PHARM Engage RN 2.0 : Medication Administration (Foundational Concepts of RN Practice)
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A nurse is preparing to administer medication. Which action demonstrates the nurse's understanding of their role as the last line of defense in preventing medication errors?

  • Consulting with the pharmacist to clarify any concerns about potential drug interactions.
  • Delegating the task of medication administration to a certified nursing assistant.
  • Verifying the medication order, drug label, and patient identification at the bedside. (correct)
  • Documenting the medication administration immediately after giving the drug.

An organization aims to improve medication safety. Which systematic approach would be MOST effective in achieving this goal?

  • Increasing the workload of pharmacists to allow them to double-check all medication orders.
  • Developing interprofessional team policies and procedures for medication administration. (correct)
  • Mandating annual training sessions on new medications for all nursing staff.
  • Implementing stricter disciplinary actions for nurses who commit medication errors.

When calculating medication dosages, which strategy BEST minimizes errors, especially when dealing with complex calculations?

  • Asking another nurse to check the calculated dosage before administration. (correct)
  • Using a standard calculator without double-checking the input values.
  • Rounding the final answer to the nearest whole number.
  • Relying on memory and previous experience to perform the calculations quickly

A hospital is implementing new technology to reduce medication errors. Which option represents the MOST effective integration of technology with nursing practice?

<p>Using barcode technology to verify medication identity at the bedside along with continued education. (C)</p> Signup and view all the answers

A registered nurse (RN) and a practical nurse (PN) are working together. Which action is MOST critical for ensuring that both nurses are practicing within their legal scope?

<p>Both nurses understand and adhere to their state's guidelines and institutional policies regarding medication administration. (A)</p> Signup and view all the answers

A new medication reconciliation process is being implemented. Which scenario exemplifies the PRIMARY goal of this process?

<p>To minimize medication errors that occur during transitions of care. (C)</p> Signup and view all the answers

High-alert medications require special safeguards due to their potential for harm. Which strategy is MOST effective for reducing risks associated with these medications?

<p>Using independent double checks during the preparation and administration of high-alert medications. (A)</p> Signup and view all the answers

A nurse is teaching a patient about a new medication. Which approach BEST empowers the patient to actively participate in their medication safety?

<p>Encouraging the patient to ask questions and discuss any concerns they may have. (B)</p> Signup and view all the answers

A client vomits shortly after receiving an oral medication. Which factor is LEAST important when determining whether to repeat the dose?

<p>The client's preference on whether to repeat the dose or not. (A)</p> Signup and view all the answers

Why might a pregnant client require a lower dose of an oral medication?

<p>Decreased GI motility. (B)</p> Signup and view all the answers

A client vomits after receiving oral medication, and the nurse collaborates with the provider to determine if redosing is needed. Which of the following is the MOST important reason for this collaboration?

<p>To determine the correct redose amount based on several client-specific factors. (C)</p> Signup and view all the answers

A nurse is preparing to administer an oral medication. Which factor would most likely lead to the slowest rate of absorption?

<p>Administration of an enteric-coated tablet (A)</p> Signup and view all the answers

Following oral administration, how are medications distributed throughout the body?

<p>Via the circulatory system after absorption (B)</p> Signup and view all the answers

Why do highly vascular areas receive the greatest amount of medication after distribution?

<p>These areas receive the greatest blood supply. (C)</p> Signup and view all the answers

A medication's absorption rate can be affected by its chemical properties. Which characteristic of a medication would likely result in the fastest absorption?

<p>High lipid solubility and non-ionized form. (C)</p> Signup and view all the answers

A patient with decreased GI motility is prescribed an oral medication. How does this condition potentially affect the absorption of the drug?

<p>Decreased absorption due to reduced contact time with the intestinal wall. (D)</p> Signup and view all the answers

When administering medications to a pregnant woman, what should a healthcare provider consider regarding the fetal-placental barrier?

<p>Lipid-soluble medications cross this barrier more readily. (C)</p> Signup and view all the answers

When administering a medication intravenously, what aspect of pharmacokinetics is most directly affected?

<p>Absorption (D)</p> Signup and view all the answers

Why is it important for healthcare providers to evaluate a client's renal and hepatic function before prescribing medications?

<p>Clients with kidney and liver disease may have slower medication clearance. (A)</p> Signup and view all the answers

A nurse is teaching a client about a new transdermal patch. What information is most important to include regarding absorption?

<p>Rotate patch application sites to enhance absorption and prevent skin irritation. (A)</p> Signup and view all the answers

Which of the following is an example of a medication being transformed into a more active form through metabolism?

<p>Codeine being transformed into morphine. (D)</p> Signup and view all the answers

The rate at which a medication is absorbed is significantly influenced by the route of administration. Rank the following routes from fastest to slowest absorption:

<p>Intravenous, Intramuscular, Subcutaneous (D)</p> Signup and view all the answers

A medication is administered via a sublingual route to bypass which effect?

<p>First-pass effect. (D)</p> Signup and view all the answers

What is the primary implication of the first-pass effect on oral medications?

<p>Decreased medication bioavailability. (B)</p> Signup and view all the answers

A client is prescribed a medication that is best absorbed in an acidic environment. Which of the following instructions should the nurse provide to maximize absorption?

<p>Take the medication on an empty stomach. (C)</p> Signup and view all the answers

How do CYP enzymes on lever cells affect medication metabolism?

<p>By regulating the rate at which a medication is broken down (A)</p> Signup and view all the answers

How does increased blood flow to an injection site affect the absorption of a medication administered via intramuscular injection?

<p>Increased absorption due to more rapid removal of the drug into circulation. (C)</p> Signup and view all the answers

A patient is prescribed both an antacid and an enteric-coated medication. What is the most important consideration for the nurse regarding the timing of administration?

<p>Avoid administering the antacid within 1-2 hours of the enteric-coated medication. (B)</p> Signup and view all the answers

How might liver function in older adults affect medication administration safety?

<p>May lead to prolonged effects of medications. (D)</p> Signup and view all the answers

How do nutrients influence medication metabolism via the cytochrome P-450 (CYP) system?

<p>By either allowing or preventing enzymes of the CYP system to function normally. (A)</p> Signup and view all the answers

A nurse is caring for a client with significant edema. How might this condition affect the absorption of a medication administered subcutaneously?

<p>Decreased absorption due to impaired circulation. (C)</p> Signup and view all the answers

What is the role of the kidneys in medication excretion?

<p>To filter medications from the blood for elimination in the urine. (B)</p> Signup and view all the answers

Which of the following factors would MOST likely affect the absorption of a topical medication?

<p>Integrity of the skin (B)</p> Signup and view all the answers

Which of the following organs plays the LEAST significant role in medication excretion?

<p>Spleen (C)</p> Signup and view all the answers

A nurse is administering a medication to an older adult client. What age-related physiological change can affect medication absorption?

<p>Decreased gastric acid production (C)</p> Signup and view all the answers

A nurse is administering medication to two patients. Both medications are the same, same dose, and same administration route. Patient A has a large surface area of the absorptive site while patient B does not. How will that effect the absorption of the medication in patient A?

<p>Medication absoprtion will occur more rapidly. (C)</p> Signup and view all the answers

A client is prescribed a medication in both an orally disintegrating tablet (ODT) and a standard tablet form. What advantage does the ODT form offer in terms of absorption?

<p>ODTs dissolve rapidly in the mouth, leading to faster absorption. (A)</p> Signup and view all the answers

Which of the following is the most important reason why it is essential for nurses to understand pharmacokinetics?

<p>To enhance safe clinical practice and minimize medication errors. (C)</p> Signup and view all the answers

A client with a history of liver disease is prescribed a medication primarily metabolized by the liver. What adjustments, if any, might be necessary and why?

<p>Lower the dose to prevent potential toxicity due to impaired metabolism. (B)</p> Signup and view all the answers

Why is Therapeutic Drug Monitoring (TDM) particularly important for medications with a narrow therapeutic window?

<p>To maintain medication levels within a safe and effective range, avoiding toxicity or subtherapeutic effects. (A)</p> Signup and view all the answers

A medication has a half-life of 8 hours. How long will it approximately take for the medication concentration in the body to be reduced to 25% of its initial dose?

<p>16 hours (A)</p> Signup and view all the answers

When administering a medication, what does the 'onset of action' refer to?

<p>The time it takes for the medication to produce a noticeable therapeutic effect after administration. (A)</p> Signup and view all the answers

A medication that acts as an agonist does which of the following?

