Medication Administration & Nursing Process

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Questions and Answers

Which of the following is NOT an advantage of oral administration compared to parenteral administration?

Oral administration can be reversed easier in case of accidental ingestion.

Oral administration is generally safer than injection.

Oral administration is usually more convenient than injections.

Oral administration bypasses the first-pass effect of the liver. (correct)

What is the primary advantage of administering medications via the intravenous route?

Intravenous administration provides the quickest onset of action due to direct entry into the bloodstream. (correct)

Intravenous administration is the most convenient route for self-administered medications.

Intravenous administration is the most cost-effective route for medication delivery.

Intravenous administration bypasses the first-pass effect of the liver, resulting in higher bioavailability.

Sublingual drug administration offers which of the following advantages?

Rapid absorption due to the rich blood supply under the tongue. (correct)

Direct absorption into the bloodstream, bypassing the first-pass effect of the liver.

Slow and sustained release of the drug over an extended period.

Localized action, primarily affecting only the oral cavity.

Which route of administration is preferred when oral administration is not feasible and a rapid systemic effect is desired?

Intravenous Signup and view all the answers

Which of the following statements about the rectal route of administration is TRUE?

Rectal administration can be used for both local and systemic drug delivery. Signup and view all the answers

Which route of administration is characterized by avoiding first-pass metabolism?

Transdermal Signup and view all the answers

Which factor DOES NOT influence the rate of drug absorption?

Patient's age Signup and view all the answers

What is a key advantage of topical drug administration?

Delivers medication directly to the affected area Signup and view all the answers

Which statement accurately describes the relationship between drug absorption and the gastrointestinal (GI) tract?

The small intestine is the primary site of drug absorption due to its large surface area and rich blood supply. Signup and view all the answers

What is the primary route of administration for drugs that are poorly soluble and often given in "depot" preparations?

Intramuscular Signup and view all the answers

Which statement accurately describes the process of drug absorption in the enteral route?

Drugs are absorbed from the intestinal lumen into the bloodstream and transported to the liver, where they undergo metabolism before entering the general circulation. Signup and view all the answers

What is the term for the process by which a drug is converted from its original form to a more readily excreted form?

Metabolism Signup and view all the answers

Which of the following factors can affect the rate of drug absorption?

Time of day Signup and view all the answers

What type of data includes information obtained through the senses?

Objective data Signup and view all the answers

Which of the following examples represents subjective data?

Patient complaints of pain Signup and view all the answers

What is the first pass effect in pharmacology?

Initial metabolism of a drug in the liver before systemic circulation Signup and view all the answers

Which of the following routes is NOT associated with the first pass effect?

Intravenous route Signup and view all the answers

How does the first pass effect influence the concentration of a drug?

Decreases the active drug's concentration Signup and view all the answers

What does the acronym SMART stand for in the context of setting outcomes?

Specific, Measurable, Attainable, Relevant, Timed Signup and view all the answers

Which component of the nursing process involves prioritizing nursing diagnoses?

Planning Signup and view all the answers

What is the purpose of the 'AEB' section in a nursing diagnosis?

To provide evidence supporting the diagnosis Signup and view all the answers

During which phase of the nursing process is patient education included?

Implementation Signup and view all the answers

What should be the nature of outcome criteria in patient care?

Concrete and descriptive Signup and view all the answers

What is evaluated at the end of the nursing process?

The effectiveness of nursing interventions Signup and view all the answers

In the nursing diagnosis formulation, what does 'R/T' stand for?

Related To Signup and view all the answers

What is a key characteristic of the evaluation phase in the nursing process?

It is systemic, ongoing, and dynamic. Signup and view all the answers

Which property allows sublingually administered drugs to have rapid absorption?

Highly vascularized tissue under the tongue Signup and view all the answers

What is the main organ responsible for drug metabolism?

Liver Signup and view all the answers

How does the drug-protein complex affect drug distribution?

Decreases the volume of distribution Signup and view all the answers

Which areas are identified as having rapid drug distribution?

Brain and liver Signup and view all the answers

What term describes the biochemical alteration of a drug into an inactive metabolite?

Biotransformation Signup and view all the answers

What is the primary process for eliminating drugs from the body?

Excretion Signup and view all the answers

Which of the following factors influences a drug's distribution in the body?

Capillary permeability and blood flow Signup and view all the answers

What is a characteristic of drugs absorbed via the buccal route?

Bypass the liver and achieve systemic bioavailability Signup and view all the answers

What is a primary concern regarding the use of ginseng in conjunction with prescription medications?

Ginseng can alter the metabolism of prescription drugs, affecting their distribution and elimination. Signup and view all the answers

Which of the following is NOT a characteristic of the Market for Medicinal Herbs, as described in the text?

It primarily involves prescription-only medications. Signup and view all the answers

What is the role of the Food and Drug Administration (FDA) in the context of investigational new drugs?

The FDA oversees the approval process for investigational new drug applications. Signup and view all the answers

What is the role of DNA in genetic inheritance?

