Lakeland Community College Nursing 1090 Medication Administration Exercise PDF

**[LAKELAND COMMUNITY COLLEGE NURS 1090]** **MEDICATION ADMINISTRATION EXERCISE** **THIS IS ALL TESTABLE MATERIAL - USE THIS AS A STUDY GUIDE** Student Name \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ All page references are from Pearson Volume III. 1. List the "si...

**[LAKELAND COMMUNITY COLLEGE NURS 1090]** **MEDICATION ADMINISTRATION EXERCISE** **THIS IS ALL TESTABLE MATERIAL - USE THIS AS A STUDY GUIDE** Student Name \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ All page references are from Pearson Volume III. 1. List the "six rights" of medication administration 1) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Patient\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 2) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Drug\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 3) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Dose\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 4) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Route\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 5) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Time\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 6) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Documentation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 2\. When administering any medication (PO, IM, SL, etc) or when using any solutions for purposes of irrigation or topical administration, etc. how many times do you perform an *accuracy* check from the label? \_\_\_\_\_\_*3\_*\_\_\_\_\_\_\_ What information are you checking 1\) *Drug name* *2) Dose* *3) Route* *4) Time* *5) Patient* With what are you comparing this information? \_\_\_\_\_\_*[MAR and the medication label]*\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 3. When do the above number of "checks" occur during the preparation of the medications? *[Prior to administering the medication at the bedside]* 4\. What is the proper interpretation of each of the following medical abbreviations? prn *[Whenever necessary/as needed]* stat *[Immediately]* IV *[Intravenous]* IM *[Intramuscular]* po *[by mouth]* 5\. Four-one-hundredths gram (0.04 g) is the equivalent of how many milligrams? *[40 mg]* How many micrograms would be the equivalent? *[40,000 micrograms]* 6\. ORDER: Artane elixir 3 mg po tid with meals AVAILABLE: Artane elixir 2 mg per 5 mL How much of this medication should be administered in mL? \_\_\_\_*[7.5 mL]*\_\_\_\_\_ in tsp? *[1.5 or 1 ½]* 7\. ORDER: Lodine^®^ (etodolac) 400 mg p.o. Q8H prn pain AVAILABLE: Lodine^®^ 200 mg per capsule What is the maximum number of milligrams that could be given over a 24-hour period? \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_*[1200 mg/day total]*\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 8\. List three reasons why administering oral medications would be contraindicated for a patient. 1\) \_\_\_\_\_\_\_*[Gastrointestinal alterations]*\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 2\) \_\_\_\_\_\_\_*[Inability to swallow]*\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 3\) \_\_\_\_\_\_\_*[Unresponsive or comatose]*\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ *[There are many more....of course!!!]* 9\. A medication to be administered at 1700 hours would be due at what standard time? \_\_\_\_\_\_\_\_\_*[5:00 PM]*\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 10\. When measuring liquid medications, read the \_*[base (bottom)]*\_\_\_ of the \_*[meniscus]*\_\_\_\_\_ at eye level to ensure accuracy. 11\. When instilling eye drops, at what distance should the eye dropper be held above the conjunctival sac? \_\_\_\_\_\_*[1-2 cm (0.4 -- 0.8 inches) ]* 12\. When administering an eye medication that should not be absorbed systemically, what should be done immediately after instilling the drops? *[Press firmly on the lacrimal duct for at least 30 seconds.]* 13\. When instilling eardrops, in what direction should the pinna be gently pulled in the adult patient? *[Upward and backward]* 14\. After instillation of ear drops, how long should the patient remain on their side to allow the medication to run down into the ear canal? *[about 5 minutes.]* 15\. Name three nursing considerations when applying topical medications or patches. 1\) *[Be sure to remove old patch before applying new patch]* 2\) *[Use gloves when applying medication (for nurses protection)]* 3\) *[Clean area thoroughly but gently using soap and water]* *4) [Never cut a transdermal patch]* ***There are several others too!!*** 16\. Name four types of topical medication preparations 1\) *[Ointments]* 2\) *[Lotions]* 3\) *[Creams]* 4\) *[Powders]* 17\. Nasal medications may be used for *[relieving sinus congestion]* or *[treating infections]* (Class Notes) 18\. What effect will overuse of a nasal decongestant cause? *[A rebound effect; will increase nasal congestion or swelling.]* (Class notes). 19\. When instilling nose drops, what position of the patient will assure the drops come in contact with all of the nasal surfaces and will not leak out of the nostrils? (Class notes, pg. 147) *[Lie in a back lying position and tilt head backward ]* 20\. What should the nurse ask the patient to do what to relax the external anal sphincter when administering a rectal medication? *[Take slow deep breaths through mouth.]* 21\. List two pieces of equipment needed in the administration of rectal medication. 