<p>Activates a receptor site to initiate a specific biological response. (D)</p> Signup and view all the answers

What is the primary purpose of a 'black box warning' on a medication label?

<p>To identify medications that have a high risk of causing serious or life-threatening adverse effects. (C)</p> Signup and view all the answers

Which of the following physiological factors has the most significant impact on medication excretion?

<p>Kidney function (D)</p> Signup and view all the answers

Why are older adult clients at a higher risk for medication toxicity?

<p>Decreased kidney function and reduced liver metabolism. (A)</p> Signup and view all the answers

What does 'pharmacodynamics' primarily study?

<p>How drugs affect the body, including their mechanisms of action and therapeutic effects. (D)</p> Signup and view all the answers

When should a trough blood level be measured for therapeutic drug monitoring?

<p>Just before administering the next scheduled dose. (B)</p> Signup and view all the answers

A client has been taking a medication that has a known adverse effect of causing photosensitivity. What is the most important instruction the nurse should provide to this client?

<p>Avoid direct sunlight and use sunscreen. (B)</p> Signup and view all the answers

If a medication has a longer half-life, how does this affect the frequency of dosing?

<p>It can be administered less frequently because it takes longer to be eliminated from the body. (D)</p> Signup and view all the answers

A nurse is preparing to administer a medication to a client. What is the most critical step to ensure safe medication administration?

<p>Checking the client's MAR (Medication Administration Record) for allergies, contraindications and potential drug interactions prior to administration. (A)</p> Signup and view all the answers

What is the significance of a medication's 'peak' effect?

<p>It’s when the medication reaches its highest concentration in the bloodstream and the maximum therapeutic effect is achieved. (C)</p> Signup and view all the answers

What is an adverse drug reaction (ADR)?

<p>An unintended and nontherapeutic effect of a medication. (A)</p> Signup and view all the answers

Why is obtaining a current weight crucial before initiating medication for any client?

<p>Because medication dosages are often prescribed according to weight in kilograms. (B)</p> Signup and view all the answers

What physiological factor in infants and premature neonates increases their risk of medication toxicity?

<p>Lack of fully developed metabolizing enzymes. (D)</p> Signup and view all the answers

How might decreased muscle mass and increased body fat in older adults affect medication efficacy?

<p>Medications being stored in fatty tissue, leading to decreased plasma levels and reduced efficacy. (D)</p> Signup and view all the answers

Why is it important for nurses to inquire about the use of herbal compounds when taking a medication history?

<p>Some clients may prefer herbs, and to understand potential interactions and impacts on medication effectiveness. (D)</p> Signup and view all the answers

A client with Liddle phenotype and hypertension is prescribed a common medication, but it proves ineffective. What additional medication might be necessary?

<p>Diuretics (A)</p> Signup and view all the answers

A patient develops respiratory distress, fever, chills, and a diffuse rash followed by blisters after starting a new medication. Which potentially fatal reaction is the MOST likely cause?

<p>Steven-Johnson syndrome (SJS) (A)</p> Signup and view all the answers

A pregnant client at 8 weeks gestation asks the nurse about taking an over-the-counter cold medicine for her symptoms. What is the most appropriate response?

<p>Advise consulting with the provider about the risks and benefits of specific medications. (D)</p> Signup and view all the answers

What IMMEDIATE action should a nurse take when a client exhibits signs of an allergic reaction to a medication?

<p>Discontinue the medication (D)</p> Signup and view all the answers

How does a pediatric client's rate of metabolism typically compare to that of an adult?

<p>Higher rate of metabolism (D)</p> Signup and view all the answers

Which of the following BEST describes how a drug-food interaction can lead to medication toxicity?

<p>Food alters the metabolism or excretion of the drug, increasing its concentration in the body. (A)</p> Signup and view all the answers

What is a primary consideration when calculating medication dosages for pediatric clients?

<p>Weight dosing in kilograms for all medications. (C)</p> Signup and view all the answers

A client taking iron supplements is also prescribed an antacid containing magnesium. What instruction should the nurse provide regarding administration?

<p>Take the iron supplement with orange juice or foods containing vitamin C. (A)</p> Signup and view all the answers

An error occurs when a hospitalized pediatric client's weight is recorded in pounds instead of kilograms. What is the most likely consequence?

<p>An incorrect amount of medication prescribed. (D)</p> Signup and view all the answers

What is polypharmacy, and why is it a concern in older adults?

<p>The use of five or more medications by a nonhospitalized client; increases risk of ADEs and medication interactions (B)</p> Signup and view all the answers

A nurse is reviewing a client's medication list and notices a potential drug-drug interaction. What is the nurse's MOST appropriate action?

<p>Consult a drug reference resource to gather more information. (C)</p> Signup and view all the answers

What is the significance of the new medication label including information about the risk of untreated disease during pregnancy?

<p>It promotes discussion between health care providers and clients about the potential medication use risks and benefits during pregnancy. (B)</p> Signup and view all the answers

Which factor is MOST important for the nurse to assess when determining a client's potential for adverse medication reactions?

<p>The client's allergies. (B)</p> Signup and view all the answers

Which of the following substances are known to cross the fetal-placental barrier and potentially harm the fetus or newborn?

<p>Codeine, morphine, some herbal supplements, and alcohol (A)</p> Signup and view all the answers

Why is a cautious approach to medication administration particularly important for pregnant and nursing clients?

<p>Medications can be transferred to the fetus or infant and cause harm. (D)</p> Signup and view all the answers

What is the PRIMARY reason for the FDA's changes to medication labeling regarding pregnancy and lactation risks?

<p>To provide more comprehensive information about medication use during pregnancy and breastfeeding. (A)</p> Signup and view all the answers

What should a nurse do when administering medications to a pregnant client, considering the potential impact on the fetus?

<p>Always check medication information, as some medications may cross the fetal–placental barriers. (C)</p> Signup and view all the answers

What is the best way to ensure medication effectiveness takes into account the client's cultural and genetic factors?

<p>Educate clients about the genetic components influencing medication response and by determining cultural food practices that might impact medication effectiveness. (A)</p> Signup and view all the answers

A nurse is teaching a client about a medication that should be taken on an empty stomach. Which instruction is MOST accurate?

<p>Take the medication at least 1 hour before or 2 hours after a meal. (C)</p> Signup and view all the answers

What is an important consideration regarding renal excretion when dosing medications for pediatric clients, especially infants?

<p>Full renal function is not achieved until 1 year of age, impacting medication dosing. (A)</p> Signup and view all the answers

Which of the following is an example of a medication classified as teratogenic?

<p>Gentamicin (B)</p> Signup and view all the answers

A client reports taking an herbal supplement along with their prescribed medications. Why is it important for the nurse to assess this?

<p>Herbal supplements can interact with medications, altering their effects. (D)</p> Signup and view all the answers

A medication package has a black box warning related to cardiovascular risks. What does this signify?

<p>The medication carries a significant risk of serious or life-threatening adverse effects. (A)</p> Signup and view all the answers

A client develops hives after receiving a new medication. Which type of medication reaction is this MOST likely to be?

<p>Allergic reaction (C)</p> Signup and view all the answers

Which client factor has the GREATEST potential to influence the action of a medication?

<p>The client's prescribed medications (A)</p> Signup and view all the answers

A client on multiple medications reports feeling very tired. What is the BEST initial nursing action related to potential medication effects?

<p>Consult a drug reference resource to check for potential adverse effects and interactions (B)</p> Signup and view all the answers

A nurse is preparing to administer an intramuscular injection to an obese adult. Considering the factors influencing needle selection, which needle length would be MOST appropriate?

<p>1.5 inches (C)</p> Signup and view all the answers

What is the MOST significant implication of using a higher-gauge needle when administering a viscous medication?

<p>Difficulty in drawing up and injecting the medication. (C)</p> Signup and view all the answers

A nurse needs to administer a subcutaneous injection. Which needle length is generally MOST appropriate for this type of injection?

<p>3/8 to 5/8 inches (C)</p> Signup and view all the answers

When selecting a needle for an intramuscular injection, what is the PRIMARY reason for considering the client's body size?

<p>To ensure the medication reaches the muscle tissue. (C)</p> Signup and view all the answers

A nurse is preparing to administer an injection and notes that the medication is particularly thick. What adjustment to needle selection would be MOST appropriate?

