Questions and Answers
What is the term for reactions that are peculiar to a particular individual?
Idiosyncratic reactions
What is the term for when the combined effect of two medications is greater than the effect of the medications given separately?
What is the term for the time it takes for a medication to produce a response?
Onset
What is the term for the time at which a medication reaches its highest effective concentration?
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What is the term for the minimum blood serum concentration before the next scheduled dose?
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What is the term for the time a medication takes to produce its greatest result?
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What is the term for the point at which blood serum concentration is maintained?
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What is the term for the time for serum medication concentration to be halved?
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What type of order is administered until the dosage is changed or another medication is prescribed?
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What type of order is given when the patient requires it?
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What type of order is given one time only for a specific reason?
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What type of order is given immediately in an emergency?
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What type of order is given when a medication is needed right away but not STAT?
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What is assessed in a patient's evaluation?
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What is the term for anxiety, ineffective health maintenance, and noncompliance with medications?
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What is the focus of implementation in health promotion?
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What should be avoided during oral administration of medication?
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What precautions should be taken during eye instillation?
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What type of medication is a disk that resembles a contact lens?
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What special care should be taken during ear instillation?
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What is required for using pressurized metered-dose inhalers (pMDIs)?
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What determines the medication release in breath-actuated metered-dose inhalers (BAIs)?
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What is activated by the patient's breath during inhalation?
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What is the procedure for medication administration via a nasogastric (n/g) tube?
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What is the most appropriate next step for the nurse to take when having difficulty reading a physician's order?
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The patient has an order for 2 tablespoons of Milk of Magnesia. How much medication does the nurse give him or her?
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How does the nurse pull the patient's ear when administering eardrops to an 8-year old patient?
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How many tablets does the nurse administer for cephalexin (Keflex) 500 mg if the pharmacy has sent 250-mg tablets?
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What should the nurse do when a mother states her child has not taken a medication before?
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What is a priority for the discharge nurse when a patient is transitioning to home care?
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Which information must the nursing student provide to the patient about his antibiotic?
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What is the next best course of action if a patient insists that he cannot swallow a sustained-release capsule?
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If a patient refuses to take medication, what should the nurse's next action be?
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The nurse receives an order to start giving a loop diuretic to lower blood pressure. What determines the appropriate route for administering the diuretic?
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What should the nurse do if IV push medication infiltrates into the outer tissues?
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What does the nurse suspect if a patient receiving IV fluids develops tenderness, warmth, and redness at the site?
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What should a nursing student do first after receiving a verbal order for a new medication?
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What is the first priority when a nurse accidentally gives medication at the wrong time?
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How many days will a pMDI that contains 200 puffs last if the patient takes 2 puffs every 4 hours? __________ days
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What is the most important nursing action to ensure effective absorption of medication through a nasogastric tube connected to suction?
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What medication will be absorbed the quickest for immediate pain relief?
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Knowing that a drug requires low pH to be metabolized, through which route is this medication most likely administered?
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What should the nurse do upon recognizing that an order for phenytoin (Dilantin) is likely incorrect?
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What indicates that patient education about a sublingual medication has been effective?
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What actions should the nurse take to prevent medication errors?
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What should the nurse do when a patient requests a prn medication before the time interval has elapsed?
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How should the nurse perform ear irrigation on a 2-year-old child?
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When should the ideal time to draw a trough level for phenytoin (Dilantin) at 0900 be?
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What must be reported immediately in narcotic counts?
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What is a medication that provides an exact description of its composition?
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What is the name of a medication assigned by the manufacturer, listed in the U.S. Pharmacopeia?
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What is the name of a medication known as the brand or proprietary name under which it is marketed?
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What is the study of how medications enter and exit the body?
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What are raised, irregularly shaped skin eruptions with reddened margins called?
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What are small, raised vesicles that are usually reddened and distributed over the entire body?
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What term describes itching of the skin that accompanies most rashes?
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What term describes inflammation of mucous membranes lining the nose?
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What is the expected physiological response that each medication causes termed as?
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What are predictable, often unavoidable secondary effects produced at a usual therapeutic dose?
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What term describes unintended, undesirable, and often unpredictable severe responses to medication?
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What describes the effects developed after prolonged intake of a medication?
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What are unpredictable effects called when a patient overreacts or underreacts to a medication?
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Study Notes
Medication Administration Principles
- Clarify unclear medication orders with the prescriber to ensure accurate administration.
- Verify medication orders if a caregiver questions the medication being administered.
- Engage with patients regarding the names and effects of their medications to promote understanding and compliance.
Dosage Calculations
- 1 tablespoon equals 15 mL; therefore, 2 tablespoons equal 30 mL of Milk of Magnesia.
- For administering cephalexin (Keflex) at 500 mg with 250 mg tablets, administer 2 tablets.
Pediatric Considerations
- Eardrops for children over 3 years: pull the ear upward and outward for proper administration.
- For children under 3, pull the auricle down and back during ear irrigation.
