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39 Cards in this Set
- Front
- Back
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Which age group is more at risk for experiencing medication errors?
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Children are 3x more at risk than adults! |
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How are nurses involved in medication administration?
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2. Administration 3. Evaluation of medication effects 4. Documenting patient response to treatment 5. Patient teaching including side effects 6. Ensuring adherence to the medication regimen 7. Evaluating the patient's or caregivers ability to self-administer |
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True or false: The Nurse Practice Act has no influence over nursing practice.
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FALSE! |
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What factors influence absorption?
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- Ability of the medication to dissolve - Blood flow to the site of administration - Body surface area - Lipid solubility of medication - Circulation - Membrane permeability - Protein-binding - Metabolism - Excretion |
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What are the three types of drug effects?
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- Therapeutic effects - Side effects - Adverse effects |
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Therapeutic effects
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The expected or predicted response |
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Side effects |
Predictable often unavoidable, related to normal therapeutic doses |
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Adverse effects |
Three types: toxic effects, idiosyncratic reactions, allergic reactions |
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Toxic effects |
- Type of adverse effect - Develop after prolonged intake of medication - Medication accumulates in the blood related to impaired metabolism or excretion |
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Idiosyncratic reactions |
Reaction other than normal (over or under reacts) |
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Allergic reactions |
Allergic response develops from a repeated administration |
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Anaphylactic reactions |
- Life threatening |
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Synergistic effect
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- i.e.: alcohol & antidepressants |
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Peak
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The highest level of medication concentration in the blood
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Trough |
- Usually drawn 30 minutes before time of administration |
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What is the difference between t.i.d. (three times a day) and q8h (every 8 hours)?
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- If a medication is prescribed 3 times a day (t.i.d.), that does not mean it is the same as q8h (every 8 hours). - 3 times a day medications should be administered during waking hours (i.e.: breakfast, lunch, dinner) - q8h is a more specific time of administration and should be followed more strictly (i.e.: 0600, 1400, 2200) |
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Half-life
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- Time it takes for the excretion process to lower the amount of unchanged medication by half - Time it takes for the body to get rid of (excrete) half the amount of drug originally administered |
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How is drug-receptor interaction affected by aging?
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Brain receptors become more sensitive, making psychoactive drugs very potent. |
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How is circulation affected by aging?
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- Vascular nerve control is less stable - Antihypertensives may overshoot, dropping blood pressure too low - Digoxin may slow the heart rate too much |
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How is metabolism affected by aging?
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- Liver mass shrinks - Hepatic blood flow and enzyme activity decline - Metabolism drops to 1/2 - 2/3 the rate of young adults - Enzymes lose ability to process some drugs, thus prolonging drug half-life |
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How is excretion affected by aging?
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- Renal blood flow, glomerular filtration rate, renal tubular secretion and reabsorption, and functional nephrons decline - Blood flow and waste removal slow - Age-related changes lengthen half-life for renally excreted drugs - Many drugs stay in the body longer |
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How is absorption affected by aging? |
- Absorption capacity of cells and active transport mechanism decline |
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How is distribution affected by aging? |
- Adipose stores increase - Total body water declines, raising concentration of water-soluble drugs (i.e.: digoxin) which can cause heart dysfunction - Plasma protein diminished, reducing sites available for protein-bound drugs and raising blood levels of free drug |
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Oral medication administration has a _________ onset of action and a ____________________ effect than parenteral.
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Slower; more prolonged |
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Sublingual means...
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under the tongue |
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Buccal means.... |
in the mouth against the cheek |
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What are the four types of parenteral medications?
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- Subcutaneous (SQ) - Intramuscular (IM) - Intravenous (IV) |
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What are other routes of medication administration?
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- Intrathecal (spinal cord) - Intraosseous (bone) - Intraperitoneal - Intrapleural - Intraarterial - Intraocular |
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Topical medications include...
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- Inserting into body cavity: suppositories - Irrigations: bladder - Instilling in nose or throat |
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CPOE
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- Reduces medication errors |
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What are the types of medication orders?
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- Verbal orders (preferably emergency only) - Telephone orders (must RBO and get signature within 24 hours) - PRN orders (as needed) - Single (One Time) orders: pre-op "on call" medication - STAT orders: to be given immediately, usually one time order - Now order: to be given ASAP - Prescriptions: to be filled at patient's own pharmacy |
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Should you delegate medication administration to an NAP/CNA?
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NOPE |
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Examples of medication errors include:
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- Administering the wrong medication - Giving the medication using the wrong route - Giving the medication at the wrong time - Administering extra doses - Failing to administer a medication |
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When an error occurs what is your priority as a nurse?
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Patient safety and well-being
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Medication Reconciliation
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Comparing the medications the patient took in a previous setting to the current medication orders |
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When should medication reconciliation occur?
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2. When a patient is received from another unit in the hospital 3. Upon discharge home or to another facility |
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When should you compare the label of the drug with the MAR before administering a medication?
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1. Before removing the med from its holding place 2. As the med is removed from the container 3. At the patient's bedside before administering |
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What information should you obtain before administering medication?
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- History - Medications - Diet - Perception/Coordination problems - Current condition - Attitude about medication use - Understands/adheres to medication therapy - Learning needs |
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Polypharmacy
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- Patient is taking multiple drugs - Puts patient at risk of adverse reactions and medication interactions |
