Term
| A client tells the nurse, “This pill is a different color than the one that I usually take at home.” Which is the best response by the nurse? |
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Definition
| “I will recheck your medication orders.” |
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Term
| The primary care provider prescribed 5 mL of a medication to be given deep intramuscular for a 40-year-old female who is 5’7” tall and weighs 135 pounds. Which is the most appropriate method of administration? |
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Definition
Two 3-mL syringes, #20–#23 gauge, 1 1/2-inch needle
Rationale: Five milliliters is too large an amount to inject into one site. The nurse needs to divide the amount into two 2.5-mL injections. A 3-mL syringe could be used. The length of the needle will depend on the muscle development of the client. The nurse needs to assess the client. The presumption, based on the information provided, is that this client’s muscle mass is within normal limits. The needle length would need to be 1 1/2 inches because the medication is ordered to be given “deep IM.” This also suggests that the medication should be given in the preferred site for IM injections—the ventrogluteal site—because it provides the greatest thickness of gluteal muscle. The gauge of the needle for an IM injection into the ventrogluteal muscle can range between #20 and #23. The nurse needs to assess the viscosity of the medication. Smaller gauges (e.g., #23) produce less tissue trauma; however, viscous solutions may require a larger gauge (e.g., #20–#21). |
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Term
| The nurse is to administer 0.75 mL of medication subcutaneously in the upper arm to a 50-year-old 300-pound client. The nurse can grasp approximately 2 inches of the client’s tissue at the upper arm. Which is the most appropriate for the nurse to use? |
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Definition
2-mL syringe, #25 gauge, 5/8-inch needle
Rationale: The type of syringe for subcutaneous injections depends on the medication to be given. Generally a 2-mL syringe is used for most subcutaneous injections. Generally, a #20- to #23-gauge needle is used for IM injections. Needle size and length are based on the client’s body mass, the intended angle of insertion, and the site of the injection. Generally, a #25-gauge, 5/8-inch needle is used for adults of normal weight and the needle is inserted at a 45-degree angle. Because 2 inches of tissue can be grasped or pinched at the site of the injection, the nurse should administer the medication at a 90-degree angle to ensure the medication reaches subcutaneous tissue. |
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Term
| The nurse is to administer a tuberculin test to a 22-year-old male who is 6 feet tall and weighs 180 pounds. Which is the most appropriate for the nurse to use? |
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Definition
:
A tuberculin syringe, #25–#27 gauge, 1/4- to 5/8-inch needle
Rationale: A tuberculin test is given by intradermal injection. A tuberculin syringe is used because the dosage will most likely be 0.1 mL. A short, fine needle is needed to avoid entering the subcutaneous tissue. The needle should have a short bevel and usually be between #25 and #27 gauge. The needle should be between 1/4 to 5/8 inch long. |
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Term
| The nurse is to administer 0.5 mL of a medication by intramuscular injection to an older emaciated client. Which is the most appropriate for the nurse to use? |
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Definition
2-mL syringe, #20–#23 gauge, 1-inch needle
Rationale: If the nurse goes by the amount of the medication (0.5 mL) only, the deltoid muscle would be the site. However, knowing and assessing the client is critical. The muscles of an older, emaciated client will most likely be diminished or atrophied. The nurse should consider the ventrogluteal site because that site will have the most muscle mass. |
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Term
| An older client with renal insufficiency is to receive a cardiac medication. Which is the nurse most likely to administer? |
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Definition
A decreased dosage
Rationale: Due to renal insufficiency, the dose of the medication would need to be decreased in order to avoid accumulation of the medication and the risk of toxicity. |
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Term
| Proper administration of an otic medication to a 2-year-old client includes which of the following? |
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Definition
Pull the ear down and back.