<p>Use a lower-gauge needle. (B)</p> Signup and view all the answers

A client refuses to take their prescribed oral medication. What is the MOST appropriate initial nursing action?

<p>Investigate the reasons for the refusal and address any fears or misconceptions. (C)</p> Signup and view all the answers

During medication administration, at which point should the nurse perform the third check of the medication label against the MAR?

<p>At the client’s bedside immediately prior to administration. (B)</p> Signup and view all the answers

A nurse is about to administer a medication, but realizes they are unsure about the prescribed dose. What is the MOST appropriate action?

<p>Withhold the medication and verify the order with the prescribing provider or pharmacist. (D)</p> Signup and view all the answers

What is the PRIMARY purpose of documenting the effectiveness of a PRN pain medication in the client's medical record?

<p>To evaluate whether the medication achieved the desired therapeutic effect and inform future treatment decisions. (A)</p> Signup and view all the answers

Which element is MOST essential to include in a medication prescription to ensure clarity and prevent errors?

<p>The indication for use of the medication. (B)</p> Signup and view all the answers

A nurse is teaching a client about a newly prescribed medication for long-term use. Which instruction is MOST important to include?

<p>How to refill the medication and maintain an adequate supply. (C)</p> Signup and view all the answers

A client with a history of heart failure is prescribed digoxin. Prior to administering the medication, what specific assessment should the nurse prioritize?

<p>Assessing the client’s apical pulse. (B)</p> Signup and view all the answers

A nurse notes that a medication order is missing the route of administration. What is the nurse's BEST course of action?

<p>Contact the prescribing provider to clarify the missing information. (B)</p> Signup and view all the answers

A client reports experiencing a new side effect after starting a medication. What is the nurse's MOST important next step?

<p>Assess the side effect, notify the provider, and document the findings. (D)</p> Signup and view all the answers

What is the MOST effective way for a nurse to ensure a client understands the purpose of a newly prescribed medication?

<p>Ask the client what they already know about the medication and correct any misinformation. (D)</p> Signup and view all the answers

Which action is MOST important for a nurse to take to prevent medication errors related to the 'right client' during medication administration?

<p>Checking the client's identification bracelet using two approved identifiers and comparing them to the MAR. (A)</p> Signup and view all the answers

A healthcare organization implements Computerized Provider Order Entry (CPOE). How does this system PRIMARILY contribute to medication safety?

<p>It reduces transcription errors and facilitates accurate order entry. (C)</p> Signup and view all the answers

A nurse is preparing to administer a medication. What should the nurse do to ensure they are following the 'right route' of medication administration?

<p>Verify the route of medication administration as prescribed by the provider in the client’s medical record. (D)</p> Signup and view all the answers

A client refuses to take their oral medication. What is the MOST appropriate initial nursing action?

<p>Educate the client about the medication's purpose, benefits, and potential side effects and then document the refusal. (A)</p> Signup and view all the answers

A nurse is preparing to administer a medication from a multi-dose vial. After withdrawing the prescribed dose, what action is essential to promote medication safety?

<p>Labeling the syringe with the medication name and dose. (D)</p> Signup and view all the answers

After administering a medication, a nurse realizes that they gave the medication at the wrong time (one hour early). What is the nurse's priority action?

<p>Notify the charge nurse and assess the client for any adverse effects. (B)</p> Signup and view all the answers

Which of the following actions BEST demonstrates the 'right evaluation' component of medication administration?

<p>Monitoring the client for therapeutic effects and adverse reactions after medication administration. (D)</p> Signup and view all the answers

A nurse is preparing to administer a medication and notes that the dosage is higher than the usual recommended dose. What is the BEST course of action?

<p>Consult with the prescribing provider to clarify the medication order before administering the medication. (C)</p> Signup and view all the answers

A nurse is responsible for ensuring informed content. They should confirm that the client understands:

<p>The indications, adverse effects, and expected benefits of the treatment. (A)</p> Signup and view all the answers

A nurse is preparing medications for several clients. To minimize distractions and prevent errors, what should the nurse do?

<p>Prepare medications in a quiet, designated area. (B)</p> Signup and view all the answers

To ensure the 'right time' when administering medications, the nurse should:

<p>Confirm the prescribed administration schedule and adhere to it, considering the last time the medication was administered. (D)</p> Signup and view all the answers

Which of the following is the MOST appropriate way for a healthcare facility to ensure client rights regarding medication safety?

<p>Implementing processes to prevent harm and ensure quality care related to medication administration. (A)</p> Signup and view all the answers

A nurse is preparing medications for multiple clients. What is the BEST way to prevent medication errors related to distractions?

<p>Using a designated, quiet area for medication preparation and minimizing interruptions. (B)</p> Signup and view all the answers

What is the MOST significant reason for healthcare providers to write out the generic name and indication for a medication when prescribing?

<p>To reduce confusion caused by similar brand names and pronunciations. (B)</p> Signup and view all the answers

A nurse is educating a client about a new medication. Which statement BEST reflects the 'right education' component of medication administration?

<p>&quot;This medication is called [name]. It is expected to [benefit], but it may cause [potential adverse effects].&quot; (B)</p> Signup and view all the answers

A client has a documented allergy to penicillin. Before administering a different antibiotic, what is the MOST important action for the nurse to take related to the 'right assessment'?

<p>Checking the client's allergy history and potential for cross-reactivity. (A)</p> Signup and view all the answers

A nurse accidentally administers the wrong dose of a medication to a client. What is the FIRST action the nurse should take?

<p>Notify the prescribing provider and assess the client for adverse effects. (B)</p> Signup and view all the answers

Which of the following actions demonstrates the 'right documentation' component of medication administration?

<p>Documenting the medication name, dose, route, time, and any client response after administration. (B)</p> Signup and view all the answers

An elderly client is prescribed multiple medications and is having difficulty managing their medication schedule at home. What should the nurse consider?

<p>Collaborating with the client, family, and healthcare team to simplify the medication regimen or explore assistive devices. (C)</p> Signup and view all the answers

A nurse is caring for an elderly client who is taking multiple medications. Which of the following nursing actions promotes safe medication administration considering age-related physiological changes?

<p>Regularly review the client's medication list for potential drug-drug interactions, monitor for toxicity, and collaborate to assess medication appropriateness. (B)</p> Signup and view all the answers

A patient experiencing nausea and vomiting requires an antiemetic medication. Which route of administration would be MOST appropriate?

<p>Intravenous (IV) (C)</p> Signup and view all the answers

Which of the following routes of administration is LEAST likely to be affected by the first-pass effect?

<p>Subcutaneous (D)</p> Signup and view all the answers

A medication is prescribed to be administered via inhalation. What is the primary advantage of this route?

<p>It allows for highly accurate dosage control based on patient response. (C)</p> Signup and view all the answers

A patient requires a medication that is most effective when delivered directly to the lungs. Which route of administration is BEST?

<p>Inhalation (C)</p> Signup and view all the answers

A client has difficulty swallowing pills. Which medication route would be MOST appropriate for medication administration?

<p>Intramuscular injection (B)</p> Signup and view all the answers

A medication needs to be absorbed quickly and is known to cause gastric irritation. Which route would be MOST suitable?

<p>Intravenous injection (D)</p> Signup and view all the answers

What is a key advantage of administering a medication via the sublingual route compared to the oral route?

<p>Sublingual medications are less affected by the first-pass effect. (C)</p> Signup and view all the answers

When administering medications via the buccal route, what instruction is MOST important to provide the client?

<p>Avoid eating or drinking until the medication is fully absorbed. (A)</p> Signup and view all the answers

A client requires a medication that needs to be released slowly over 24 hours. Which route is MOST appropriate.

<p>Transdermal patch (A)</p> Signup and view all the answers

A nurse is preparing to administer an otic medication to an adult. What is the correct technique for positioning the ear?

<p>Pull the ear lobe up and back. (C)</p> Signup and view all the answers

Which of the following is a disadvantage of administering medication via the rectal route?

<p>Absorption rates can be inconsistent. (D)</p> Signup and view all the answers

A client with a known allergy to local anesthetics requires an intramuscular injection. What is the priority nursing action?

<p>Contact the prescriber to discuss an alternative medication or route. (A)</p> Signup and view all the answers

Which route of administration allows for the MOST precise and immediate control over the medication's serum concentration?

<p>Intravenous (B)</p> Signup and view all the answers

What is the maximum volume typically recommended for a single subcutaneous injection?

