Medication Administration Basics
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Questions and Answers

Why might older adults receive prescriptions from multiple providers?

  • To have varied medical opinions about treatments
  • To manage multiple chronic conditions (correct)
  • To ensure they have a wider selection of drugs
  • To receive better discounts on medications

    • What is an appropriate method to ensure an older adult has swallowed their medication?

  • Ask them how they feel after taking the medication
  • Observe for any signs of discomfort after taking the medication
  • Check the buccal area for any remnants of the pill (correct)
  • Check if they can recite the medication's name

    • How can visual deficits in older adults be addressed when providing medication information?

  • Provide information on a mobile device
  • Use small print to save paper
  • Rely on verbal explanations instead of written ones
  • Create a chart with large letters on a white background (correct)

    • What should be done if an older adult has difficulty swallowing a pill?

    <p>Offer to crush the pill unless contraindicated</p> Signup and view all the answers

    What risk do older adults face when prescribed the same medication by multiple providers?

    <p>They might take higher doses than necessary</p> Signup and view all the answers

    What is the recommended way to administer small amounts of oral medication for accuracy?

    <p>Utilize an oral syringe to prevent errors</p> Signup and view all the answers

    What should be done if oral syringes are not available in a facility?

    <p>Inform the charge nurse about the lack of oral syringes</p> Signup and view all the answers

    What is the primary benefit of conducting medication reconciliation for older adults?

    <p>To prevent duplicate prescriptions and improve safety</p> Signup and view all the answers

    What is the appropriate needle gauge for an intradermal injection?

    <p>25 gauge</p> Signup and view all the answers

    Which angle is used for subcutaneous injections?

    <p>45 to 90 degrees</p> Signup and view all the answers

    Where is the preferred site for intramuscular injections in children?

    <p>Vastus lateralis</p> Signup and view all the answers

    What syringe size is generally used for intramuscular injections?

    <p>3 mL syringe</p> Signup and view all the answers

    When administering high alert medications, what is recommended?

    <p>Have another nurse double-check the medication</p> Signup and view all the answers

    Which of the following needle gauges is most appropriate for viscous solutions during intramuscular injections?

    <p>20 gauge</p> Signup and view all the answers

    What is the angle for administering intradermal injections?

    <p>5 to 15 degrees</p> Signup and view all the answers

    Which location is the least preferred for subcutaneous injections?

    <p>Abdomen near the navel</p> Signup and view all the answers

    What should you inform UAP about when a patient is taking medication that may cause dizziness?

    <p>The patient may need assistance with ambulation or hygiene</p> Signup and view all the answers

    Why is it essential to specifically ask patients about OTC drugs and herbal remedies?

    <p>They can cause drug-drug interactions</p> Signup and view all the answers

    What is the best approach when giving medication to young children?

    <p>Explain that the medication will help them get well</p> Signup and view all the answers

    In what position should a patient be when assessing their swallowing ability?

    <p>High Fowler position</p> Signup and view all the answers

    How often should you ask about medication allergies when administering medication?

    <p>Every time you give a drug</p> Signup and view all the answers

    Why is it beneficial to develop a strong relationship with a pharmacist?

    <p>They can provide clinical information about drug interactions</p> Signup and view all the answers

    What action should be taken when observing a patient's swallow capability?

    <p>Place your thumb and finger over the larynx</p> Signup and view all the answers

    What common misconception might patients have regarding OTC medications and herbal remedies?

    <p>They are generally safe and do not require reporting</p> Signup and view all the answers

    What is the maximum amount of medication that can be safely injected into the mid-deltoid site for adults?

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

    Which intramuscular injection site is considered the safest for avoiding damage to nerves or blood vessels in adults?

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

    What position should an adult patient be in to relax the gluteal muscles during an injection?

    <p>Prone position</p> Signup and view all the answers

    Which muscle is the site of choice for intramuscular injections in infants from younger than 12 months to 2 years?

    <p>Vastus lateralis</p> Signup and view all the answers

    What is a recommended technique for preparing a child for an injection?

    <p>Demonstrate on a doll</p> Signup and view all the answers

    When giving a deltoid injection to a child, where should the injection be administered?

    <p>In the thickest part of the muscle</p> Signup and view all the answers

    What might risk a patient moving during an intramuscular injection procedure?

    <p>If the patient is confused or unable to follow instructions</p> Signup and view all the answers

    Why is it important to place an alcohol swab next to the injection site before administering an intramuscular injection?

    <p>To indicate the exact location of the injection</p> Signup and view all the answers

    What is the correct technique for inserting the needle during the tuberculin skin test?

    <p>Insert the needle bevel up at a 5- to 15-degree angle.</p> Signup and view all the answers

    How can a practitioner determine if the needle is in the dermis during the injection?

    <p>Resistance will be felt when the needle is pushed further.</p> Signup and view all the answers

    What should be done after withdrawing the needle from the skin?

    <p>Activate the safety guard over the used needle.</p> Signup and view all the answers

    What indicates a positive reaction to the tuberculin skin test for someone at low risk?