Rationale: To straighten the ear canal in children less than 3 years of age, the ear must be pulled down and back. In individuals over 3 years of age, the ear is pulled up and back. |
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Term
| when medications act on receptors they do which of the following? (select all) |
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Definition
-mimic the action of the body's own hormones
-block the action of the bodys own compounds |
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Term
| After an oral medication has been absorbed, most of the medication is inactivated as the blood initially passes through the liver, producing little therapeutic effect. What is this called? |
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Definition
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Term
| intravenous administration of a medication eliminates the need for _____. |
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Definition
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Term
| what equipment is needed for a intradermal injection? |
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Definition
| a tuberculin syringe with a fine gauge needle (26-27) |
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Term
| what equipment is needed for a subcutaneous injection? |
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Definition
| a short, fine gauge needle (3/8 in to 5/8 inch, 25-27 gauge) |
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Term
| what equipment is needed for a intramuscular injection? |
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Definition
| Needle size 18 to 27 (101.5 inch, 22-25 gauge) |
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Term
| what equipment is needed for a intravenous injection? |
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Definition
| 16-24 gauge catheters appropriate for most adults, smaller-gauge catheters appropriate for infants and children |
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Term
| Correct client position for oral medication administration |
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Definition
| siting, semi-fowlers of Fowlers |
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Term
| Correct client position for otic medication administration |
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Definition
| client lying on side with the ear that is receiving the drops facing up |
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Term
| Correct client position for vaginal medication administration |
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Definition
| Supine with the knees bent, the feet flat on the bed and close to the hips |
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Term
| Correct client position for rectal medication administration |
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Definition
| lying on the left side with the right knee brought up towards the chest (sims Postition) |
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Term
| A nurse prepares an injection of morphine. to give to a client who reports pain. Prior to administering the medication, the nurse is called to another room to assist another client onto a bed pan. this nurse asks a second nurse to give the injection so that she can help the client needing the bedpan. What action should the second nurse take? |
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Definition
Offer to assist the client needing a bedpan.
only the nurse who prepared the medicine should administer it |
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Term
| When can you give a medicine that is ordered at a specific time? |
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Definition
| within 30 min of the scheduled time |
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Term
| What should you do if a single dose of a med requires administering multiple tablets? |
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Definition
| Check with the provider, its possible an error occurred in the transcription of the order |
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Term
| In what step of the nursing process would you Identify client allergies? |
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Definition
| Assesment/data collection |
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Term
| In what step of the nursing process would you determine client outcomes? |
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Definition
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Term
| In what step of the nursing process would you follow the 10 rights of medication administration consistently? |
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Definition
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Term
| In what step of the nursing process would you recognize side/adverse effects? |
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Definition
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Term
| what are the nurses responsibilities when implementing medication therapy? |
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Definition
-observing for medication side effects
-monitoring for therapeutic effects.
-maintaining an up-to-date knowledge base. |
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Term
| A nurse is performing an ear irrigation. Which nursing action is correct? |
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Definition
| The nurse explains to the client that he may experience a feeling of fullness, warmth and, occasionally, discomfort when the fluid come in contact with the tympanic membrane. |
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Term
| when evaluating a clients understanding of administering a vaginal foam, the client says "I will remain lying in a supine position for 2 minutes following insertion of the vaginal foam." What is the problem with this statement? |
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Definition
| the client should remain in the supin position for 5-10 minutes, not 2. |
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Term
| what do you measure insulin in? |
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Definition
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Term
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Definition
- Safe, rapid absorption
- Middle third of the muscle
- Mid-lateral portion of the thigh
- Infants, children, adults
- Needle 1" or less |
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Term
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Definition
- Immunizations and non-irritating meds
- Less than 2 mL
- Risk injury to brachial artery and radial nerve
- Acromium process
- Index and middle finger
- 1-2" below acromium in center of triangle |
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Term
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Definition
| Med that is kept locked up, controlled substances. May require special inventory form for recording use of controlled substances. The info required usually includes the name of the client, time and date of the administration; name of the dug dosage, signature of person who administered med. Verification requires two nurses. |
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Term
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Definition
| Desired effect: the primary effect intended, that is, the reason the drug is prescribed. |
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Term
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Definition
| secondary effect: effect of a drug that is not intended. |
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Term
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Definition
| more severe side effects. |
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Term
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Definition
| an immunologic reaction to drug |
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Term
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Definition
| Deleterious (toxic) effects of a drug on an organism or tissue. Results from over dosage, ingestion of a drug intended for external use and build up of the drug in the blood. |
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Term
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Definition
| Inraepidermal vesicle rash, uricarial wheal, or macular eruption |
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Term
| When is the highest threat level of taking drugs during pregnancy? |
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Definition
| 1st trimester, due to the vital organs and functions of the fetus during this time most drugs are contraindicated because of the possible adverse effect on the fetus. |
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Term
| facts about older adults and medications |
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Definition
different responses to drugs due to physiological changes that accompany aging. Changes include decreased liver and kidney function, which can result in an accumulation of the drug in the body. Also, older adults may be taking multiple drugs and they may not be compatible.