<p>1.5 mL (C)</p> Signup and view all the answers

Considering the potential for systemic effects, what is an important consideration when administering ophthalmic medications, particularly beta-blockers?

<p>Monitoring for bradycardia (C)</p> Signup and view all the answers

A nurse finds a medication order hasn't been reviewed by the pharmacist in an automated dispensing system (AMDS). What is the MOST appropriate action?

<p>Contact the pharmacist to review the order before obtaining the medication. (B)</p> Signup and view all the answers

What is the primary reason a nurse should avoid leaving medications at a client's bedside for self-administration?

<p>It doesn't adhere to the rights of medication administration and may lead to errors. (C)</p> Signup and view all the answers

Which scenario represents the MOST appropriate instance for a nurse to override an automated medication dispensing system (AMDS)?

<p>In a documented emergency situation where delaying medication administration could harm the client. (B)</p> Signup and view all the answers

A nurse is consistently interrupted while preparing medications. Which intervention is MOST effective in reducing medication errors related to interruptions?

<p>Requesting that the medication preparation area be designated as a distraction-free zone. (C)</p> Signup and view all the answers

Which strategy would be MOST effective in preventing errors associated with high-alert medications like intravenous heparin?

<p>Performing independent double checks with another qualified nurse. (C)</p> Signup and view all the answers

A new nurse is assigned to work on a busy medical surgical unit. What is not a key responsibility of the nurse regarding medication administration?

<p>Diagnosing a client based on their response to the intervention. (A)</p> Signup and view all the answers

A client's medication wristband is missing, and the nurse is tempted to override the barcode scanning system. What is the nurse's BEST course of action?

<p>Follow facility policy to obtain a new client identification band before administering the medication. (B)</p> Signup and view all the answers

A nurse is administering insulin and performs an independent double check with another nurse. Which action is MOST important during this process?

<p>Confirming the medication order, dose, route, and time with each other, separately. (A)</p> Signup and view all the answers

What is the primary purpose of utilizing barcode scanning during medication administration?

<p>To verify the right client, medication, dose, route, and time at the point of care. (D)</p> Signup and view all the answers

A nurse receives frequent alerts and warnings from the automated dispensing cabinet system. What approach will BEST prevent errors related to alert fatigue?

<p>Evaluating each alert critically and resolving the underlying issue before proceeding. (C)</p> Signup and view all the answers

Which of the following strategies is LEAST likely to reduce medication errors?

<p>Relying on memory to recall medication dosages and routes. (C)</p> Signup and view all the answers

When administering medications, what does the 'right documentation' primarily ensure?

<p>Other healthcare providers are informed about what medications the client has received. (A)</p> Signup and view all the answers

Which statement accurately describes the benefit of Automated Medication Dispensing Systems (AMDS) in reducing medication errors?

<p>AMDS contribute to a significant reduction in dispensing errors and support medication record-keeping. (A)</p> Signup and view all the answers

Which statement BEST describes 'workarounds' in the context of medication administration?

<p>Practices that avoid established policies or procedures, potentially undermining safety. (C)</p> Signup and view all the answers

Nurses are responsible for all steps within the medication administration process, including observations, education and documentation. Leaving medications for the client at bedside could MOST likely result in what implication?

<p>Medication error or a serious ADE. (A)</p> Signup and view all the answers

Why should a nurse hold the medication label in the palm of their hand when pouring liquid medication from a multidose container?

<p>To prevent the liquid medication from obscuring the label. (A)</p> Signup and view all the answers

What is the primary reason for remaining with a client until oral medications are swallowed?

<p>To ensure compliance and observe for any immediate adverse effects. (C)</p> Signup and view all the answers

A client is prescribed a buccal medication. What instruction should the nurse provide regarding its administration?

<p>Place the medication between the cheek and gum line and allow it to dissolve. (B)</p> Signup and view all the answers

What is the primary indication for the placement of an enteral feeding tube (EFT)?

<p>To provide nutrition or medication to clients unable to take them orally. (A)</p> Signup and view all the answers

A nurse is preparing to administer medication through an enteral feeding tube. What is the MOST important preventive measure to avoid clogging?

<p>Flushing the tube before, between, and after medication administration. (C)</p> Signup and view all the answers

Which medication forms should NOT be crushed when administering medications through an enteral feeding tube?

<p>Enteric-coated tablets (A)</p> Signup and view all the answers

What is the MOST important reason to avoid mixing medications with enteral feeding formulas?

<p>To prevent potential delays in medication absorption or drug-formula interactions. (D)</p> Signup and view all the answers

To prevent tubing misconnections when administering medications via enteral tubes, what should nurses do in addition to using the correct enteral connector?

<p>Trace the tubing from the client to its origin before making any connections. (A)</p> Signup and view all the answers

What is a primary purpose of topical medications?

<p>To achieve local effects on a specific body part or systemic absorption. (A)</p> Signup and view all the answers

Compared to other routes of administration, what is a distinct advantage of transdermal medications?

<p>Prolonged medication release over several days (C)</p> Signup and view all the answers

Why is it crucial for a nurse to maintain strict aseptic technique when administering ophthalmic medications?

<p>To prevent contamination and subsequent eye infections. (B)</p> Signup and view all the answers

Why should a nurse rotate application sites when applying transdermal patches?

<p>To prevent skin irritation and promote skin integrity. (C)</p> Signup and view all the answers

A nurse is preparing to administer an ophthalmic solution. Where should the nurse instill the medication?

<p>Into the lower conjunctival sac. (D)</p> Signup and view all the answers

A nurse is preparing to administer eye drops to a client. What action should the nurse take to minimize systemic absorption of the medication?

<p>Apply gentle pressure to the inner canthus after instillation. (A)</p> Signup and view all the answers

A nurse is preparing to administer an oral medication via a syringe. After drawing the medication, what is the MOST important next step?

<p>Tapping the syringe to remove air bubbles. (A)</p> Signup and view all the answers

A nurse is preparing to administer a liquid medication using a metered measuring cup. What technique will ensure the MOST accurate measurement?

<p>Placing the cup at eye level on a flat surface. (C)</p> Signup and view all the answers

Prior to administering a transdermal patch to a client, what is the MOST important action for the nurse to perform related to the previous patch?

<p>Remove the old patch. (D)</p> Signup and view all the answers

Why is it important to administer otic medications at room temperature?

<p>To prevent dizziness and pain in the client. (D)</p> Signup and view all the answers

Nonsterile gloves are recommended during the administration of transdermal patches. What is the primary reason for this precaution?

<p>To protect the nurse from absorbing the medication. (B)</p> Signup and view all the answers

A health care provider orders 1.5 mg of a medication. The pharmacy only stocks 3-mg tablets that are scored. What action should the nurse take?

<p>Contact the pharmacy for an alternative medication form or dose. (A)</p> Signup and view all the answers

Prior to administering eardrops to an adult, how should the nurse position the pinna to straighten the ear canal?

<p>Pull the pinna up and back. (D)</p> Signup and view all the answers

A patient is prescribed a medication through an enteral feeding tube. The nurse consults with the pharmacist to ensure the medication can be crushed. What could happen if the medication is crushed when it shouldn't have been?

<p>Adverse effects (D)</p> Signup and view all the answers

A client has been using a nasal decongestant spray multiple times a day for several weeks. What potential adverse effect should the nurse educate the client about?

<p>Rebound congestion. (B)</p> Signup and view all the answers

A nurse attempts to split a non-scored pill using a pill cutter, but the tablet crumbles. What is the nurse's BEST course of action?

<p>Request the medication in liquid form from the pharmacy. (D)</p> Signup and view all the answers

A client has difficulty swallowing tablets. Which medication form would be MOST appropriate for this client, assuming the medication is available in multiple forms?

<p>Liquid (B)</p> Signup and view all the answers

A nurse is teaching a client about administering nasal spray. What instruction is most important for ensuring proper absorption of the medication?

<p>Ensure the nostrils are clear of mucus before administration. (D)</p> Signup and view all the answers

A client is prescribed an enteric-coated tablet. The client reports difficulty swallowing large pills. What instruction should the nurse provide?

<p>Ask the provider or pharmacist for an alternative form if available. (B)</p> Signup and view all the answers

A nurse is preparing to administer an intravaginal cream. What intervention is essential to ensure the safety of the nurse?

<p>Administer the medication using clean gloves. (D)</p> Signup and view all the answers

What is the PRIMARY reason capsules generally act more quickly than tablets within the body?

