Medication Administration Techniques for Nurses
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Questions and Answers

What action should the nurse take to verify the trough level of a medication?

  • Ask the client to provide a urine specimen after the next dose of medication.
  • Administer the medication, and obtain a blood specimen 30 min later.
  • Verify that the client has been taking the medication for 24 hr before obtaining a blood specimen.
  • Obtain a blood specimen immediately prior to administering the next dose of medication. (correct)

    • Medications with long half-lives remain at therapeutic levels between doses for short periods of time.

    False

    What should be done before applying a transdermal patch?

    Wash the skin with soap and water and dry it thoroughly.

    The client should apply the patch to a ______ area of skin to promote absorption.

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

    Which position should the client be in to facilitate the instillation of eye drops?

    <p>Sitting or supine position</p> Signup and view all the answers

    What is the correct method for dropping medication into the eye?

    <p>In the conjunctival sac</p> Signup and view all the answers

    How many times per day should the nurse expect to administer phenobarbital for a client with a seizure disorder if it has a half-life of 4 days?

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

    Which factors should the educator include as a reason to administer lower medication dosages? (Select all that apply)

    <p>Increased renal excretion</p> Signup and view all the answers

    Which actions should the nurse take when preparing to administer eye drops? (Select all that apply)

    <p>Drop the medication into the client’s conjunctival sac.</p> Signup and view all the answers

    What should clients do while the sublingual tablet is in place?

    <p>Not eat or drink until it has completely dissolved.</p> Signup and view all the answers

    What is the purpose of a spacer when using a metered-dose inhaler (MDI)?

    <p>To increase the amount of medication delivered to the lungs</p> Signup and view all the answers

    Nasal drops should be sprayed into the nose while the client inhales, and the client should not blow their nose for ______ minutes after administration.

    <p>5</p> Signup and view all the answers

    What does pharmacokinetics refer to?

    <p>How medications travel through the body.</p> Signup and view all the answers

    Which of the following can be barriers to absorption? (Select all that apply)

    <p>Large spaces between capillary walls</p> Signup and view all the answers

    Oral medications have no barriers to absorption.

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

    What is the absorption pattern for intravenous administration?

    <p>Immediate and complete absorption.</p> Signup and view all the answers

    Where does the metabolism of medications primarily occur?

    <p>In the liver.</p> Signup and view all the answers

    The time for the medication in the body to drop by 50% is called the ______.

    <p>half-life</p> Signup and view all the answers

    What occurs during the first-pass effect?

    <p>Medications are inactivated on their first pass through the liver</p> Signup and view all the answers

    What is the safety margin indicated by a high therapeutic index?

    <p>Wide safety margin.</p> Signup and view all the answers

    Which of the following factors can influence the rate of metabolism? (Select all that apply)

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

    Agonists mimic the receptor activity of endogenous compounds.

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

    What is pharmacodynamics?

    <p>The study of interactions between medications and target cells.</p> Signup and view all the answers

    Medications directly applied to the skin and mucous membranes are referred to as ______ medications.

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

    How many times per day should the nurse expect to administer phenobarbital, which has a long half-life of 4 days?

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

    Which of the following factors should a nurse educator include as reasons to administer lower medication dosages? (Select all that apply)

    <p>Increased renal excretion</p> Signup and view all the answers

    Which actions should the nurse take when administering eye drops to a client? (Select all that apply)

    <p>Instruct the client to close the eye gently after instillation.</p> Signup and view all the answers

    What should clients do after instilling ear drops?

    <p>Remain in a side-lying position for 2 to 3 minutes.</p> Signup and view all the answers

    True or False: Clients should not eat or drink while a sublingual tablet is in place until it has completely dissolved.

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

    For nasal spray, the tip should be inserted into the ______ and pointed away from the center of the nose.

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

    Match the following medication administration routes with their advantages and disadvantages:

    <p>Intravenous = Rapid onset and precise control over dosage Sublingual = Bypasses GI tract, direct bloodstream entry Intramuscular = Can accommodate larger volumes Subcutaneous = Suitable for self-administration, slower absorption</p> Signup and view all the answers

    What should the nurse do to verify the trough level of the client’s medication?