may experience decreased gastric motility and decreased gastric acid production and blood flow which can impair drug absorption, increased adipose tissue and decreased total body fluid proportionate to the body mass can increase the possibility of drug toxicity |
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Term
| oral route of administration |
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Definition
most common least expensive and most convenient route because drug is swallowed and there’s no break in skin, oral is a safe method.
Major disadvantage: possible unpleasant taste, irritation to gastric mucosa, irregular absorption from the GI tract, slow absorption and some cases can be harmful to clients teeth. Ex: liquid iron can stain teeth |
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Term
| sublingual route of administration |
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Definition
| goes under tongue where its absorbed. Med is largely absorbed into blood vessels under tongue in relatively short time. Ex: nitroglycerin. Sublingual meds should not be swallowed. |
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Term
| buccal route of administration |
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Definition
| pertaining to cheek. Med usually pill is held in mouth against mucous mbrane of cheek till drug is dissolved. Drug may act locally on the mucous membranes of the mouth or systemically when it is swallowed in the saliva. |
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Term
| parenteral route of administration |
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Definition
| other than through the alimentary (digestive)(Mouth to Anus) or respiratory tract; that is by needle |
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Term
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Definition
| means med must be given immediately and only once ( ex: Demerol 1—mg IM stat) |
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Term
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Definition
| one time order; to be given once at a specific time (ex: Seconal 100 mg hs before surgery) |
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Term
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Definition
| may or may not have a termination date standing order may be carried out indefinitely ex: supplemental vitamins) until an order is written to cancel it, or it may be carried on for a specific numbers of days(ex: Demerol 100 mg q4hrX5days) some agencies will automatically cancel an order after a certain amount of days and a new order will have to be given to give med. |
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Term
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Definition
| as needed order: permits the nurse to give a med when in the nurses judgment the client requires it (ex: ampho 15 mL prn) the nurse must give good judgment about when med is needed. And when it can be given safely MAKE SURE YOU KNOW WHEN THE LAST DOSE WAS GIVEN. |
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Term
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Definition
Med
Dose
Time
Route
Client
Education
Documentation
Refusal
Assessment
Evaluation |
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Term
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Definition
1. Read MAR, remove med from client’s drawer verify pt name & room # match MAR compare med label against MAR determine if math calc is needed, check expiration date
2. While preparing med(pouring up placing unopened package in med cup)check med label with MAR
3. Recheck label on container (vial bottle, unused, unit dose med,)before returning to storage or check med label with Mar before opening package at bedside. |
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Term
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Definition
1. Read MAR, remove med from client’s drawer verify pt name & room # match MAR compare med label against MAR determine if math calc is needed, check expiration date
2. While preparing med(pouring up placing unopened package in med cup)check med label with MAR
3. Recheck label on container (vial bottle, unused, unit dose med,)before returning to storage or check med label with Mar before opening package at bedside. |
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Term
| Method of determining length |
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Definition
| pinch the tissue at site and select length that’s half the width of skinfold |
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