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88 Cards in this Set

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blood serum concentration of a medication reached and maintained after repeated fixed doses
plateau
An Effect that is Intended or predicted physiological response
Thearapeutic Effects
Drugs will cause unintended secondary effects.
-May be harmless or cause injury
-Often stop taking med's
Side Effects
Something different alwaysis possible, opposite effect then what was intended.
Idiosyncratic Reaction
Idiosyncratic Reaction
After prolonged intake of high doses of med's, or when drug accumulates in the body, b.c. of the impared metabolism or excretion.
Toxic Effects
greater effects of 2 drugs combined.
-May be desired: Diurectics & Vasodilaors to lower Bp
-May be undesire:Alcohol & Narcotics
Synergistic Effects
Drug Dose Response
After drug is administered it undergoes
-Absorption
-Distrubution
-Metabolism
-Excretion
-Easiest
-Slowest onset of action and more prolonged effect
Oral Route
Sublingual Application
Placed under the tongue
Buccal Administration
Placing solid medication n mouth against the mucous memebrance of the cheek until it dissolves
Exposure to inital dose may cause an immunological response
Drug acts as an antigen which causes antibodies to be produced
Allergic reaction
Allergic reaction
Raised irregular shaped skin eruptions with varying sizing and shapes eruptions have reddened margins and pale centers.
Urticaria
Small raised vesicles that are usually reddened often distrubuted over the entire body
Rash
Itching of the skin accompanies most rashes.
Pruritus .
inflammation of mucous membrane lining nose causes swelling and clear watery discharge
Rhinitis
An application to mucous membrane
Topical
Ex: Eye gtts,Ear gtts, Nasal spray,Bladder and Rectal installation
Respiratory Tract
Large rich surface area for drug absorption.
-Some are designed to have local effects
*bronchodilators
Inhallation
Parental Routes
Injecting Med's into body tissue.
ex;ID,IM,IV,SubQ
injection into the dermis just under epidermis
Intradermal Route ID
injection Into the muscle
Intramuscular Route IM
injection into the vein
Intravenous Route IV
injection into the tissue below the dermis of the skin
Subcutaneous SUB-Q
Allergic Response
Common or Mild
Ex: Hives,eczema,rash,pruritus,rhinitis,urticaria,wheezing
-Severe
Ex:Anaphylactic Reaction
severe sudden constriction of bronchioali muscles,edema of pharynx & larynx with severe wheezing and shortness of breathe
Anaphylactic Reaction
Alcohol and opiates are common forms that react to slow metabolism and cause a need for increased dosage.
Drug Tolerance
One drug modifies the action of another
-May potentiate or diminsh the action other drugs
Drug Interaction
-For seizure treatment
-Administered by mouth or IV pushin large doses
-Affects rhythms of the heart
Dilantin
A substance used in the diagnosis treatment cure relief or prevention of diease.
Drug
Given by the manufacturer who irst developed the drug
ex:aspirin and Tetracycline HCl
-may have different names
Generic name
Brand Name or proprietary name under which a manufacturer markets a drug
Trade name
indicates the effect on the body system, systems relieved or desired effects.
-May belong to more than one
ex: Aspirin-analagesic,antiinflammatory,anticlor,antipyretic

Drug Classification
Drug classification
ex: Aspirin-analagesic,antiinflammatory,anticlor,antipyretic
Does not create a function in a tissue or organ but rather alters physiological functions
-Alters body fluids,cell membrances or interacts with receptor sites.
Drug
Study of how drugs enter the body, reach their site of action are metablized and exit the body
Pharmacokinetics
Passage of drug molecules into the blood
-most drugs enter systemic circulation to exert therapeutic effects except topicals
Absorption
Factors-
-Route of admistion
-Ability to dissolve
-Conditions at site of absorption
after drug is absprbed it is sent to the tissues and organs and ultimately to the specific site of action
Distrubition
Factors
-physical & chemical properties of drugs
After drug reaches its site of action it is broken down into an inactive form that is more easily excreted aka Biotransformation
Metabolism
after metabolism drugs exit the body trhough the kidneys,liver,bowels,lungs & exocrine glands chemical makeup of drug determines the organ of excretion
Excretion
Time it takes for a medication to reach highest effective concentration
Peak
Time it takes after medication is administrated for it to produce a response
Onset
Minimum blood serum concentration of medication reached just before the next schedule dose.
Trough
Trough
time during which the med's is present in concentration great enough to produce a response.
Duration
The 6 Rightsof Medication Administration
-Medication
-Dose
-Client
-Route
-Time
-Documentation
A type of order that is carried out until MD cancels it or until the prescribed number of days elapse.
Standing Orders
MD may order drug on a when necessary basis. Nurse decides need
MD sets max intervals for time administration.
PRN Orders
PRN Orders
One time order
One dose
eg; pre operative order
Single Orders
Single Orders
Single dose of medication to be given immediately and only once
Stat Orders
up to an hour to give the meds
Components of a Drug order
-Clients full name
-Date order is written
-Drug name
-Dosage
-Route of administration
-Time and frequency
-Signature of MD or NP
Injection technique
Nurse needs to know the volume to be administered.
-drug characteristics & viscosity
-location of anatomical structures underlying injection site.
Technique Failure
-Nerve or bone damage
no aspiration- vein or artery
too large of volume-pain and local tissue damage
Subcutaneous Site
-Vascular and easily accessible
-Sites require rotation
-abdominal wall best for Heparin
Heparin
Anticoagulant
-used to treat or prevent clots in the veins, arteries, lungs, or heart.
-stops clots from forming or getting bigger.
Sub Q Amount
only small doses 0.5 to 1ml of fluid
medication can collect within the tissue causing sterile abscess' hardened painful lumps under the skin.
Sub Q Needle
25 guage - 5/8 inch needle
@ 45 degree but not always

