Medication Administration Basics Quiz
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Questions and Answers

Which gauge needle is commonly used for intradermal injections?

  • 30G
  • 21G
  • 18G
  • 25G (correct)

    • Aspiration is required for intradermal injections.

    False

    What is one reason needles should never be recapped after use?

    To prevent needle stick injuries

    The maximum volume for subcutaneous injections is ______.

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

    Match the injection method with the correct angle of administration:

    <p>Intradermal = 5-15 degrees Subcutaneous = 45-90 degrees Intramuscular = 90 degrees Z-track method = Not applicable</p> Signup and view all the answers

    What is the maximum time frame for administering medications given more frequently than every 6 hours?

    <p>30 minutes before or after scheduled time</p> Signup and view all the answers

    Enteral medications can be administered via feeding tubes.

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

    List two patient identifiers that should be utilized when identifying a patient.

    <p>Name, Birthdate</p> Signup and view all the answers

    Medications given _____ or less frequently should be administered within 60 minutes before or after the scheduled time.

    <p>Q6 hours</p> Signup and view all the answers

    Match the type of medication administration with its description:

    <p>Enteral = Routes involving feeding tubes or oral administration Topical = Applied directly to the skin or mucous membranes Rectal = Administered via the rectum as suppositories Trans-dermal = Delivered through the skin via patches</p> Signup and view all the answers

    Which of the following is NOT classified under topical medications?

    <p>Oral Liquid</p> Signup and view all the answers

    Scored oral medications can only be administered as whole tablets without cutting.

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

    What does 'QID' represent in medication orders?

    <p>Four times a day</p> Signup and view all the answers

    What is the therapeutic range of a drug?

    <p>Concentration causing the desired effect without toxicity</p> Signup and view all the answers

    The half-life of a drug refers to the total time the drug remains effective in the body.

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

    What is the purpose of medication reconciliation?

    <p>To ensure accurate medication information during patient care transitions.</p> Signup and view all the answers

    The _____ level is the point when the drug is at its lowest concentration in the blood serum.

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

    Which of the following is NOT considered a right of medication administration?

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

    Match the type of medication order with its description:

    <p>Verbal Orders = Instructions given verbally by a provider PRN Orders = Medications to be given as needed Stat Orders = Immediate administration of required medication Standing Orders = Routine administration of medication for specific conditions</p> Signup and view all the answers

    A decreased kidney function can lead to an increased risk of drug toxicity in older adults.

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

    List two factors that can affect drug response in aging patients.

    <p>Decreased liver function, decreased gastric motility.</p> Signup and view all the answers

    How much sterile water is needed to reconstitute a 2.5g vial of Chlorothiazide?

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

    It is safe to recap a used needle before disposing of it.

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

    What must be reported immediately after a medication error?

    <p>The patient's condition and any adverse effects.</p> Signup and view all the answers

    The recommended concentration of Chlorothiazide after reconstitution is _____ mg/mL.

    <p>125</p> Signup and view all the answers

    Match the following medication documentation protocols with their correct explanations:

    <p>Drugs Given = Record the sites and parameters Doses Missed = Explain the reason why they were missed Incident Reports = Report medication errors using a specific form Patient Education = Teach the patient about their medications</p> Signup and view all the answers

    What is the purpose of aspiration during injections?

    <p>To check for blood vessel penetration</p> Signup and view all the answers

    Aspiration is necessary for all intramuscular injections.

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

    Name one organization that states aspiration is not necessary for immunizations.

    <p>Centers for Disease Control (CDC)</p> Signup and view all the answers

    The concentration of fluid after reconstituting with 2 mL of diluent will be _____ mg/mL.

    <p>225</p> Signup and view all the answers

    Which of the following statements about aspiration is true?

    <p>Aspiration may be indicated for large molecule IM medications.</p> Signup and view all the answers

    Younger nurses are less likely to follow the latest recommendations on IM injections.

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

    Match the injection types with their aspiration requirements:

    <p>Subcutaneous injections = Not indicated IM injections of vaccines = Not indicated IM injections of large molecule medications = May be indicated Intravenous injections = Not discussed</p> Signup and view all the answers

    How much sterile water must be added to reconstitute a vial of Cefazolin?

    <p>2 mL</p> Signup and view all the answers

    Study Notes

    Medication Administration Basics

    • Frequency of Orders: Daily, BID (twice a day), TID (three times a day), QID (four times a day), ac (before meals), pc (after meals), HS (at bedtime)
    • Identifying the Patient: Two patient identifiers, including name, birthdate, and MRN, should be used and compared with the EMR.
    • Right Time: Medications given more frequently than Q6 hours (Q1, Q2, Q3, Q4) or rapid short-acting insulin (regular, Aspart/Novolog) should be given within 30 minutes before or after the scheduled time. Medications given Q6 hours or less frequently (Q6, Q8, Q12) should be given within 60 minutes before or after. Daily, weekly, or monthly medications should be administered within 2 hours before or after scheduled time.
    • Oral Medication Administration: Includes enteral (PO, feeding tubes), sublingual, buccal, and solid (scored, SR, XL, CR, enteric coated), and liquid forms.