1[) *Water soluble lubricant*] 2) *[Clean gloves]* 22\. After administration of a rectal suppository, encourage the patient to remain in bed or on their side for how many minutes? *[For at least 5 minutes]* 23\. After administration of a vaginal medication, encourage the patient to remain flat on their back for how many minutes? [ For at least 5 - *10 minutes.* ] 24\. Vaginal medications come in five forms. Name them: 1\) *[Cream]* 2\) *[Foam]* 3\) *[Jelly]* 4\) *[Suppository]* 5\) *[Irrigation (douche)]* 25\. How far should a vaginal **suppository** medication be inserted? [2*-4 inches/5-10 cm* ] 26\. How long should the patient wait between inhalations of the Metered-dose inhaler? *[1 to 2 minutes between inhalations of bronchodilators.]* 27\. What is the best position for the patient to assume when receiving a nebulized/inhaled medication? [ ] (Class notes) *[Sitting or standing position]* 28\. You are to give the 1100 medications to your patient. According to the MAR, an IM injection of Cefazolin is due at this time. Discuss how and when each of the eleven Universal Steps (when initiating a procedure) would be implemented in the administration of this drug. **Medication Preparation Area:** - *[Check Physician's order (MAR e-Mar)]* - *[Hand Hygiene (as you enter the room)]* - *[ID self, ID patient]* - *[Explain procedure]* - *[Focused assessment related to the medication procedure]* - *[Equipment (go back to med area and prepare medication safely -- FOLLOW 3 CHECKS AND SIX RIGHTS)]* - *[Body Mechanics (for nurse)]* - *[Safety (for patient)]* - *[Privacy (for patient)]* - *[Medical Asepsis (for nurse and patient) -- use of gloves during an injection]* 29\. Upon completion of the injection procedure, how and when will you implement the three concluding Universal Steps? - *[Dispose of used equipment (needles in sharps, no caps left in bed, etc).]* - *[Wash Hands]* - *[Document (for injection, don't forget site of administration)]* **FOR THE NEXT QUESTIONS, YOU WILL NEED TO GO TO THE BEDSIDE STATIONS AS INDICATED** **H-249 OTIC , OPTHALMIC & NASAL MEDICATIONS:** **OTIC MEDICATIONS:** 31\. What is the rationale for assuring medication is at room temperature before instilling it in to the ear? *[Promotes patient comfort and prevents nerve stimulation and pain or dizziness.]* **OPHTHALMIC MEDICATIONS**: 32\. Why should the patient be encouraged to close their eyelid(s) and move eyes after ophthalmic ointment is applied? *[Closing the eye spreads the medication over the eyeball.]* 33\. Why should the patient be encouraged to look up to the ceiling during administration of eye medication? *[The patient is less likely to blink and the cornea is partially protected by the upper lid. ]* **NASAL MEDICATIONS**: 34\. Why should the patient be encouraged to remain on their back for at least 5 minutes after nose drops are administered? *[To help the solution come in contact with the nasal surface or flow into the desired area]* **H-250 -- TOPICAL, VAGINAL & RECTAL MEDICATIONS**: **TOPICAL MEDICATIONS:** 35\. Where is the transdermal patch located on the mannequin in H-257? *[Left Upper Chest]* 36\. What are the guidelines to ensure safe administration of transdermal or topical medications and why? - *[ON THE MAR -- document location on the patient's body where the med was placed]* - *[Ask patient if he/she has an existing patch before applying new patch]* - *[If the patch is difficult to see (clear) apply a noticeable label to the patch (add date ,time, initials)]* - *[Cleanse and dry area before applying]* 37\. Why is it important to dry the skin thoroughly before application of topical medications?) *[Wet skin enhances drug absorption and may possibly cause a systemic effect.]* **VAGINAL AND RECTAL MEDICATIONS**: 38\. What is the reason the nurse instructs the patient to lie in a supine position after insertion of vaginal medications? *[Promotes drug absorption and prevent medication loss]* 39\. What two (2) vaginal medication administration methods are shown in the skills station area? *[Suppository with vaginal applicator ]* *[External Cream (vulvar)]* 40\. The rectal suppository needs to be inserted beyond what rectal muscle (name)? *[Anal/Rectal Sphincter ]* **H-253 (\# 41) & H-254 -- (\#42 & 44) INHALATION MEDICATIONS**: 41\. Why is it important to shake the metered dose inhaler (MDI) before use? *[To mix the medication evenly. Shake for 3-5 seconds. ]* 42\. How long does an inhalation treatment by nebulizer last? *[Until all the medication is used and no mist is seen.]* 43\. Why is a spacer used with an MDI? *[It momentarily suspends the medication, eliminating the need for simultaneous activation of the MDI on inhalation...(needing to press the MDI and inhale at the same time. This coordination is very difficult for patients of all ages) ]* 44\. Which type of nebulizer delivery device is being demonstrated on the mannequin at the skills station? *[It will be either the mouthpiece OR the mask]* **H-246 PILL CRUSHER:** 45\. Locate the pill crusher on the over-the-bed table in H-246. Crush a "pill" (Smartie) for practice!!! **H-246 LIQUID MEDICATIONS:** 46\. When measuring liquid medication in a medicine cup, where is the measurement read? *[At the base of the meniscus]* 47\. In what circumstances might you administer liquid medications instead of a pill? *[If patient has difficulty swallowing]* 48\. Locate the liquid medications on the over-the-bed table. Practice pouring the following medications into a medication cup and draw up medication into an oral syringe. Follow instructions listed at station: **Medication cup: Klorvess 20 meq (10 mL)** **Benadryl 12.5 mg. (5 mL)** **Oral Syringe:** **Vancomycin 125 mg (2.5 mL)** Alt. route activity college lab key.doc Rev. 8/23cg