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97 Cards in this Set

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5 rights of drug administration
1)right patient
2)right drug
3)right amount or dose
4)right route
5)right time
Any prescription must have.
(5 things)
1)Pt's name, date, time order was written
2)Date and time or times drug is to be taken
3)generic or trade name of drug
4)dosage form and route of administration
5)dr's signiture
Can orders be taken verbally?
yes. must be signed by dr. in 24 hrs.
ex- John Doe, MD by Jane Doe, RN (VO)
meds given immediately.
written and signed by dr.
stat orders
given to pt. as necessary.
frequent pain meds.
PRN orders
meds only given once at designated time.
if meds are to be repeated, order must be written
single orders
order written and signed
written order
For needles, the smaller the lumen, the _____ the gauge.
larger
What dictates the size and gauge of a needle chosen for a pt?
*viscosity
*the pt need
Do you save medication if not all is used?
No, never.
Oral route
available in liquid, tablet, capsule
Specific directions with oral route
*pill with enteric coating(capsule) must not be crushed, cut, or chewed
*sublingual or buccal are uncoated and must not be given with water
*scored pills may be cut
Is a larger or smaller dose better?
larger- it ensures that some of the drug will remain to perform the intended effect
Parenteral
*all equipment besides gloves must be sterile
*skin must be prepped
*pt. should be observed 1 hr after injection
Types of parenteral drug administration
*intradermal
*subcutaneous
*intramuscular(IM)
*intravenous(IV)
Intradermal needle specs
*25 to 27 g 1/2 inch needle
*5 to 15 deg angle
Whelp will appear at injection site. (don't massage the area)
Intradermal
TB skin test is an example of ____.
Intradermal
Subcutaneous needle specs
*23 to 25 g 1/2 to 5/8 inch needle
*45 deg angle
*Injection given in outer aspect of upper arms, abdomen, scapula, ant. thigh
*Only small amounts of nonirritating drugs should be given (don't rub)
Subcutaneous
Intramuscular needle specs
*18 to 22 g 1 1/2" needle
(22 to 23 g 1" for very thin pt)
*90 deg angle
IM sites
*upper cheek, side or top of thigh, upper arm
On IM, what do you do with the needle before injection and why?
Aspirate the needle to be sure it is not in a vessel. If blood returns, pull out and find new location.
What can large doses be given with and why?
IM bc of good absorption due to good blood supply in area.
Used when immediate effect of a drug is needed or can't be injected without damaging body tissues.
Intravenous(IV)
What is the most hazardous method of drug administration and why?
Intravenous b/c once the drug is injected directly into the circulatory system the reaction to it is instantaneous.
Intravenous needle specs
18 to 20 gauge 1" long
Intrathecal needle specs
20 to 22 gauge 3 1/2" long
Venous catheter that is left in place in the vein for designated period of time but isn't attached to IV tubing
Heparin or saline lock
A small infusion which is attached to an adjoining or already existing line; when it has been fully administered the original IV solution is continued.
IV piggyback
A designated amount of drug is given at one time usually over a period of several minutes.
Bolus
Epidural is an example of a _____.
Bolus
A larger amount of drugs that is administered over a longer period of time (from hrs to days)
Infusion
4 things that influences the site of an IV.
1)type of drug
2)reason for giving drug
3)age of pt
4)condition of pt
2 things needed to discontinue and IV.
1)Dr.'s orders
2)clean cloves
Rules for choosing IV sites.
*2 tries, then pass off
*veins in hands and arms are better than legs
*don't use vein over a joint
Is RT licensed to dispense drugs?
no
Drugs that have the potential for abuse.
Controlled drugs
Controlled drug.
*Highest potential for abuse, not recognized for medical use.
Schedule I
Controlled drug.
*Written prescriptions by MD. No phone renewals unless emergency, then prescrip within 72 hrs.
Schedule II
Controlled drug.
*Prescriptions must be rewritten after 6 months or five refills. May be phone ordered.
Schedule III
Controlled drug.
*Prescriptions are required to be rewritten after 6 months or five refills.
Schedule IV
Controlled drug.
*Drugs my be dispensed as any non-narcotic prescription drug. Some may be purchased without prescription.
Schedule V
Heroine, LSD, marijuana, meth are examples of _____.
Schedule I
High abuse potential.
Codeine, morphine, amphetamines are examples of ____.
Schedule II
Less abuse potential.
Barbituris derivatives, codeine of less than 1.8 grains.
Schedule III
Chloral hydrate, meprobromate, phenoberbitals are examples of ____.
