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Questions and Answers
What is pharmacokinetics primarily concerned with?
What is pharmacokinetics primarily concerned with?
Which factor affects the absorption route of medication based on the text?
Which factor affects the absorption route of medication based on the text?
Why does oral or enteral route have a lower rate of absorption compared to other routes?
Why does oral or enteral route have a lower rate of absorption compared to other routes?
What is a characteristic that makes intramuscular injection faster in absorption compared to subcutaneous injection?
What is a characteristic that makes intramuscular injection faster in absorption compared to subcutaneous injection?
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Why is IV administration considered the fastest route for medication delivery?
Why is IV administration considered the fastest route for medication delivery?
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How can vomiting or diarrhea affect the absorption of medication in the body?
How can vomiting or diarrhea affect the absorption of medication in the body?
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What is a key reason for administering medication either 30 minutes before or after the scheduled time?
What is a key reason for administering medication either 30 minutes before or after the scheduled time?
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According to CMS regulations, what must healthcare facilities have in place regarding medication timing?
According to CMS regulations, what must healthcare facilities have in place regarding medication timing?
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What is an essential step for nurses to take before administering medication to a patient?
What is an essential step for nurses to take before administering medication to a patient?
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Why is it important for patients to know why a medication has been prescribed to them?
Why is it important for patients to know why a medication has been prescribed to them?
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What type of medications are considered 'time critical' and require immediate administration?
What type of medications are considered 'time critical' and require immediate administration?
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What is a crucial aspect of maintaining client safety concerning medication administration?
What is a crucial aspect of maintaining client safety concerning medication administration?
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What is the primary organ responsible for the removal of medication from the body?
What is the primary organ responsible for the removal of medication from the body?
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In medication metabolism, which enzyme in the liver plays a significant role?
In medication metabolism, which enzyme in the liver plays a significant role?
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Which medication is transformed into morphine during metabolism?
Which medication is transformed into morphine during metabolism?
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What does Therapeutic Drug Monitoring help healthcare providers to monitor?
What does Therapeutic Drug Monitoring help healthcare providers to monitor?
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What characterizes the through blood level of medication?
What characterizes the through blood level of medication?
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Which organ receives high vascular supply according to the text?
Which organ receives high vascular supply according to the text?
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What is meant by a 'blackbox warning' on a medication label?
What is meant by a 'blackbox warning' on a medication label?
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In medication metabolism, what influences metabolism related to age?
In medication metabolism, what influences metabolism related to age?
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'Pharmacodynamics' studies how medication works concerning what two factors?
'Pharmacodynamics' studies how medication works concerning what two factors?
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'Adverse Drug Reactions' can range from tolerable to potentially causing what?
'Adverse Drug Reactions' can range from tolerable to potentially causing what?
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What is considered a medication error?
What is considered a medication error?
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What technology helps reduce medication errors according to the text?
What technology helps reduce medication errors according to the text?
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What should nurses not resort to when problems arise during medication administration?
What should nurses not resort to when problems arise during medication administration?
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What should nurses do if an error occurs during medication administration?
What should nurses do if an error occurs during medication administration?
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Which of the following is a strategy to reduce medication administration errors?
Which of the following is a strategy to reduce medication administration errors?
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What is a potential complication associated with nasogastric, gastrostomy, or jejunostomy tubes?
What is a potential complication associated with nasogastric, gastrostomy, or jejunostomy tubes?
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How should tablets be handled to ensure proper administration?
How should tablets be handled to ensure proper administration?
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What is a characteristic of liquid medications according to the text?
What is a characteristic of liquid medications according to the text?
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What is the recommended volume of water for flushing before and after medication administration?
What is the recommended volume of water for flushing before and after medication administration?
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Where are ophthalmic medications typically placed?
Where are ophthalmic medications typically placed?
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What is the purpose of Punto occlusion or nasolacrimal inclusion during medication administration?
What is the purpose of Punto occlusion or nasolacrimal inclusion during medication administration?
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How should a nurse administer otic medications?
How should a nurse administer otic medications?
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What is the purpose of engaging in safe device disposal immediately after use?
What is the purpose of engaging in safe device disposal immediately after use?
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How should nasal medications be administered?
How should nasal medications be administered?
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What does a tuberculin syringe specifically measure?
What does a tuberculin syringe specifically measure?