Medication Administration Protocols
- Sustain-release capsules should not be crushed; refer to the prescriber if a patient cannot swallow.
- Assess patients' reasons for refusing medications to ensure safety and understanding.
IV Medication Management
- Infiltration of IV medications requires stopping administration and following agency policy.
- Signs of phlebitis include tenderness, warmth, and redness at the IV site.
Medication Error Management
- Assess patients for adverse effects after a medication error occurs.
- Report discrepancies in narcotic counts immediately to maintain safety and accountability.
Controlled Substances Handling
- Daily counts of controlled substances should be performed; report any discrepancies promptly.
Pharmacokinetics Overview
- Pharmacokinetics covers how medications enter, distribute, metabolize, and exit the body, impacting therapeutic effects.
Understanding Drug Names
- Chemical names provide detailed descriptions of drug structure (e.g., N-acetyl-para-aminophenol).
- Generic names (e.g., acetaminophen) are assigned by manufacturers and are commonly used in practice.
- Trade names (e.g., Tylenol) are proprietary names designated by the manufacturer for marketing.
Common Medication Reactions
- Therapeutic effects are the expected responses from a medication's administration.
- Side effects are predictable but may also cause discomfort or additional concerns.
- Adverse effects are severe, unintended reactions, which can be immediate or develop over time.
- Toxic effects occur due to drug accumulation or prolonged use leading to potential harm.
Patient Education and Rights
- Educate patients about the correct usage of sublingual medications, emphasizing they must dissolve completely under the tongue to be effective.
- Prioritize patient safety by ensuring patients have the right to refuse medication and understanding the necessity for treatment changes.
RN Responsibilities for Medication Safety
- Follow the six rights of medication administration: right patient, right drug, right dose, right route, right time, and right documentation.
- Collaborate with healthcare teams and community resources to ensure safe medication transitions during patient discharge.### Idiosyncratic Reactions
- Unique and unexpected responses to medications that are often unrelated to the drug's pharmacological effects.
Synergistic Effect
- Occurs when two medications work together to produce a combined effect that is greater than their individual effects.
Onset
- The period required for a medication to begin producing its therapeutic effect.
Peak
- The time point at which a medication achieves its highest effective concentration in the bloodstream.
Trough
- The minimum concentration of a drug in the blood serum before the next scheduled dose is administered.
Duration
- The time duration over which a medication produces its maximum therapeutic effect.
Plateau
- The level at which the concentration of a medication in the bloodstream is stabilized and maintained after administration.
Biological Half-Life
- The time required for the concentration of a drug in the serum to decrease by half.
Standing or Routine Order
- A medication order that remains in effect until it is altered or discontinued by prescriber.
PRN Order
- Allows for medication administration as needed, typically based on the patient's request or condition.
Single (One-Time) Order
- A medication dose prescribed for administration only once for a specific condition or purpose.
STAT Order
- An urgent medication order that requires immediate administration without delay.
Now Order
- An order for medication administration that must occur promptly but not immediately, typically within 90 minutes.
Assessment
- Involves evaluating the patient's medical history, current condition, and understanding of medication therapy, including:
- Allergies and current medications
- Coordination issues
- Patient adherence and learning needs
Diagnosis
- Identifies the patient's healthcare problems related to:
- Anxiety
- Noncompliance with medications
- Impaired swallowing and other health concerns
Implementation: Health Promotion
- Involves educating patients and families about:
- Medication benefits and proper administration
- Side effects and safe medication storage
- Establishing a medication routine and connecting to community resources
Oral Administration
- Preferred method of medication delivery, with considerations such as:
- Potential food interactions that can affect therapeutic effects
- Aspiration precautions
- Timing with enteral feedings
Eye Instillation
- Guidelines for administering eye medications:
- Avoid contact with cornea and eyelids to reduce infection risk
- Use only the prescribed eye and never share medications
Intraocular Instillation
- Involves the use of a disk similar to a contact lens, requiring patient education on insertion, removal, and potential adverse effects.
Ear Instillation
- Key precautions include:
- Sensitivity of ear structures to temperature
- Using sterile solutions and avoiding occlusion of the ear canal
- Monitoring for signs of eardrum rupture
Pressurized Metered-Dose Inhalers (pMDIs)
- Require sufficient hand strength for effective use.
Breath-Actuated Metered-Dose Inhalers (BAIs)
- The release of medication is dependent on the strength of the patient's breath.
Dry Powder Inhalers (DPIs)
- Activated by inhalation, allowing for direct delivery of medication to the lungs.
N/G or G-Tube Medication Administration
- Important practices include:
- Preparing each medication separately with a small amount of water
- Checking for proper placement and flushing with water before and after administration
- Keeping the patient in a sitting position and avoiding mixing medications with feedings.
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Description
This quiz covers essential principles of medication administration, dosage calculations, and specific considerations for pediatric patients. Understand the protocols for safe medication practices and enhance your knowledge of administering medications effectively. Test your understanding with scenarios related to administration and patient engagement.