<p>Capsules have a higher bioavailability than tablets. (D)</p> Signup and view all the answers

A client is being discharged with several new medications. Which action by the nurse BEST supports medication reconciliation and client safety at home?

<p>Providing a detailed list of medications, including names, dosages, frequency, purpose, and potential side effects, in written form. (A)</p> Signup and view all the answers

What is a primary advantage of administering medications via the rectal route?

<p>It is suitable for clients who are nauseous or have difficulty swallowing. (D)</p> Signup and view all the answers

A nurse is preparing to administer a medication to a client when a physician requests assistance with an emergency in another room. What is the MOST appropriate action to ensure medication safety?

<p>Securing the prepared medication and completing the administration after assisting the physician, ensuring no steps are skipped. (D)</p> Signup and view all the answers

A client prefers to take medications mixed with food. Which medication formulation is LEAST suitable to be mixed with food?

<p>Enteric-coated tablet (A)</p> Signup and view all the answers

A nurse has just administered a rectal suppository. What instruction should the nurse provide to the client?

<p>Refrain from passing stool for a minimum of 20 minutes. (A)</p> Signup and view all the answers

A nurse is preparing to administer an oral medication to a client with dysphagia. Which action is MOST important?

<p>Assessing the client's ability to swallow before administration. (B)</p> Signup and view all the answers

Which factor is most important to consider when administering medications via inhalation?

<p>The particle size of the medication. (D)</p> Signup and view all the answers

During medication reconciliation, a client reports taking an OTC medication not listed in their health record. What action should the nurse take FIRST?

<p>Document the OTC medication in the client's medication list, including dosage, frequency, and purpose. (A)</p> Signup and view all the answers

A client is having difficulty coordinating the activation of their metered-dose inhaler (MDI) with their breathing. What intervention might a nurse recommend?

<p>Use a spacer with the MDI. (D)</p> Signup and view all the answers

Which position is BEST for a client receiving oral medications to prevent aspiration?

<p>Semi-Fowler’s. (B)</p> Signup and view all the answers

A nurse notes that a medication prescription is missing the client's weight, which is needed to calculate the correct dose. Which action is MOST appropriate?

<p>Contacting the prescribing provider to obtain the missing information before administering the medication. (B)</p> Signup and view all the answers

A nurse is preparing to administer a high-alert medication. What strategy BEST aligns with established safety protocols?

<p>Asking a colleague to double-check the prepared dosage against the prescription before administration. (A)</p> Signup and view all the answers

A client reports that their oral medication has an unpleasant taste. What action should the nurse take FIRST?

<p>Consult with the pharmacist about adding a flavoring if appropriate. (C)</p> Signup and view all the answers

What is the primary role of a spacer when administering medication via a metered-dose inhaler (MDI)?

<p>To improve medication delivery into the lungs. (A)</p> Signup and view all the answers

Which of the following lists the oral medication forms from the FASTEST to SLOWEST rate of absorption?

<p>Liquid, suspension, powder, capsule, tablet, enteric-coated tablet (B)</p> Signup and view all the answers

A nurse is caring for a client who refuses to take a prescribed medication, stating they had a bad reaction to it in the past, even though it's not documented in their allergy history. What is the nurse's MOST appropriate response?

<p>Documenting the client's refusal and informing the provider of the reported adverse reaction. (A)</p> Signup and view all the answers

A nurse is preparing to administer a rectal suppository to a client who is thrombocytopenic. Which action should the nurse take?

<p>Contact the provider to question the order for the suppository. (C)</p> Signup and view all the answers

A nurse discovers they administered the wrong dose of medication to a patient. After assessing the patient, what is the nurse's immediate next step?

<p>Notify the health care provider to determine appropriate interventions. (D)</p> Signup and view all the answers

A nurse is preparing to administer an oral medication via an enteral feeding tube. What is an essential consideration to prevent tube occlusion?

<p>Ensuring the medication is compatible with the feeding formula. (C)</p> Signup and view all the answers

Why should the client close their eye after the nurse administeres the eye drop?

<p>Helps distribute the medication evenly across the eye. (D)</p> Signup and view all the answers

Which scenario BEST demonstrates effective use of the 'Rights of Medication Administration' to prevent errors?

<p>A nurse checks the medication label against the MAR three times before administering the medication. (B)</p> Signup and view all the answers

A nurse is teaching a client about a new medication that should be taken on an empty stomach. Which statement indicates that the client understands the instructions?

<p>&quot;I should take this medication 30 minutes before or 2 hours after eating.&quot; (A)</p> Signup and view all the answers

A client is transferring from the ICU to a medical-surgical unit. What aspect of medication reconciliation is MOST important during this transition?

<p>Comparing the client's pre-ICU medications with the medications administered in the ICU and newly prescribed medications for the medical-surgical unit. (C)</p> Signup and view all the answers

A nurse is preparing to administer ear drops to a 4 year old child. How should the nurse position the pinna of the ear to straighten the ear canal for this age group?

<p>Pull the pinna down and back. (B)</p> Signup and view all the answers

When completing an incident report after a medication error, which of the following is MOST important for the nurse to include?

<p>Actions taken after the error was discovered and the patient's response. (A)</p> Signup and view all the answers

Which action represents a failure to follow medication administration rights, potentially leading to a medication error?

<p>Administering a medication without checking for potential interactions with other medications. (D)</p> Signup and view all the answers

A client is prescribed a medication that has variable absorption rates depending on food intake. What is the nurse's MOST important intervention?

<p>Teach the client to consistently take the medication in relation to meals. (D)</p> Signup and view all the answers

A nurse is preparing to administer a medication. Which of the following actions reflects appropriate technique in verifying client identity?

<p>Scanning the client's wristband and asking the client to state their name and date of birth. (C)</p> Signup and view all the answers

A healthcare facility uses multi-dose vials for some medications. Which of these practices is MOST important to ensure patient safety when using multi-dose vials?

<p>Labeling multi-dose medications in syringes, cups, or basins when prepared. (D)</p> Signup and view all the answers

A nurse is preparing medications in a noisy and busy medication room. What strategy would BEST minimize the risk of error?

<p>Taking a short break to find a quieter environment to focus on medication preparation. (B)</p> Signup and view all the answers

A nurse receives a verbal order for a medication from a healthcare provider during a busy shift. Which action is MOST appropriate?

<p>Request the healthcare provider to enter the order electronically or provide a written order. (C)</p> Signup and view all the answers

A new graduate nurse is unsure about a medication prescription. What is the MOST appropriate action?

<p>Consulting with a more experienced nurse or the pharmacist to clarify any questions or concerns. (C)</p> Signup and view all the answers

A nurse is preparing to administer an IV medication. What is the MOST important step to ensure proper administration technique?

<p>Flushing the IV line with sterile saline before and after administration. (D)</p> Signup and view all the answers

In which situation is medication reconciliation MOST critical to ensure client safety?

<p>When a client is admitted to the hospital, transferred between units, and discharged home. (C)</p> Signup and view all the answers

How does the interprofessional team contribute to effective medication reconciliation?

<p>By communicating and collaborating to review medications, address discrepancies, and educate the client. (B)</p> Signup and view all the answers

A patient refuses to take an oral medication, stating they have never seen it before. What is the nurse’s BEST course of action?

<p>Educate the patient about the medication, its purpose, and potential side effects. (A)</p> Signup and view all the answers

Which of the following is the MOST reliable way to ensure the ‘right route’ of medication administration?

<p>Consulting the provider's prescription and verifying the route before administration. (A)</p> Signup and view all the answers

Which approach is MOST effective when educating a patient about a newly prescribed medication?

<p>Asking the patient to repeat back the key information about the medication and its side effects. (B)</p> Signup and view all the answers

A nurse is preparing to administer a medication and notes that the prescription reads 'Morphine 2mg IV STAT'. Which action should the nurse take first?

<p>Clarify the prescription with the prescribing health care provider, specifically the route. (B)</p> Signup and view all the answers

What is the PRIMARY goal of medication reconciliation?

<p>To prevent medication errors and ensure an accurate medication list across transitions of care. (B)</p> Signup and view all the answers

Before administering medication, the nurse checks the label against the MAR. Which of the following elements is MOST critical to verify?

<p>The medication name, dose, route, and time of administration. (C)</p> Signup and view all the answers

A nurse is preparing to administer a medication to a patient with a known allergy. What action should the nurse take immediately?

