coumadin therapy?

    <p>2-3</p> Signup and view all the answers

    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.

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    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.

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