    <p>Obtain a blood specimen immediately prior to administering the next dose of medication.</p> Signup and view all the answers

    Why should the client apply a transdermal patch to a hairless area of skin?

    <p>To promote absorption of the medication.</p> Signup and view all the answers

    Increased renal excretion increases the concentration of the medication.

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

    Which of the following statements about medications with long half-lives is correct?

    <p>Medications with long half-lives stay at therapeutic levels for longer periods.</p> Signup and view all the answers

    What should a client do just before applying a transdermal patch?

    <p>Wash the skin with soap and water and dry it thoroughly.</p> Signup and view all the answers

    What happens when two medications compete for metabolism?

    <p>It increases the concentration of one or both medications.</p> Signup and view all the answers

    What does pharmacokinetics refer to?

    <p>The travel of medications through the body</p> Signup and view all the answers

    What are the common routes of medication administration?

    <p>Enteral and parenteral routes.</p> Signup and view all the answers

    Oral medications pass through a layer of epithelial cells in the GI tract before absorption.

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

    Which of the following is a barrier to absorption?

    <p>All of the above</p> Signup and view all the answers

    What is the primary site of metabolism in the body?

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

    The time for the medication in the body to drop by 50% is referred to as _________.

    <p>half-life</p> Signup and view all the answers

    What are agonists in pharmacodynamics?

    <p>Medications that mimic receptor activity</p> Signup and view all the answers

    Nurses should monitor medications with a low therapeutic index closely.

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

    When is peak level monitoring crucial for oral medications?

    <p>1 to 3 hours after administration</p> Signup and view all the answers

    What can kidney dysfunction lead to in medication response?

    <p>Increased duration and intensity of a medication's response.</p> Signup and view all the answers

    What role do antagonists play in pharmacodynamics?

    <p>They block usual receptor activity.</p> Signup and view all the answers

    Study Notes

    Medication Administration (Inhaler)

    • Tilt head back slightly and inhale slowly and deeply for 3 to 5 seconds.
    • Hold breath for 10 seconds.
    • Remove mouthpiece and exhale slowly through pursed lips.

    Medication Administration (Eye Drops)

    • Look upward to prevent drops from falling onto the cornea.
    • Do not blink, but if you do, repeat the instillation.
    • Drop medication into the conjunctival sac.
    • Close eye gently.

    Medication Administration (Transdermal Patch)

    • Apply the patch to a hairless area of skin.

    Medication Administration (Trough Levels)

    • Obtain blood specimen immediately before administering the next dose of medication.
    • Trough levels reflect the least concentration of the medication in the blood.

    Pharmacokinetics

    • The study of how medications travel through the body
    • Involves absorption, distribution, metabolism, and excretion

    Absorption

    • The movement of medications from the administration site to the bloodstream
    • Common routes include enteral (GI tract) and parenteral (injection)
    • Rate of absorption affects the onset of action
    • Amount absorbed determines the intensity of effects

    Barriers to Absorption

    • Oral: Medications must pass through the GI tract epithelial cells
    • Sublingual/buccal: Swallowing before dissolution can inactivate medications in the stomach
    • Inhalation: Inspiratory effort is a barrier
    • Intradermal/topical: Close proximity of epidermal cells
    • Subcutaneous/intramuscular: Capillary walls have large spaces, no significant barrier
    • Intravenous: No barriers

    Absorption Patterns

    • Oral: Varies greatly due to medication stability, solubility, GI pH, emptying time, and other medications
    • Sublingual/buccal: Quick systemic absorption through highly vascular mucous membranes
    • Inhalation: Rapid absorption through alveolar capillary networks
    • Intradermal/topical: Slow, gradual absorption, primarily local effects, but systemic with lipid-soluble medications
    • Subcutaneous/intramuscular: Solubility of medication in water determines absorption rate; highly soluble medications are absorbed quickly, poorly soluble ones are absorbed slowly
    • Intravenous: Immediate and complete absorption, entering directly into the bloodstream

    Distribution

    • The transport of medications to their sites of action by bodily fluids
    • Influenced by circulation, cell membrane permeability, and plasma protein binding

    Metabolism

    • The process of changing medications into less active forms by enzymes
    • Primarily occurs in the liver, but also in kidneys, lungs, intestines, and blood