<p>Hold the medication and notify the prescribing health care provider. (C)</p> Signup and view all the answers

The nurse is preparing to administer a new medication to a patient. After reviewing the medication order, what is the MOST important question for the nurse to ask the patient?

<p>“Do you have any allergies to any medications?” (C)</p> Signup and view all the answers

Which of the following scenarios represents the highest risk for a medication error during medication administration?

<p>Administering medications during shift change. (A)</p> Signup and view all the answers

Why is it essential to avoid expressing personal opinions or placing blame in an incident report following a medication error?

<p>To ensure the report remains objective and focuses on facts. (D)</p> Signup and view all the answers

A prescriber writes an illegible order, and the nurse is having difficulty reading it. What is the nurse's BEST action?

<p>Call the prescriber to clarify the order. (C)</p> Signup and view all the answers

A nurse needs to administer a viscous medication via intramuscular injection. Which needle gauge is MOST appropriate for this task?

<p>22G (B)</p> Signup and view all the answers

What is the PRIMARY reason for using a safety needle?

<p>To prevent needlestick injuries to healthcare providers. (C)</p> Signup and view all the answers

A nurse is preparing to administer medication using a syringe with a Luer-Lok connection. What is the PRIMARY benefit of this type of connection?

<p>It provides a more secure needle attachment. (A)</p> Signup and view all the answers

When selecting a syringe for an intramuscular injection, what is the MOST important factor to consider?

<p>The amount of medication to be administered. (B)</p> Signup and view all the answers

A nurse is preparing to administer 0.75 mL of medication subcutaneously. Which syringe type would be MOST appropriate?

<p>1 mL Tuberculin syringe (B)</p> Signup and view all the answers

When administering an intradermal injection for a TB test, what is the typical gauge range of the needle used?

<p>25-27 gauge (C)</p> Signup and view all the answers

A nurse identifies that the barrel of a syringe is marked with the label 'units'. This syringe should ONLY be used for which type of medication?

<p>Insulin (D)</p> Signup and view all the answers

What part of the needle attaches to the syringe?

<p>Hub (A)</p> Signup and view all the answers

When preparing an injection, the nurse notices that the needle has a dull bevel. What is the MOST appropriate action?

<p>Use a new needle for the injection. (D)</p> Signup and view all the answers

Why is it essential to avoid touching the hub of the needle when preparing an injection?

<p>The hub must remain sterile to prevent infection. (D)</p> Signup and view all the answers

A physician orders 6 units of insulin to be administered subcutaneously. Which syringe is MOST appropriate for the nurse to use?

<p>A 1-mL insulin syringe (C)</p> Signup and view all the answers

What is the rationale for rotating injection sites when administering medications, such as insulin, subcutaneously?

<p>To prevent lipohypertrophy and skin irritation. (A)</p> Signup and view all the answers

When administering a subcutaneous injection, at what angle should the needle typically be inserted?

<p>45 degrees (D)</p> Signup and view all the answers

Which consideration is MOST important when selecting a needle length for an intramuscular injection?

<p>Client's body mass and injection site (B)</p> Signup and view all the answers

Following an intramuscular injection, a nurse notices blood return when aspirating. What is the MOST appropriate initial action?

<p>Remove the needle and apply pressure. (A)</p> Signup and view all the answers

A patient is ordered a medication at a dose higher than the typical range for their age and weight. What action is MOST appropriate for the nurse to take?

<p>Consult with the prescribing provider about the dosage and medication order. (D)</p> Signup and view all the answers

A nurse is preparing to administer a medication via a newly prescribed route that they are unfamiliar with. Which action demonstrates best practice in ensuring the right route of medication administration?

<p>Research the new route, including its administration technique and expected absorption rate. (B)</p> Signup and view all the answers

A patient is prescribed a medication to be given 'once daily'. To ensure the right timing, what is the MOST important consideration for the nurse?

<p>Administering the medication at the same time each day. (A)</p> Signup and view all the answers

A nurse receives a verbal order for a STAT medication during an emergency. Following administration, what is the nurse's MOST important next step related to documentation?

<p>Documenting the medication administration immediately on the MAR and verifying the order with the physician. (A)</p> Signup and view all the answers

A patient is scheduled to receive a time-critical medication at 0900. According to the guidelines, within what time frame should the nurse administer this medication to avoid potential harm or substandard pharmacologic effects?

<p>Between 0830 and 0930. (B)</p> Signup and view all the answers

When administering non-time-critical medications, which consideration is MOST appropriate for the nurse to consider regarding the timing of administration?

<p>Adjusting the administration time based on meal schedules, allowing a 1–2 hour window. (D)</p> Signup and view all the answers

A nurse is preparing to administer a medication. What is the BEST approach to ensure the patient receives the 'right assessment' before administration?

<p>Assessing the patient's current condition including vital signs, lab values, and medication interactions. (B)</p> Signup and view all the answers

A dose-related medication error occurs when a nurse administers the wrong amount of medication. Which of the following is the MOST common cause of this type of error?

<p>Incorrect math computation or conversion of units. (A)</p> Signup and view all the answers

A nurse is administering a medication that requires a specific dilution. What action BEST ensures the 'right dose' in this scenario?

<p>Checking the medication label, calculating the correct amount, and verifying with another nurse. (B)</p> Signup and view all the answers

A patient has difficulty swallowing oral medications. The nurse crushes the medication and mixes it with applesauce without checking if it is safe to do so. Which 'right' of medication administration is MOST compromised in this scenario?

<p>Right route. (A)</p> Signup and view all the answers

A medication reference book provides frequency of medications that should be administered (e.g., every 8 hours, once a day, or every 6 hours). On what are these frequencies based?

<p>Pharmacokinetics and pharmacodynamics. (A)</p> Signup and view all the answers

The Joint Commission has approved a short list of abbreviations that may be used for ordering medications. Besides using approved abbreviations, what else should providers do to avoid misinterpretation and medication errors?

<p>Always write out the frequency and route to avoid misinterpretation and errors. (C)</p> Signup and view all the answers

To confirm the right time, what are the key sources the nurse need to check?

<p>The provider’s prescription and the client’s MAR (medication administration record). (D)</p> Signup and view all the answers

A nurse forgot to document a medication administration. What should the nurse do?

<p>Document the medication immediately as a late entry. (D)</p> Signup and view all the answers

Which of the following regulations emphasizes the importance of facilities establishing policies and procedures for medication timing to ensure patient safety?

<p>Centers for Medicare and Medicaid Services (CMS). (C)</p> Signup and view all the answers

Flashcards

Medication Error

A preventable event causing patient harm when the medication is controlled by a healthcare professional.

Medication Reconciliation

A process of comparing a patient's current medications with newly prescribed medications.

Pharmacokinetics

The study of how the body absorbs, distributes, metabolizes, and excretes drugs.

Interprofessional Team Policies

Policies that promote safe medication practices.

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System-Related Factors

Technology for medication administration. (e.g., automated dispensing units, barcode technology)

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Rights of Medication Administration

The essential actions a nurse takes to administer medication safely.

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Scope of Practice

Differences in the scope of practice between RNs and PNs, PN scope of practice varies by state.

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Nurse's Role

Nurses are the last line of defense to protect the client from medication errors.

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GI Tract Function

GI tract must be functional for absorption of oral/enteral meds

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Redosing Factors

Time between administration and vomiting, medication in the vomitus, risks vs. benefits

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Vomiting After Meds (First Action)

Notify the provider and obtain further direction

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Distribution

Medication movement to target organs/tissues via circulatory system.

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Distribution Factors

Affected by blood flow, medication solubility, and protein-binding.

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Metabolism

Converting a medication's chemical structure.

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Metabolism Locations

Liver (primarily), kidneys, small intestines

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Cytochrome P-450 Role

Medications transformed to active/inactive substances for excretion.

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Absorption

The movement of a medication from the administration site into the circulatory system.

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Kidney/Liver Disease Impact

Slower medication clearance, higher toxicity risk.

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Metabolism Activation

Substance converted to more active or potent form (e.g., codeine to morphine).

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Route of Administration

Administration method of a medication that affects the speed and extent of absorption.

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Dissolution

The tablet must first dissolve into smaller particles before absorption can occur in the body.

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Prodrugs

Inactive chemicals requiring metabolism to exert therapeutic effects.

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First-Pass Effect

Medication concentration is reduced before reaching systemic circulation.

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Blood Flow

Medications are absorbed faster in areas with high blood flow. The lower blood flow to the area, the slower the absorption.

