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Questions and Answers
Which of the following is NOT one of the six rights of medication administration?
How many accuracy checks should be performed based on the medication label?
Which of the following abbreviations indicates that a medication should be taken immediately?
If an order specifies 3 mg of Artane elixir and the available concentration is 2 mg per 5 mL, how much should be administered in mL?
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What is the equivalent of 0.04 grams in milligrams?
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What is the maximum dose of Lodine that can be administered in a 24-hour period based on an order of 400 mg p.o. Q8H?
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When are the accuracy checks recommended to occur during the medication preparation process?
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Which of the following is a possible reason why administering oral medications would be contraindicated for a patient?
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What is the correct position for a patient receiving nose drops to ensure full contact with nasal surfaces?
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Which method should be used to prevent systemic absorption after instilling eye drops?
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What should be done immediately after applying a new transdermal patch?
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How long should a patient remain on their side after ear drop instillation?
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What effect does the overuse of nasal decongestants typically cause?
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What is the correct way to measure liquid medications for accuracy?
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When administering a rectal medication, what should the nurse ask the patient to do?
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Which of the following is a type of topical medication preparation?
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What are two essential pieces of equipment needed for administering rectal medication?
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After administering a rectal suppository, how long should the patient be encouraged to remain in bed or on their side?
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What is the recommended insertion depth for a vaginal suppository medication?
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What is the optimal position for a patient receiving nebulized or inhaled medication?
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How long should a patient wait between inhalations when using a metered-dose inhaler for bronchodilators?
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What is the primary purpose of ensuring that otic medication is at room temperature before instillation?
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What should be done immediately after completing an injection procedure?
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What is the primary reason for a patient to close their eyelids and move their eyes after applying ophthalmic ointment?
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Why should a patient look up to the ceiling while eye medication is being administered?
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What should a patient do after receiving nose drops to ensure the medication works effectively?
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Why is it crucial to dry the skin before applying topical medications?
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What position should a patient be instructed to assume after vaginal medication insertion?
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How long should an inhalation treatment using a nebulizer last?
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Why is it important to shake a metered dose inhaler (MDI) before use?
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What muscle should the rectal suppository be inserted beyond for effective administration?
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Study Notes
Medication Administration
- The six rights of medication administration are: right patient, right drug, right dose, right route, right time, and right documentation.
- When administering medication, perform three accuracy checks from the label: drug name, dose, route, time, patient. Compare this information with the MAR and the medication label.
- These checks should be done prior to administering the medication at the bedside.
- Common medical abbreviations you should know:
- prn: whenever necessary/as needed
- stat: immediately
- IV: intravenous
- IM: intramuscular
- po: by mouth
Conversions & Dosing Calculations
- 0.04 g is equivalent to 40 mg and 40,000 micrograms.
- For Artane elixir 3 mg po tid with meals, available as 2 mg per 5 mL:
- Administer 7.5 mL (or 1.5 tsp).
- For Lodine 400 mg p.o. Q8H prn pain, available as 200 mg per capsule:
- The maximum dosage in a 24-hour period is 1200 mg.
Oral Medication Contraindications
- Oral medications should be avoided for patients with:
- Gastrointestinal alterations
- Inability to swallow
- Unresponsive or comatose
Medication Administration Time & Liquid Medications
- 1700 hours is 5:00 PM.
- When measuring liquid medications, read the base (bottom) of the meniscus at eye level.
Eye & Ear Medication Administration
- When instilling eye drops, hold the dropper 1 to 2 cm above the conjunctival sac.
- After instilling eye drops that should not be absorbed systemically, press firmly on the lacrimal duct for at least 30 seconds.
- When instilling eardrops in an adult, gently pull the pinna upward and backward.
- After instilling ear drops, the patient should remain on their side for about 5 minutes.
Topical Medications
- Nursing considerations when applying topical medications:
- Remove the old patch before applying a new patch (if applicable).
- Use gloves for protection.
- Clean the area thoroughly using soap and water.
- Never cut a transdermal patch.
- Types of topical preparations: ointments, lotions, creams, and powders.
Nasal Medications
- Nasal medications can be used for relieving sinus congestion or treating infections.
- Overuse of nasal decongestants can cause a rebound effect, leading to increased nasal congestion or swelling.
- To ensure the medication reaches all nasal surfaces, the patient should lie on their back with their head tilted backward.
Rectal Medications
- To relax the external anal sphincter, instruct the patient to take slow deep breaths through their mouth.
- Equipment needed for rectal medication administration:
- Water-soluble lubricant
- Clean gloves
- After administering a rectal suppository, encourage the patient to remain in bed or on their side for at least 5 minutes.
Vaginal Medications
- Encourage the patient to remain flat on their back for at least 5 to 10 minutes after administering vaginal medication.
- Vaginal medication forms: cream, foam, jelly, suppositories, and irrigation (douche).
- Insert vaginal suppositories 2 to 4 inches (5 to 10 cm) into the vagina.
Inhalations
- Shake the metered dose inhaler for 3 to 5 seconds before use to ensure even medication distribution.
- Nebulized treatments last until all the medication is used and no mist is seen.
- Use a spacer with an MDI to suspend the medication momentarily, allowing the patient to press the MDI and inhale without needing to coordinate simultaneously.
- The optimal position for receiving a nebulized/inhaled medication is sitting or standing.
Universal Steps for Medication Administration
- For initiating an IM injection:
- Check physician's order (MAR).
- Perform hand hygiene.
- Identify yourself and the patient.
- Explain the procedure.
- Conduct a focused assessment related to the medication procedure.
- Prepare equipment (including medication) safely, following three checks and six rights.
- Ensure proper body mechanics for the nurse.
- Maintain a safe environment for the patient.
- Respect patient privacy.
- Use medical asepsis, including gloves during an injection.
- Conclude with:
- Dispose of used equipment safely.
- Wash hands.
- Document the injection, including the administration site.
Additional Considerations
- Otic Medication: Ensure medication is at room temperature to promote patient comfort and prevent nerve stimulation and pain or dizziness.
- Ophthalmic Medication: Encourage the patient to close their eyelids and move their eyes after applying ophthalmic ointment to spread the medication evenly. Encourage the patient to look up to the ceiling during administration to minimize blinking and protect the cornea.
- Nasal Medication: Encourage the patient to remain on their back for at least 5 minutes after nose drops are administered to allow the solution to interact with the nasal surface.
- Topical Medications: Document the location of the transdermal patch on the patient's body. Ask the patient if they have an existing patch before applying a new one. If the patch is difficult to see (clear), apply a noticeable label with the date, time, and initials. Cleanse and dry the area before applying. Dry the skin thoroughly before applying topical medications to enhance drug absorption and prevent systemic effects.
- Vaginal & Rectal Medications: Encourage the patient to lie in a supine position after vaginal medication insertion to enhance absorption and prevent medication loss. The rectal suppository must be inserted beyond the anal/rectal sphincter muscle.
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Description
Test your knowledge on the essential aspects of medication administration, including the six rights and accuracy checks. You'll also learn about dosing calculations and common medical abbreviations. Prepare to enhance your understanding of oral medication contraindications and conversion factors.
