NURS 250 Exam 1 Study Guide PDF

❖​ Differentiate between the routes of med admin ​ parenteral ​ not administered through the Gl, ​ enteral ​ administered through the Gl oral (buccal, sublingual), intravenous, intramuscular, intradermal, intracardial, intraspinal, in...

❖​ Differentiate between the routes of med admin ​ parenteral ​ not administered through the Gl, ​ enteral ​ administered through the Gl oral (buccal, sublingual), intravenous, intramuscular, intradermal, intracardial, intraspinal, intraosseous, subcutaneous, ear, eyes, nose, vaginally, and rectally, topical, transdermal, inhalation ❖​ Know the rights of med admin ​ right pt, right time, right med, right dose, right route, right to education, right to deny, right reason, right response, right documentation, and right assessment data ❖​ Do you give meds prepared by another provider? How do you deal with this request if it happened? ​ no, never. You should always prepare your own meds so you know exactly what you are giving to your patients. I would politely explain that I am not comfortable putting my license and good conscience on the line since I did not see the med prepared, I would offer to reprepare the med myself and then administer it if the provider agrees. ❖​ Differentiate between the types of med orders such as standing, prn, stat, etc. ​ standing ​ order that can be made if the pt meets the criteria, already approved by a provider (also called a routine) ​ PRN ​ an as needed order, use your good judgement and follow any special considerations ​ STAT ​ immediately (after the provider has approved it), given only once, the hospital will have guidelines for the time frame you have to administer it ​ one time ​ given only once, usually like an abx before surgery ❖​ Identify essential components of a med order ​ the name of the med, the dose, the route, the date and time of the order, any special considerations, pts name, providers signature, the frequency of administration ❖​ What do you do if a patient refuses a med? ​ educate of effects of not taking the med, respect decision and right to autonomy, document the refusal and notify the provider ❖​ What are signs of an allergic reaction? ​ skin rash (hive, wheals, patches), pruritus (itching), angioedema (swelling under the skin), rhinitis (irritation and swelling of the nasal cavities), lacrimal tearing, N/V/D, wheezing and dyspnea (difficulty breathing) ❖​ What does therapeutic effect mean? ​ the response after treatment which are judged to be useful or favorable ❖​ What lab values do you monitor for liver function and what for kidney function? ​ for liver: AST/ALT, ​ for kidney: BUN/CREAT ❖​ Proper technique for transdermal, oral, Sublingual, inhaled, rectal, eye drops and ear drops, etc. routes ​ always wear gloves, assess ability to swallow for oral meds, assess ability to educate, take vital signs, check the meds for sterility and expiration date, assess for drug interactions, never leave the med with the patient to take always watch them take it, use standard precautions, sublingual and buccal dissolve in the mouth ❖​ Proper technique for IM, IV, Subcutaneous, and Intradermal routes ​ standard precautions, assess ability to educate/pt knowledge, check the medication/expiration date/drug interactions, clean site, choose the right needle size and length, ❖​ Pros and cons with various routes along with nursing considerations ​ Oral: absorption time varies, most convenient and safe, least expensive, does not break the skin barrier, highly variable in absorption, contraindicated with Gl problems, inappropriate with reduced LOC and uncooperative clients, some drugs may stain/have unpleasant odors. ​ Considerations: LOC, ability to swallow, discoloration/staining, odors, meds that cannot be crushed, pt must be sitting up (risk for aphasia), do not mix with large amount of fluid or food, food interaction ​ Sublingual/Buccal: drug directly enters blood and bypasses the liver, do not swallow (will be inactivated by gastric acids), drug is rapidly absorbed into the bloodstream, assess oral cavity for sores/diseases/cancers/etc. ​ considerations: offer drink before med, do not eat or drink while tablet is in place, drug must dissolve fully, monitor for relief of sx ​ rectal: alternative to oral route, dose absorption is unpredictable, limited use. ​ Considerations: unpleasant for pts, assess WBC and Platelet counts, wear gloves, L lateral or sims position, use lubricant, insert just beyond internal sphincter, pt must lay flat for at least 5 minutes after insertion, if not careful could perforate the bowel, stay professional ​ topical: few side effects, drugs can enter body via abrasions/skin breakdown, residue on skin. ​ Considerations: wear gloves (or be exposed to the med), wash skin before applying med and pat dry, use surgical asepsis - do not contaminate the med bottle. ​ Transdermal: ​ considerations: wear gloves, apply patches as prescribed, rotate sites to prevent skin irritation, ensure old patch is off before applying new, wash site thoroughly and pat dry, date and time new patch, evaluated pts response to med  ​ Eye drops: ​ considerations: use medical asepsis, pt should sit upright or supine, drop into conjunctival sac, apply pressure to lacrimil sac for 30-60 sec, wait 5 minutes between different eye drops ​ Ear drops: ​ considerations: aseptic technic, client sit upright or lay on side, adults = up and out,