    <p>Induration of more than 15 mm.</p> Signup and view all the answers

    Within what time frame should the tuberculin skin test results be read?

    <p>48 to 72 hours after injection.</p> Signup and view all the answers

    What should be done to locate the injection site when reading the tuberculin skin test results?

    <p>Circle the injection site with a skin pencil.</p> Signup and view all the answers

    What denotes a negative reaction in the tuberculin skin test?

    <p>Induration measuring less than 5 mm.</p> Signup and view all the answers

    What is the correct action regarding hand hygiene after performing the injection?

    <p>Dispose of gloves and wash hands thoroughly.</p> Signup and view all the answers

    Study Notes

    Medication Administration

    • When administering medication to a patient, it is important to consider possible side effects and alert UAP about those that may require assistance.

    • Be sure to inquire about current medication use, including over-the-counter drugs, herbs, and illicit substances. Ensure a non-judgmental approach when discussing medication history.

    • For pediatric patients, encourage positive reinforcement and avoid comparing medication to candy. Instead, focus on the benefits of the medication and offer simple rewards.

    Medication Administration for Older Adults

    • When assessing swallowing ability, place the patient in a high Fowler's position and observe throat movements as they swallow.

    • Ensure the patient's medication is fully swallowed. Some patients, especially older adults or those with psychiatric conditions, may hold medication within their buccal area.

    • For visually impaired older adults, create charts with large, dark letters on white background, label the drugs' name, dose, time, and purpose.

    • When older adults have difficulty swallowing pills, encourage them to take a small sip of water. Place the pill towards the back of the tongue. Have them take a large sip of water, place their tongue on the top of their mouth, and tilt their chin slightly downward while swallowing. Additionally, consider crushing or cutting pills (unless contraindicated) or requesting a liquid medication form.

    • Be cautious of older adults who see multiple providers. They may have the same medication prescribed with different brand names, leading to double doses. Encourage medication reconciliation to avoid overdosing.

    Medication Safety

    • Use oral syringes for accurate measurement of small quantities (less than 30 mL) of oral medications.

    • The intradermal route (ID) is used for dermal layer injections (e.g., tuberculin tests). The injection angle should be 5 to 15 degrees.

    • The subcutaneous route (sub-Q) is used for injections below the dermal layer, commonly in the upper portion of the upper outer arm, anterior surface of the thigh, or abdomen (away from the navel). The angle should be 45 to 90 degrees.

    • The intramuscular route (IM) is used for injections in the muscle layer, including the deltoid, ventrogluteal, vastus lateralis (children), and rectus femoris of the thigh. The angle should be 90 degrees.

    • Choose syringe and needle size according to the medication, patient’s age, and size. For IM injections, a 3-mL syringe with a 22-gauge, 1 ½-inch needle is generally used.

    • Tuberculin or 3-mL syringes with 27-gauge, 3/8 to ½-inch or 25-gauge, 5/8-inch needles are used for subcutaneous injections.

    Needle Gauge and Length

    • The larger the gauge number, the smaller the needle diameter.

      • ID injections: 25, 27, or 29-gauge needles are most suitable.
      • Subcutaneous injections: 25-gauge needles are strong enough to penetrate the skin and reach below the dermis.
      • IM injections: Heavier-duty 20, 21, 22, and 23-gauge needles are needed.

    • Commonly used needle lengths for parenteral injections are 1 or 1 ½ inches.

    • For viscous or oil suspension medications, 20 or 21 gauge needles are preferred for adult IM injections.

    High Alert Medications

    • When administering insulin, heparin, injectable heart medications, or parenteral chemotherapy drugs, double-check the medication and dose with another nurse.

    • Tuberculin Skin Test:

      • Read the test results between 48 and 72 hours after injection.
      • Inspect the injection site for erythema and palpate the margin of induration.
      • Measure the transverse diameter of the indurated area with a ruler.
      • Induration, not erythema, indicates a positive reaction.
      • Positive reaction: swelling greater than 5 mm.
      • Negative reaction: induration less than 5 mm.

    Intramuscular Injections

    • The ventrogluteal area is considered the safest site for intramuscular injections in adults.

    • Mark the injection site with an alcohol swab to prevent patient movement during the procedure.

    • Relaxed muscles decrease pain during IM injections. Ask the patient to lie in a prone position with toes turned inward or the Sims position to relax the gluteal muscles.

    • The vastus lateralis is the preferred site for IM injections for infants younger than 12 months to 2 years of age. The deltoid muscle can be used for children older than 13 months if developed.

    • When giving a deltoid injection to a child, ensure it is administered in the thickest part of the muscle and that the needle points at a slight angle toward the shoulder.

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    Exam 3 Study Guide PDF

    Description

    This quiz covers essential guidelines for medication administration focusing on various patient demographics, including pediatric and older adult considerations. It emphasizes the importance of understanding medication history, potential side effects, and effective communication strategies for safe administration.

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