Schedule IV
Antitussives, antidiarrheals, codeine expectorants are examples of _____.
Schedule V
What is performed with smallest needle?
TB Skin Test
What is performed with longest needle?
Interthecal (spine)
Drugs considered safe for self-administration.
(OTC)Over-the-counter drugs
All drugs not safe for self administration must have _____ on the bottle?
the legend, caution: federal law prohibits dispensing without prescription.
Name given to a drug by the manufacturer. Same drug may have many _____.
Trade name
Exact chemical formula and always remains the same.
Chemical name
Name given to drug prior to official use-always remains the same.
*aka- official name
Generic name
When the drug begins its intended effect.
Onset of action
As the drug is absorbed it reaches a peak concentration level.
Maximum therapeutic response
The length of time a drug is in the body in amounts large enough to be therapeutic.
Duration of action
The time it takes for a drug removal from the body.
Clearance rate
The process that controls absorption, distribution, metabolism and excretion of drug by the body. The whole experience of taking a drug.
Pharacokinetics
Study of drug actions on and interactions with living organisms.
Pharmacology
Do all patients process drugs the same way?
no
Drugs must advance from its dosage form to a form that makes it available to be absorbed.
Drug absorption
Do form of drugs can be absorbed the fastest?
liquid
When a drug is absorbed and taken by the bloodstram to its intended site so it can begin to act.
Bioavailability
The amount of time needed to become bio available depends upon what?
*route of administration
*GI mobility
*dosage form
*interaction with food
*interaction with other drugs in pt's system
Examples of things that affect bioavailability.
*food in stomach
*other drugs in system
*altering the surface of a drug
*severe pain or stress
Which routes do not have first pass effect?
*sublingual
*vaginal
*parental
*buccal
The manner in which drugs are inactivated in the body.
Metabolis/Biotransformation
The center for most drug metabolism.
Liver
An altered metabolic state may allow a drug to _____.
accumulate in the body and produce an adverse reaction
What happens in biotransformation?
Drug is metabolized and changed into water-soluble substance.
Time it takes for 50% decrease in a drug's presence in the body.
Half-life
To maintain a ______ the same amount of a drug must be taken in as it eliminated in each 24 hrs. period.
steady-state concentration
The study of the change in normal physiological function of the body due to a drug.
Pharmacodynamics
Pharmacodynamics may cause alterations in ____?
*BP
*heart rate
*urinary output
* response of central nervous system
Reactions that may take weeks or months to happen or can be immediate.
Adverse drug reactions
Unintended effect and essentially harmless action resulting from a drug.
Side Effects
Harmful side effect
Adverse-Reaction
Drowsiness, allergic or hypertensive reactions. Some drugs may produce blood dyscrasis, bleeding or thrombosis.
Adverse-reactions (immediate)
3 Routes of Drug Administration
1)Enteral
2)Parenteral
3)Topical
Types of Internal Admin.
*oral
*sublingual or buccal
*rectal
Usually most efficient and cost-effective if slower absorption and longer duration are desired.
Oral
Fastest absorption of the enteral route.
Sublingual or buccal
Used if n&v is a problem and pt can't retain meds, a disadvantage is an accurate amount of dosages if difficult.
Rectal
Administration that requires surgical aseptic technique invasive procedure.
Parenteral
Administration through the GI tract.
Enteral
5 types of Parenteral admin.
1)Intradermal
2)Subcutaneous
3)Intramuscular
4)Intra-arterial
5)Intravenous
In Parenteral, the most rapid response. Most often used in administration contrast agent in rad.
Intravenous
Drug administration through skin, eyes, nose, throat, vaginal, rectal, mucosa.
Topical
Topical drugs(hormones) applied for systemic effect. (Skin ailments and systemic treatment)
Transdermal
Chosen selectively for use according to their ability to inhibit or destroy particular bacteria, fungi, protozoa, viruses or other parasites.
Drugs used to treat infections
Iodinated contrast media
*a feeling of flushing or warmth, nausea, headache, pain
--response--notify nurse/dr., apply warm compress, watch pt.
Side effects
Iodinated contrast media
*itching of nose or eyes, anxiety, cough, hives
Minor reactions
Iodinated contrast media
*stop injection, call nurse, stay with pt.
Response
Iodinated contrast media
*vomiting, coughin, difficult breathing, chest pain
--response--stop injection, call nurse/dr., place in semi-fowlers, call Dr. Heart
Secondary reactions
The drugs that RT works with the most.
Intravascular & Iodinated Contrast Media