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Alternative Routes

Route (parenteral, sublingual, transdermal, rectal).

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Lipid Solubility

Medication formulation absorption rate with high lipid solubility.

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Surface Area

The larger the surface area, the more rapid the absorption.

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Excretion

Medication removed from the body.

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Excretion Organs

Kidneys (primary), skin, lungs, exocrine glands, liver, mammary glands, intestines

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Client-Specific Factors

The condition of the body affects, the absorption rate of a medication. The medication must be absorbed by the body.

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Intravenous (IV) Route

Medications given via which route bypasses absorption factors and is the most rapid?

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Topical Administration

Application of a medication, absorbed through the skin or mucous membranes.

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enteral route

Administration through the GI tract.

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subcutaneously

Medication administered under the skin.

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intramuscularly

Medication administered directly into the muscle

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Topical medications

Administration application directly to the area needing medication

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orally disintegrating tablets

Tablets that dissolve rapidly when placed on the tongue leading to faster absorption

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Pharmacodynamics

The study of how a medication works within the body including its relationship to medication concentrations and the body's responses.

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Therapeutic Range

The concentration of medication in the blood that produces the desired therapeutic effect without causing toxicity.

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Therapeutic Drug Monitoring (TDM)

Monitoring medication concentrations in a client's blood to ensure adequate and safe medication administration.

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Peak Blood Level

The highest concentration of a medication in the blood after a dose is administered.

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Trough Blood Level

The lowest concentration of a medication in the blood, measured just before the next dose.

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Half-life

The time it takes for the concentration of a medication in the body to decrease by 50%.

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Onset of Action

The time it takes for a medication to produce a noticeable therapeutic effect after administration.

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Peak Effect

Occurs when absorption is complete, the medication is distributed throughout the body, and the medication is at its highest concentration.

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Duration of Action

The period of time which the medication maintains its therapeutic effects.

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Agonist

A medication that activates receptors to initiate a desired response.

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Antagonist

A medication that prevents the activation of a receptor, blocking a response.

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Adverse Drug Reactions (ADR)

Unintended and nontherapeutic effects of a medication, ranging from tolerable to harmful.

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Adverse Drug Event (ADE)

A life-threatening medication reaction requiring medical intervention to prevent severe outcomes like death or disability.

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Black Box Warning

A warning placed on medication labels indicating the potential for lethal or iatrogenic results.

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Medication Toxicity

Medication toxicity develops when the body is unable to metabolize and excrete a medication.

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Iatrogenic

Harm caused by medical treatment or examination.

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Allergic Reaction

The body recognizes medication as a foreign substance, which then stimulates an immune response.

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Anaphylaxis

A severe, life-threatening allergic reaction with dyspnea, hypotension, and tachycardia.

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Stevens-Johnson Syndrome (SJS)

A rare, serious disorder of your skin and mucous membranes. It's usually a reaction to a medication or an infection.

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Urticaria

Hives; a possible manifestation of an allergic reaction.

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Drug-Drug Interactions

Occur when a client is prescribed more than one medication which may intensify or decrease the effects of one or more of the medications.

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Drug-Food Interactions

Occur when medications are taken with substances that affect their absorption, metabolism, or excretion.

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Drug-Herbal Supplement Interactions

Can result in effects similar to those seen with drug–drug interactions.

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Teratogenic

A substance known to cause fetal defects, pregnancy loss, developmental disabilities, or prematurity.

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Medication in Pregnancy

Caution must be observed when administering medications to pregnant and breastfeeding women.

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Developmental Changes & Meds

Changes in body functions across the lifespan can affect medication response.

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Factors Affecting Medication Actions

Individual factors like weight, gender, genetics, nutrition, and disease states.

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Celecoxib Black Box Warning

Increased risk of cardiovascular events, bleeding, and GI complications.

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Avoiding Adverse Drug Events

Careful monitoring and planning to minimize the occurrence of ADEs.

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Polypharmacy

Use of multiple medications by a single patient.

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Drug-Drug Interaction Review

Reviewing the client's medication list to identify potential interactions is vital for patient safety.

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Medication Toxicity Monitoring

Monitoring for signs like confusion or GI issues indicates medication toxicity.

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Age-Related Dosage Adjustment

Adjusting dosages considers how age affects drug processing.

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Pharmacist Collaboration

Collaboration ensures medication appropriateness.

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Client Rights

Clients have the right to quality care and a safe environment.

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Right Client

Verify the client’s identity, reduces risk of administering medication to the wrong patient.

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Client Identifiers

Using name, DOB, MRN, or phone number.

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Right Medication

Confirming name and form prevents wrong medication errors.

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Medication Name Similarity

Drug names can sound alike.

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Check Expiration Dates

Administering expired medication.

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Right Dose

Confirming the dosage prescribed.

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Right Route

How the medication will be administered

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Right Time

Confirm the time for administration.

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Teratogenic Medications

Substances causing fetal abnormalities.

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Fetal-Placental Barrier

Some drugs cross this barrier, potentially harming the fetus.

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Weight-Based Dosing

Dosage determination based on the patient's weight in kilograms.

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Age-Related Metabolism Changes

Reduced capability to process and eliminate drugs due to organ decline.

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OTC Meds in Pregnancy: Nurse's Role

Explain risks/benefits, and consult with a provider.

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Pediatric Metabolism

May need higher or more frequent doses due to increased processing.

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Infant Renal Excretion

Reduced kidney function affects drug clearance.

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Pediatric Weight Dosing

Use kilograms for accurate pediatric medication calculations.

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Fatty Tissue Medication Storage

Medications are stored in the fatty tissue, resulting in decreased plasma levels and reduced efficacy

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ADEs in Pediatrics

Higher risk due to weight-based calculations.

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Polypharmacy Risks

Increased risk of ADEs and drug interactions.

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Aging and Pharmacokinetics

Changes in the body affect how drugs are processed.

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Body Composition and Meds

Differences in muscle and fat affect medication distribution.

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Dose-related errors

Errors can occur from a misplaced decimal point, math errors or incorrect unit conversion.

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IV vs. Oral

Medications given intravenously have a quicker reaction time than those given orally.

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Medication reference books

These books give the frequencies with which medications should be administered.

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STAT Medication

Given immediately, usually one time.

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PRN Medication

Given as required for specific symptoms.

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Time-Critical Medications

Medications that can cause harm if given too early or late.

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Non-Time-Critical Medications

Medications that be given 1-2 hours early or late without harm.

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Right Assessment

Assessing the client's condition before administering a medication.

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Right Documentation

Checking the MAR before and after giving a medication.

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CMS Regulations

Policies to address the timing of all medications.

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Urgent medications

1-hour time frame.

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Single prescriptions

One-time doses like preoperative medications.

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Electronic MAR

An electronic record of medications.

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Right Drug, Dose, Route

Check the medication label against the MAR three times.

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Right Evaluation

Evaluate and chart the medication's effect after administration.

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Medication Error Cause

Failure to follow the rights of medication administration.

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Prescription Accuracy

Check for accuracy with pharmacist/provider before giving.

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High-Risk Variables

Assess for age, disease, labs, allergies, and past responses.

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Pharmacy Verification

Avoid giving medications before pharmacy verification.

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Illegible Prescriptions

Avoid abbreviations and illegible prescriptions.

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Best Possible Medication History

Maintain an accurate list of all medications.

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When to Reconcile Meds

Performed upon admission, transfer, and discharge.

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Medication Reconciliation Goal

Develop, update, coordinate, and communicate medication information.

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Reconciliation Process

Review current medications; address omissions, duplications, and interactions.

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Needle Gauge

The diameter or thickness of a needle, indicated by a number (e.g., 22G).

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Needle Length

The measurement from the hub to the tip of the needle.

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Longer Needle Use

Deeper locations in the body, such as muscle tissue.

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Subcutaneous Needle Length

3/8 to 5/8 inches is the typical range.

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Needle Length (Pediatrics)

May require shorter needles for IM injections, compared to larger adults.

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MAR Check

Verifying client, medication route, dose, time, and frequency before administration.

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Post-Administration Documentation

Record time given, your initials, and reason if PRN.

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Right to Refuse

Clients can refuse medication or treatment.

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Nurse's Response to Refusal

Investigate refusal reasons, dispel fears, notify the provider, and document.

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Medication Education

Ensure understanding of medication use, adverse effects, and benefits.

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Medication Evaluation

Assess if the medication had the expected effect.

