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69 Cards in this Set
- Front
- Back
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3 checks of reading the label |
1. as you reach for the med 2. before opening or pouring 3. as you replace the med in the drawer/before giving it to the patient |
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7 Rights of Medication |
PMART DR patient, medication, amount, routes, time, documentation and reason |
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how to maintain patients rights |
refusal, education, medication history, labeled meds, supportive therapy, no unnecessary meds, and informed of meds in studies |
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Medication Forms |
Oral, Topical, and Parenteral |
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Oral Medication |
solid, liquid, troche, aerosol, sustained release |
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Topical Medication |
Skin, body cavity, Irrigation |
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Parenteral Medication |
Injections (subcutaneous, intramuscular, Intradermal, intravenous) |
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Solid form of oral medication |
tablets, capsules, pills |
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what is special about oral medications |
can be scored, can be enteric coated, and can be extended release |
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Liquid forms of oral medications |
elixirs, spirits, suspensions, syrups |
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why would we use liquid oral medication over the solid form |
sometimes a patient cannot swallow a solid form, place syringe of medication between the cheek and the gum and give slowly |
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what is the easiest and most desirable route for medications |
Oral Administration |
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Enteral or small-bore feedings |
verify tube location, follow ASPEN guidelines, use liquids when possible, if meds need to be w/ empty stomach - wait 30 min before and after feedings, drug-drug interaction risk is higher |
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Oral Route |
having patient swallow drug - stay with pt until med is swallowed, do not leave meds at bedside & only give 1 med at a time |
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Enteral Route |
administering meds through enteral tube |
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Sublingual Route |
placing drug underneath the tongue - should not be swallowed - may offer pt drink of water or oral care prior |
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Buccal Route |
placing the drug between the tongue and the cheek - should not be swallowed - may offer pt drink of water or oral care prior |
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what pills do we never crush |
Enteric - coated or extended release tablets or capsules |
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how should we measure liquid medications |
using a plastic measuring cup, while cup is placed on a flat surface - don't measure if cup not on flat surface |
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what position should the pt be in to take oral medications |
Semi- to High- Fowler's |
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what should we offer the patient if we are giving crushed medications and why |
some type of food to mix it with (applesauce, pudding or custard) - to kill the bad taste of the crushed up meds |
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how to administer meds with feeding tube |
flush tube (15/30mL of H2O), then give meds, flush the line with water between each med |
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what do we document for enteral/feeding tubes |
I/O's for both the water we used to flush and the medications |
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Types of Inhalation methods |
aerosol spray, mist, or powder via handheld inhalers |
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what are inhalation methods used for |
used for respiratory "rescue" and "maintenance" |
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pMDI's |
Pressurized metered-dose inhaler - need sufficient hand strength for use |
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BAI's |
Breath- Actuated metered-dose inhaler - release depends on strength of patients breath |
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DPI's |
Dry Powered Inhaler - activated by patients breath |
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rescue medications |
short-acting and are taken for immediate relief of acute respiratory distress |
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Maintenance Medications |
used on a daily schedule to prevent acute respiratory distress - starts within hours and lasts longer than rescue medications |
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Spacer for inhalers |
4-8" long tube that attaches to the pMDI and allows particles of medications to slow down and break into smaller pieces, which improves drug absorption |
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Skin Applications |
applying a transdermal patch - rubbing drug into skin |
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Instillation |
placing a drug into direct contact with mucous membranes (eye drops, ear drops, nasal sprays) |
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Irrigation |
flushing mucous membranes with drugs in solution (eye and ear irrigation) |
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Vaginal |
drug inserted into the vagina |
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Rectal |
drug inserted into the rectum |
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how to apply topical medications |
use gloves, clean pt skin, follow drug instructions - remove old patch, document patch location, ask about patches in history, document removal of patch - label the patch if it is difficult to read |
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Tuberculin Syringe |
used to prepare small amounts of medications |
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Insulin Syringe |
each U-100 of insulin contains 100 units of insulin |
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Carpuject Syringe |
holds prefilled, disposable, sterile needle units |
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what are the parts of a syringe |
plunger, barrel, and tip |
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parts of a needle |
Bevel, shaft, hub, and gauge number |
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what do we need to consider when selecting a needle and syringe |
route (SQ vs IM), site, age, size, viscosity of medications (aqueous vs oily), fluid volume, and type of medication |
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ways to prevent patient discomfort |
use a sharp needle, smallest length/gauge possible, proper injection site, apply topical anesthetic, divert patients attention, insert needle quickly and smoothly, hold syringe steady, inject medication slowly and steadily |
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Injection angle for Intramuscular Injections |
90 degrees |
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Injection angle for SQ injections |
45 degrees or 90 degrees |
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Injection angle for ID injections |
15 degrees |
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what should we know before injecting any type of medication |
volume of meds, characteristics/viscosity of solution, location site of injection |
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Sites of Intradermal Injections |
inner surface of forearm, upper back |
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types of needle for intradermal injections |
short and fine 1/4" - 1/2" - 26 or 27 gauge |
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what are intradermal injections used for |
TB test, allergy testing, sensitivity testing |
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Sites for Subcutaneous Injections |
abdomen ( costal margin to iliac crest), outer aspect of upper arm, anterior aspects of thigh, upper back, upper ventral or dorsogluteal area |
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what sites should we avoid for SQ injections |
bruised, tender, hard, swollen, inflamed, or scarred areas |
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Needles used for SQ injections |
3/8"-5/8" - 25 to 30 gauge |
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what volume should SQ injections hold |
0.5mL to 1.0 mL |
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what do we do to the skin when administering SQ injection |
Pinch skin or hold taut at the site |
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what volume should ID injections hold |
small amounts of fluid - under 0.5mL |
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what should we NOT do with SQ injections |
DO NOT rub the site of the injection |
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how should we inject the meds with a SQ injection |
1 mL per every 10 seconds during injection |
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how must insulin be injected |
only with an insulin specific type of needle |
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needle sizes for insulin/heparin/lovenox injections |
5/16"-1/2" - 28 to 30 gauge |
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fluid volume for insulin/heparin/lovenox injection |
0.3 - 1 mL sizes |
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how to administer heparin |
use abdomen, avoid area within 2" of umbilicus, gently pinch skin, insert injection at 90 degree angle into fat pad - DO NOT RUB INJECTION SITE |
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what is important to know about lovenox |
it is a prefilled syringe - DO NOT expel air bubble prior to administration |
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Needle sizes used for IM injections |
1/2"-1" - 22 Gauge (if pt is very obese, use 3" needle) |
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key points when giving IM injection |
stretch skin taut, "dart" to insert needle, aspirate, injection slowly and withdraw, gentle pressure over injection site, DO NOT massage area |
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Sites of IM injections |
vastus lateralis, ventrogluteal, deltoid, dorsogluteal |
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what is important to know about IM injections and the dorsogluteal site |
no longer recommended because of significant injury, pain, and paralysis due to damage of the sciatic nerve |
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things to know about the vastus lateralis site for an IM injection |
anterolateral aspect of thigh, no large nerves or vessels, does not cover a joint, preferred site for infants, divide thigh into thirds horizontally and vertically, injection given in outer middle third |