    Factors Affecting Metabolism Rate

    • Age: Infants have limited capacity, aging can affect it, older adults require smaller doses
    • Enzyme increases: Can metabolize a medication faster, requiring increased dosage
    • First-pass effect: Liver inactivates some medications on their first pass, requiring a non-enteral route for medications with a high first-pass effect
    • Similar metabolic pathways: Can alter the metabolism of multiple medications
    • Nutritional status: Malnourishment can impair medication metabolism

    Outcomes of Metabolism

    • Inactivation of medications
    • Increased therapeutic effects
    • Activation of pro-drugs
    • Decreased toxicity
    • Increased toxicity

    Excretion

    • Elimination of medications from the body
    • Primarily occurs through the kidneys
    • Also occurs through the liver, lungs, intestines, and exocrine glands (e.g., breast milk)
    • Kidney dysfunction can lead to medication accumulation and increased duration/intensity of response

    Medication Responses

    • Therapeutic range: Effective and not toxic
    • Therapeutic index (TI): Wide safety margin for high TI medications, low TI medications require close monitoring
    • Peak levels: Highest plasma level when elimination = absorption
    • Trough Levels: Obtained immediately before the next dose
    • Plateau: Steady concentration in plasma during a series of doses

    Half-Life (t½)

    • Time for medication levels to decrease by 50%
    • Affects the time to reach steady state
    • Short half-life: Medications leave the body quickly, short dosing intervals
    • Long half-life: Medications leave the body slowly, longer dosing intervals, increased risk of accumulation

    Pharmacodynamics

    • The interaction of medications with target cells, body systems, and organs to produce effects
    • Involves agonist, antagonist, and partial agonist medications

    Agonists

    • Medications that bind to and mimic the activity of endogenous compounds
    • Activate receptors to produce effects (e.g., morphine at opioid receptors)

    Antagonists

    • Block receptor activity of endogenous compounds or other medications
    • Prevent the action of the targeted compound (e.g., losartan at angiotensin II receptors)

    Partial Agonists

    • Act as both agonists and antagonists
    • Have limited affinity to receptor sites
    • May produce limited effects or block the effects of strong agonists (e.g., nalbuphine at opioid receptors)

    Oral Route (Enteral)

    • Common and convenient
    • Advantages: Inexpensive, easy to administer
    • Disadvantages: Variable absorption, inactivation in GI tract, requires cooperation

    Sublingual and Buccal

    • Sublingual: Under the tongue
    • Buccal: Between the cheek and gum
    • Bypass the liver, directly enter the bloodstream

    Topical Route

    • Medications applied to mucous membranes or skin
    • Include powders, sprays, creams, ointments, pastes, and lotions
    • Limited adverse effects
    • Painless

    Transdermal Route

    • Medications in a skin patch for absorption through the skin
    • Produce systemic effects

    Eye Route

    • Instillations for direct application to the eye

    Ear Route

    • Instillations for direct application to the ear canal.

    Medication Administration: Inhalers

    • Tilt head back slightly while pressing the inhaler, and inhale deeply and slowly for 3-5 seconds.
    • Hold breath for 10 seconds to allow medication to deposit in airways.
    • Remove mouthpiece from mouth and exhale slowly through pursed lips.

    Medication Administration: Dosage Adjustments

    • Liver failure decreases metabolism, increasing medication concentration. Therefore, dosage should be decreased.
    • When two medications are metabolized by the same pathway, they compete for metabolism, increasing the concentration of one or both medications. This requires decreasing the dosage of one or both medications.

    Medication Administration: Eye Drops

    • Look upward to prevent drops from falling onto the cornea
    • Drop medication into the conjunctival sac to promote distribution.
    • Close eye gently after application to promote distribution.

    Medication Administration: Transdermal Patches

    • Apply patch to a hairless area of skin to promote absorption.

    Medication Administration: Trough Levels

    • Trough levels should be measured immediately before administering the next dose of medication to verify the lowest concentration of the medication in the client's blood.

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    ATI RN Pharmacology for Nursing (8th Edition) PDF

    Description

    This quiz covers essential nursing actions and protocols for proper medication administration, including verifying trough levels, applying transdermal patches, instilling eye drops, and understanding dosage considerations. Test your knowledge on best practices and factors influencing medication administration for optimal patient care.

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