DNA acts as the primary molecule transferring genes from parents to offspring. Signup and view all the answers

Which of the following is NOT one of the four organic bases found in DNA?

Uracil Signup and view all the answers

What specific liver function test should a nurse monitor when considering the potential influence of ginseng on drug metabolism?

Liver Enzymes (e.g. AST, ALT) Signup and view all the answers

Which of the following conditions is described in the text as having complex interactions involving multiple factors, including genetics and environment?

Myocardial infarction Signup and view all the answers

What is the primary role of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA)?

To provide drug benefits for seniors and individuals with disabilities. Signup and view all the answers

Study Notes

Key Medication Terms

Key terms for medication prescriptions are listed in each module chapter.
A written prescription should include the patient's name, the date the order was written, the name of the drug(s), the dosage amount, the frequency, the route of administration, and the prescriber's signature.

Documentation of Medication Administration

Document the date and time of administration, including the drug name, dose, route, and site.
Record any changes in vital signs, adverse effects, other concerns (like toxicity), and the amount of fluid given (intake and output).
Note any improvements or deterioration.

Important Considerations for Medication Administration

Five Rights: Ensure the right drug, dose, time, route, and patient are used.
Nine Rights: Include the five rights, plus right documentation, right reason (appropriateness for the patient's history), and right response (desired drug response).

Nursing Process Steps

Assessment: Data collection, review, analysis of medication profiles (prescriptions, OTC meds, vitamins, herbs, supplements), and compliance/adherence to medication regimens.
Diagnosis: Identify human needs statements, analyze cues, and prioritize hypotheses related to the patient's condition and medication needs.
Planning: Establish measurable and realistic patient goals/outcomes criteria, ideally using SMART goals, for safe and effective medication administration.
Implementation: Take actions and interventions, including patient education, based on specific outcomes for identified diagnoses.
Evaluation: Monitor the patient's response (expected and unexpected responses) to medication therapy.

Medication Errors

Medication errors should be documented in an incident report, but not as an "accident report".
Patient age is already part of the patient's record, so it doesn't need to be repeated.

Routes of Drug Administration

Enteral: Oral (usually easier, more convenient, safer than injection), rectal (good alternative, rapid absorption).
Parenteral: Intravenous (fastest, directly into circulation), intramuscular (slower, often used for depot preparations), subcutaneous (slower absorption compared with IV).
Topical: Directly to affected area, less likely to cause systemic drug effects.
Transdermal: Constant drug absorption over time (e.g., patches).
Inhalation: Rapid absorption, administered directly to lung tissue.

First-Pass Effect

Drugs absorbed from the gastrointestinal tract are initially metabolized in the liver
This effect reduces the amount of drug reaching systemic circulation.
Some routes (e.g., intravenous) bypass this effect.

Time of Day and Drug Administration

Time of day can affect stomach acidity, impacting drug absorption.

Distribution

Drugs travel to areas of rapid distribution (heart, liver, kidneys, brain) faster than areas of slower distribution (muscle, skin, fat).

Metabolism

Liver is the primary organ of drug metabolism; other tissues may also be involved, including, skeletal muscle, kidneys, lungs, plasma, and intestinal mucosa.

Excretion

Kidneys are the primary organ responsible for eliminating drugs from the body.

Patient Groups and Considerations

Elderly: Consider declining organ function, high medication use, polypharmacy (multiple medications), noncompliance, and chronic illnesses when giving drugs to older adults.
Infants: Consider the immature liver and kidney function, thinner skin, and weaker mucous membranes, leading to changes in drug dosages and effects.
Pregnancy: Nurses should carefully review potential risks and benefits when administering drugs to pregnant patients. Drug effects on the fetus should be evaluated.

Medication Reconciliation

Medication reconciliation involves reviewing all medications a patient is on at different points in their healthcare journey.
It involves verification (current medications), clarification, and reconciliation (identify any discrepancies and rectify as needed).

Patient Education and the Nursing Process

Patient education aims to help patients learn healthy behaviors and incorporate them into their lives.
Educational learning involves cognitive, affective, and psychomotor domains.
Consider memory issues in older adults.

Other Important Information

Drug Properties: Drug properties influence safety and potential harm of drug delivery in relation to the patient.
Cultural Factors: Culture influences patients' responses to drugs and should be considered when determining appropriate drug dosages.
Ethical Principles: Withholding important information from a patient is unethical.
Legal Considerations: Health Insurance Portability and Accountability Act (HIPAA) protects patient information, and the Federal Food, Drug, and Cosmetic Act (FFDCA) governs new drug approval requirements.
Drug Interactions: Drug interactions should be taken into account in all types of patients.
Drugs and DNA: DNA and genetics can affect the way a person reacts to and metabolizes a drug.

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Description

This quiz covers key terms and considerations for medication administration, including the necessary documentation and the crucial 'Five Rights' and 'Nine Rights' of medication. It also addresses the nursing process steps related to assessment and administration practices. Perfect for nursing students and professionals looking to test their knowledge.