    Topical Medications

    • Includes lotions, creams, ointments, medicated powders, transdermal patches, eye drops, nose drops/mists, ear drops, rectal suppositories, and vaginal creams/suppositories.

    Nursing Drug Knowledge

    • Includes generic & trade names, classifications, indications, pharmacokinetics (metabolism, excretion), and effects (adverse effects, allergic reactions, tolerance, toxic, idiosyncratic).

    Drug Dose and Serum Drug Levels

    • Therapeutic range: Drug concentration in blood serum that produces the desired effect without causing toxicity.
    • Peak Level: Highest drug concentration.
    • Trough Level: Lowest drug concentration, indicating the rate of elimination.
    • Half-life: Time it takes for 50% of blood concentration to be eliminated.

    Medication Reconciliation

    • Admission assessment should include prescribed medications, medications taken prior to admission (PTA), allergies, pregnancy and lactation status, and dietary supplements/herbal remedies.

    Aging and Drug Response

    • Decreased gastric motility, total body water, lipid content in skin, and liver and kidney function.
    • Increased risk of adverse CNS effects, altered peripheral vascular tone.

    Critical Thinking

    • Key considerations include proper order, calculating adult medication dosages, considering the patient's condition, equipment selection, documenting medication administration, and providing patient teaching.

    Medication Orders

    • Verbal Orders: Must be written and signed by the doctor.
    • Telephone Orders: Should be given by the doctor and documented by the nurse, then signed by the doctor.
    • Standing Orders: Pre-written orders for routine treatments.
    • PRN Orders: Given "as needed" based on the patient's symptoms.
    • Stat Orders: Given immediately and only once.
    • One Time Orders: Given only once at a specific time.

    Three Rights Checks

    • Patient: Check the patient's identification using two patient identifiers.
    • Medication: Check the label of the medication against the medication administration record (MAR).
    • Dose: Verify the correct dose.
    • Route: Confirm the correct route of administration.
    • Time: Verify the correct time for administration.
    • Reason: Assess rationale for medication administration.
    • EMR/MAR: Check against the EMR/MAR.
    • Documentation: Record administration time, route, and any associated assessment data.
    • Response: Observe patient's response to medication.

    Parenteral Medications

    • Intradermal: Used for TB testing, typically using a ¼ - ½ inch, 25G, 27G needle with less than 0.5 mL of medication administered at a 5-15 degree angle. No aspiration or massage is required.
    • Subcutaneous: Used for insulin, heparin, and other medications. Typically using a 3/8-5/8 inch, 25G-30G needle with a maximum volume of 1 mL. Administered at 45-90 degree angle. Optionally, the skin can be pinched. No aspiration and no massage is required.
    • Intramuscular: Used for administering medications that require fast absorption. Common sites include the deltoid (upper arm), ventrogluteal (buttock), and vastus lateralis (thigh). Typically using a 5/8-1.5 inch, 20G-25G needle with up to 3 mL of medication administered. Gentle pressure, but no massage is required.
    • Z-track Technique: Used for IM injections to minimize irritation and leakage.

    Reconstituting Medications

    • Powder Medications: Many medications must be reconstituted before administration. Read and follow the reconstitution instructions carefully to ensure the correct concentration.

    Controlled Substances

    • Always stored in locked cabinets.
    • Narcotic counts are conducted at regular intervals.
    • Discrepancies must be reported.
    • Partial doses must be recorded.

    Medication Disposal

    • Follow facility policies for safe disposal, using a medication disposal system like Stryker Cactus Smart Sink.

    Documentation

    • Document medication administration, including:
      • Drugs given: site and parameters
      • Doses missed: reasons for missing doses
      • Refused medications
    • Document medication errors using appropriate incident reporting forms.
    • Provide patient education/teaching about medications.

    Medication Errors

    • Immediately check the patient’s condition and monitor for adverse effects.
    • Obtain vital signs.
    • Notify the nurse manager and primary care provider.
    • Complete the appropriate facility error reporting forms.

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    Related Documents

    Medication Administration Part 1 PDF

    Description

    Test your knowledge on the essential principles of medication administration, including frequency of orders, patient identification, and proper medication timing. This quiz also covers oral and topical medication forms, ensuring a comprehensive understanding of safe practices in medication delivery.

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