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Incorrect Medication Label

Collaborate with the pharmacist to resolve the discrepancy.

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Three Checks of Medication

When obtaining, during preparation, and at the bedside before administration.

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Complete Medication Prescription

Client name, date/time, med name, dosage, route, frequency, indication, and provider signature.

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Medication Administration Record (MAR)

Record of medications prescribed; used to confirm administration.

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Computerized Physician Order Entry (CPOE)

Medication orders entered electronically by the provider.

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Pre-Administration Assessment

Checking apical pulse before giving digoxin.

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Informed Consent

Understanding indications, ADEs, and expected benefits.

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Medication Administration

The nurse's action of giving medication to a patient.

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Medication Error Risk

Increased risk of error at the bedside due to a lack of preventative systems.

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Enteral Medication

Administering medication via the gastrointestinal tract.

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Steps After Error

Assess patient, notify provider ASAP, follow organizational protocols, complete incident report.

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Incident Report

Objective account of what happened, actions taken, and involved parties without personal opinions.

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Parenteral Medication

Administering medication by injection, bypassing the digestive system.

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Incident Report Placement

Not included in the patient's medical record.

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Medical Record Documentation

Document the error, patient assessment, actions, and provider notification.

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Sublingual (SL)

Medication absorbed under the tongue.

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Buccal Route

Medication absorbed between the cheek and gum.

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Patient Identification

Using two identifiers (name, DOB) to confirm patient identity.

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Administration Technique

Using correct methods for giving medications.

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Intravenous (IV)

Administered into a vein for rapid onset of action.

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Aseptic Technique

Using sterile procedures when giving injectable medications.

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Inhalation Route

Administered by inhaling into the lungs.

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Dosage Calculation

Always double-checking to ensure dose accuracy, especially with high-risk and pediatric drugs.

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Intramuscular (IM)

Administered directly into a muscle.

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Subcutaneous (Subcut)

Administered directly under the skin.

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Sound-Alike Medications

Double check with the prescriber because medicine names can sound similar, leading to errors.

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Complete medication order

Name, dose, route, form, and time of drugs

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Transdermal Route

Applied to the skin for systemic absorption.

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Unit Dose Medication

The medication is pre-packaged in a single dose.

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Otic Route

Administered into the ear.

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Ophthalmic Route

Administered into the eye.

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Multi-Dose Vial

A container with multiple doses of medication.

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Nasal Route

Administered into the nose.

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Safe Medication

Hand hygiene, using gloves, two patient identifiers, aseptic technique.

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Rectal (PR)

Administered into the rectum for absorption.

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Oral Route Advantages

Method of administering a drug that is safest, cheapest and most convenient

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Medication Administration Responsibility

Nurse's legal and ethical duty in medication includes observation, education, and documentation.

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Medication Bedside Rule

Never leave medications at the bedside for self-administration.

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Automated Medication Dispensing System (AMDS)

AMDS reduces errors by controlling medication dispensing.

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AMDS Access

AMDS requires a personal password.

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Barcode System

Handheld scanner devices used for client's ID and medication label.

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Barcode Alert

Prevents medication administration if there is a discrepancy.

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Factors Contributing to Med Errors

Identification, interruption, and correction.

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Preventing Interruptions

Mark area, limit noises, reduce cellphone use.

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Correction (Med Errors)

Ignoring frequent alerts, which could cause client harm.

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AMDS Override

Removing medication before pharmacist review, generating an alert.

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Workaround

Avoiding policy or procedure. Short cut.

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Override Definition (ISMP)

An instance where the medication is removed before pharmacy review due to nurse perceiving client will be harmed if administration is delayed.

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High-Alert Medications

Increased risk of significant harm if errors occur.

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Independent Double Checks

Two nurses verify information independently.

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Examples of High-Alert Meds

Insulin, opiates, intravenous heparin, and injectable potassium chloride.

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Punctal Occlusion

Blocks medication entry into the nasolacrimal duct to prevent systemic absorption.

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Aseptic Technique (Eye)

Prevents contamination when giving eye medications.

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Otic Meds: Temp Matters

Administering cold ear drops that might cause dizziness and pain.

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Pinna Position (Adult)

Straightens the ear for medication entry.

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Otic Meds: Positioning

Side-lying with affected ear up to keep medication in.

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Rebound Congestion

Can occur with overuse of nasal decongestants.

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Intravaginal Route

Medications absorbed through the vaginal wall

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Gloves with Vaginal Meds

Required to administer intravaginal medications.

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Rectal Route

Used for clients unable to swallow or with bowel issues.

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Stool Before Suppository

Decreases effectiveness of rectal medication.

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Hold it!

Time to retain suppository

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Rectal Surgery

Surgery contraindication

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Inhaled Medications

Treats respiratoy conditions

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Metered-Dose Inhalers (MDIs)

Device used for inhaled medications.

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MDI Spacer

Helps deliver more medication to the lungs.

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Liquid Med Measurement

Use syringe, dropper, or metered cup for accurate liquid medication dosing.

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Syringe Measurement

Black line at top of plunger at desired marking.

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Pill Cutter Use

To split tablets accurately to ensure the right dosage. The pill must be scored.

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Pill Splitting Steps

Clean, gloves, place, close, split, administer, clean.

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Med Timing w/ Food

Some meds need an empty stomach, others with food to aid absorption.

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Tablet

Pressed medication mixture, various shapes, may be scored or coated.

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Capsule

Gelatin shell surrounding medication, faster action than tablets.

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Liquid Medication

Easiest to swallow, may need flavoring for palatability.

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Oral Med Absorption Rate (Fastest to Slowest)

Liquid, suspension, powder, capsule, tablet, coated tablet, enteric-coated tablet

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Oral Med Admin Principles

Assess swallowing, elevate HOB, offer water or preferred beverage.

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Swallowing Assessment

Assesses the client's ability to swallow before administering oral medication.

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Head of Bed Elevation

Elevating the head of the bed to prevent choking and aspiration.

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Beverage Administration

Offering water or a beverage to help the client swallow the medication.

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Mixing Medications

Some clients may prefer to take their oral medications mixed in applesauce or pudding.

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Liquid Medication Prep

Pour liquids into a metered measuring cup, holding the label in your palm.

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Sublingual Medications

Medications placed under the the tongue, not chewed or swallowed, until dissolved.

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Buccal Medications

Medications placed between the cheek and gum line, not chewed or swallowed, until dissolved.

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Enteral Feeding Tube (EFT)

A tube used to deliver nutrition/medications to those unable to take them orally.

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EFT Medication Form

Administer medications in liquid form to prevent the tube from clogging.

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Medications NOT to Crush

Do not crush these medications as adverse effects can occur.

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EFT Flushing Technique

Flush with 30-60 mL of water before and after medication; 15-30 mL in between.

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EFT Medication Mixing

Mixing can cause delayed absorption or precipitation.

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EFT Tubing Check

Follow the tubing from the client to origin before connecting/reconnecting.

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Transdermal Applications

Medication absorbed slowly providing prolonged release over several days.

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Common Transdermal Meds

Medications: opioids, antidepressants, contraceptives, nicotine, and antinausea medications.

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Transdermal Patch Application

Remove the old patch. Apply nonsterile gloves. Rotate sites. Avoid irritated skin.

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Ophthalmic Medications

Applied to the mucous membranes of the eyes/conjunctiva.

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Ophthalmic Solution Placement

Solutions are instilled into the lower margin of the eyelid (conjunctival sac).

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Parenteral Route

Medications administered via injection, bypassing the digestive tract.

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Safety Needle

Safety feature on needles to prevent accidental punctures after injection.

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Syringe Barrel

Part of the syringe labeled with mL or cc to indicate volume.

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Luer-Lock Tip

Connection type on a syringe where the needle hub twists and locks into place.

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Insulin Syringe

Syringe designed to measure insulin in units.

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Tuberculin (TB) Syringe

Syringe used for intradermal injections and TB tests, measuring small volumes in hundredths of mL.

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Needle Hub

Part of the needle that attaches it to the syringe.

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Beveled Tip

The slanted, sharp opening at the tip of the needle for easier skin piercing.

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Smaller-Gauge Needle

A needle with a wider diameter.

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Higher-Gauge Needle

A needle with a thinner diameter.

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Syringe Size Selection

Choose syringe based on volume and pressure of medication

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Needle Shaft

Needle part from hub to beveled point where medication exits.

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Topical application

Route to achieve local or systemic effect by direct application.

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