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Why is it important for patients not to go to the bathroom within 20 minutes after receiving topical medications through rectal route?
Why is it important for patients not to go to the bathroom within 20 minutes after receiving topical medications through rectal route?
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What should a patient do after receiving a transdermal medication patch?
What should a patient do after receiving a transdermal medication patch?
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What is the main consideration when selecting a site for medication administration?
What is the main consideration when selecting a site for medication administration?
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Which route of medication administration involves delivering medication into large skeletal muscles?
Which route of medication administration involves delivering medication into large skeletal muscles?
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What is a common sign of inflammation of the vein when infusing intravenous fluid or medication?
What is a common sign of inflammation of the vein when infusing intravenous fluid or medication?
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Why are infants not administered intramuscular injections in the deltoid and gluteus maximus?
Why are infants not administered intramuscular injections in the deltoid and gluteus maximus?
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Why is transdermal medication administration in infants considered high risk?
Why is transdermal medication administration in infants considered high risk?
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What should a nurse inform clients about regarding their medication?
What should a nurse inform clients about regarding their medication?
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At what reading level should client education materials be ideally written according to literacy in medication administration?
At what reading level should client education materials be ideally written according to literacy in medication administration?
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What is the severe life-threatening reaction with immune response that can cause respiratory distress, fever, and blisters?
What is the severe life-threatening reaction with immune response that can cause respiratory distress, fever, and blisters?
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Which substance is categorically teratogenic, causing fetal defects, pregnancy loss, and developmental disabilities?
Which substance is categorically teratogenic, causing fetal defects, pregnancy loss, and developmental disabilities?
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Why are iron preparations better absorbed with orange juice?
Why are iron preparations better absorbed with orange juice?
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What is the key factor influencing individual response to medication mentioned in the text?
What is the key factor influencing individual response to medication mentioned in the text?
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What do children's dosages of medications typically consider in terms of metabolism and excretion?
What do children's dosages of medications typically consider in terms of metabolism and excretion?
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Why are older adults often challenged when it comes to absorbing, metabolizing, and excreting medications?
Why are older adults often challenged when it comes to absorbing, metabolizing, and excreting medications?
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What is polypharmacy as mentioned in the text?
What is polypharmacy as mentioned in the text?
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What should nurses confirm before administering medication to ensure it's correct according to the text?
What should nurses confirm before administering medication to ensure it's correct according to the text?
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What must be administered within 30 minutes from placing the order according to the text?
What must be administered within 30 minutes from placing the order according to the text?
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Study Notes
Pharmacokinetics
- Study of the absorption, distribution, metabolism, and excretion of medication in the human body
- Factors affecting absorption:
- Route of administration
- Ionization (pH of medication and site of absorption)
- Dissolution (medication must be dissolved before absorption)
- Blood flow (medication absorbs rapidly when blood flow is high)
- Lipid solubility (medication formation can have high or low lipids)
- Surface area of the absorptive site
- Client-specific factors (e.g. vomiting, diarrhea)
Distribution
- Process of delivering medication to the target organ or tissue
- Factors affecting distribution:
- Circulatory status (blood flow, medication solubility, and protein binding ability)
- High vascular areas (heart, brain, liver, and kidney receive the greatest blood supply)
- Low vascular areas (bone, skin, and adipose tissue receive less blood supply)
Metabolism
- Chemical process of converting medication structure
- Factors affecting metabolism:
- Liver enzyme (cytochrome P450) transformation
- Age (e.g. infant, child, adult)
- Genetic characteristics (e.g. race, ethnicity)
- Disease states (e.g. liver, kidney, or heart failure)
Excretion
- Process of removing medication from the body
- Factors affecting excretion:
- Kidney function
- Liver function
- Heart function
Pharmacodynamics
- Study of how medication works in relation to medication concentration and body response
- Therapeutic drug monitoring:
- Used by healthcare providers to monitor medication levels
- Important to ensure accurate medication administration and avoid adverse reactions
Adverse Drug Reactions (ADR)
- Unintended and undesired effects of medication
- Types of ADR:
- Allergic reactions
- Hypersensitivity reactions
- Anaphylaxis
- Medication interactions
Medication Administration
- Right client:
- Verify client identity
- Check medical record number
- Right medication:
- Verify medication order
- Check brand name or generic name