Obese pts pinch tissue and make sure needle is long enough. preferred need length 1/2 inch width of skin fold.
Sub Q Sites
Abdomen
-Lateral upper arm
-Deltoid
Upper Back below Scapula
-Ventrogluteal
-Vastus Lateralis
IM Amount
well developed client can tolerate 3 ml of fluid in large muscles

Child & Elderly - less than 2ml
IM Sites
-Rectus Femoris
-Vastus Lateralis
-Ventrogluteal-best site bc no vessels
-Dorsogluteal
Deltoid -small amounts only
IM Factors
Assess site before injecting
-look for hardened lesions
-free of infection
-Bruising,abrasion
-check underlying bones, nerves,major blood vessels
Z track technique
-New needle after drawing up drug
-add 0.2 ml air lock
-pull skin 1 to 1 1/2 in to side
-apirate and inject
-withdrawl needle
-release skin & seal needle track
Vistaril
AKA Hydroxyzine
Antihistamine
-treat allergy symptoms, anxiety and tension
ID Sites
used for allergy testing
-inner forearmor upper back
ID Syringes
-come in sizes 1-50 ml
-2-3 ml for IM or SUBQ
-More than 5ml for injection(uncommon)
insulin -100units/1ml
TB-1ml
Parts of a Needle
-Hub
Must remain sterile
-shaft
-bevel
Needle Size
according to size of pt.
-weight & tissue injected

General
-1 to 1 1/2 in -IM
-3/8 to 5/8 in - Sub Q
Needle Gauge
-Smaller the gauge the larger the needle diameter
*16 -18 blood products
*19-23 IM depends on viscosity
*25 SubQ
*26 ID
vacuum packed and will need to be inserted equal amounts of air before withrawled from container
Amples and Vials
Insulin
Mixed
NPH-Cloudy addition of a protein which slows absorption
Regular-clear
Insulin mixed
Must be given with in 5 mins of prep time bc binding will occur and reduce the effectiveness of the short acting insulin

Always draw up short acting insulin first so it will not become contaminated with long lasting insulin and slow down reaction time.
Contraindications for Oral Route
Liver or Renal function
ability to swallow/cough/gag
vomitting or nausea
bowel inflammation
Preparing medication
-One client at a time
-select correct med
-compare label with MAR
-check calcuation dose
-double check with another nurse if needed
-narcotics ( check Count)
-take meds to client at correct time within 30mins before/after
-2 identifiers, clients name and Identification number on MAR print out and ID Bracelet.
ask pt to state name for 3rd identifier.
-evaluate clients response to meds on onset peak and duration.
pill crushing device
mortar and pestle
nasal instillation
effective for treating sinus infections
-severe nose bleeds are treating with packing and epinephrine to reduce blood flow
-artificial tears and vasoconstrictors
ex Visine & Murine
Eye Instillation
Intraocular Administration
medication delivered that resembles a contact lens
ex pilocarpine
Nasal installation drops into the ethmoid or sphenoid sinus
lay supine and Tilt head back
use pillow or head over the edge of the bed
Nasal installation drops into the frontal and maxillary sinus
lay lateral with head tilted to the side
use pillow or head over the edge of the bed
POsition of body for ophthalmic installation
supine or sit back in chair with head hyperextended
Eye drops installation
-Have pt look at ceiling
dominant hand resting on clients forehead hold med dropper 1-2cm 1/ inch-3/4 inch from conj. sac
-have pt closes eyes after
-apply pressure from 30-60 sec
(only for systemic effect)
eye oinment installation
have pt look at ceiling
-apply ointment from inner to outer canthus
-have pt close eye and rub lid lightly in circular motionswith cotton ball
-if rubbing is not contraindicated
vaginal installation
oval shaped suppositories foams,jellies or creams
Rectal installation
thinner and more bullet shaped suppositories
-promotes defecation or systemic effects
-somes times enema used first then suppository
albuterol
a beta-adrenergic agonist bronchodilator
-Lacks major nerves and blood vessels
-Rapid drug absorption
-used in infants immunizations
Vastus Lateralis
-Deep site away from major nerves andblood vessels
-less chance of contamination from incontinence
-easily identified by bony prominent landmarks
-perferred site for meds that are in larger volume
Ventrogluteal
-Easily accessible but not well developed in all pt.
-small amounts of medications
-not used in children or infants
-recommended site for hepB and rabies.
Deltoid
Intramuscular injection site
Vastus Lateralis injection
use mid third of injection of the thigh
Deltoid injection
-1-2 inchs below acromion process(3 fingers below)
-not well developed in
many adult, risk of potential injury
-SMALL INJECTION VOLUME
Do not use this site due to risk of hitting sciatic nerve.