- Right dose:
- Calculate correct dosage
- Check concentration and dosage form
- Right route:
- Verify administration route (e.g. oral, IV, topical)
- Right time:
- Check administration schedule
- Verify timing of medication administration
Medication Errors
- Any avoidable event that results in incorrect medication use or client injury
- Factors contributing to medication errors:
- Interruptions during medication administration
- Distractions (e.g. phone calls, conversations)
- Lack of knowledge or education
- Similar medication names or packaging
Medication Reconciliation
- Process of reviewing and verifying client medication lists
- Important to ensure client safety and accurate medication administration
Route of Administration
- Three major categories: enteral, topical, and parenteral
- Factors affecting route of administration:
- Medication attributes (e.g. solid, liquid, gas)
- Location of desired action (e.g. local, systemic)
- Client conditions and adherence
Medication Forms
-
Tablet:
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Pressing and making sure of substance
-
Can be chewable or half-scored
-
Can be quick release, delayed release, or extended release
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Capsule:
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Soft and hard gelatin
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Can be enteric-coated
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Liquid:
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Can be difficult to swallow
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May be used for oral or enteral administration
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Transdermal:
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Allows for slow, sustained release of medication
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Patches can be rotated to different sites
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Ophthalmic:
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Used for local infection or inflammation
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Administered to the eye or conjunctiva
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Otic:
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Used for local infection or inflammation
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Administered to the outer ear
-
Nasal:
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Used for local infection or inflammation
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Administered to the nostrils
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Intravaginal:
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Used for infections or to administer estrogen
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Rectal:
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Used for infections or inflammation
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Administered to the rectum
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Parenteral:
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Includes intradermal, intramuscular, subcutaneous, and IV administration
-
Factors affecting parenteral administration:
-
Needle size and type
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Viscosity of medication
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Client's age, size, and condition### Selecting an Injection Site
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Avoid inflamed areas to prevent false positive results
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Deliver medication into adipose tissue due to abundant capillaries
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Medications include insulin and low molecular weight heparin
Factors to Consider for Medication Administration
- Condition of the skin
- Presence of lipohypertrophy
- Amount of audible tissue
- Age and size of the client
- Amount of medication to be given (older adults: maximum of 1 ML)
- Condition of the anticipated site (pain, mobility, edema, inflamed, bruises)
Routes of Medication Administration
- Intradermal
- Subcutaneous
- Intramuscular
- IV (deliver fluid, nutrients, blood, and blood products)
IV Infusion
- Administer via an IV infusion set with 0.9% sodium chloride or dextrose 5% in water
- Volume: 50-250 mg
- Administer over a specific period of time: 30-90 minutes
Central Access Devices
- CBD (central access device) inserted into a large central vein
- Directly delivers into central blood circulation
- Examples: PIC, central catheter, and CVC (central venous catheter)
Assessing for Complications
- Flavis (inflammation of the vein): redness, pain, heat, and swelling
- Infiltration: pain, swelling, redness, cool skin temperature around the insertion site
- signs of IV fluid or medication leakage around the insertion site
Administering Medication to Infants and Children
- Infants: use a syringe without a needle or a dropper, held in a semi-reclining position to prevent aspiration
- Toddlers and early school-age children: use a syringe or medicine cup
- School-age children: able to swallow pills, tablets, and capsules
Injection Sites for Infants and Children
- Infants: deltoid and gluteus maximus muscles not fully developed, use vastus lateralis muscle instead
- Use small gauge (25-30 G) needle to reduce pain
- Inject 0.5-1 ML at a 90° angle, 1 inch deep
- Toddlers: use deltoid muscle starting at 18 months, injecting 0.5-2 ML
Transdermal Medication in Infants
- High risk of toxicity due to thin skin and rich blood supply
- Client education is crucial to ensure active role in medication regimen
Medication Literacy
- Average reading level of adult medication instructions: 8-9th grade level
- 1/5 of Americans read at a 5th-grade level or lower
- Recommended client education material: written at a 6th-grade level
Role of the Nurse
- Educate clients about medications and encourage active role in regimen
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Description
Learn about the importance of flushing before giving medication and between administering multiple medications. Understand the recommended flushing volumes and techniques for different routes of administration. Explore the benefits and considerations of transdermal applications for slow, long-lasting medication release.
