Term
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Definition
| the layer of skin below the epidermis, contains blood/lymphatic vessels, nerves glands and hair follicles |
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Term
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Definition
| a small sterile glass container that contains a single dose of a drug solution |
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Term
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Definition
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Term
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Definition
| the superficial avascular layers of the skin |
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Term
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Definition
| into the dermal layer of the skin |
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Term
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Definition
| general term for medicinal compounds that are prepared from living organisms (Serums, vaccines, antigen, antitoxins, interferon, natural blood products) |
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Term
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Definition
| any substance that when taken into a living organism may modify one or more of its functions (alcohol, caffeine, OTC, Rx, illegal substances) |
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Term
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Definition
| branch of science dealing with all drugs |
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Term
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Definition
| druggist, one who is licensed to prepare and dispense drugs |
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Term
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Definition
| study of drugs and their actions |
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Term
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Definition
study of the motabolism and action of drugs
Emphasis on absorption, action, distribution and excretion |
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Term
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Definition
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Term
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Definition
| info concerning the standards for drug purity. Strength and direction for synthesis (Recipes to prepare drug) |
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Term
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Definition
| having medicinal or healing properties |
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Term
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Definition
| the branch of medicine concerned with the prevention of diseases and treatment of suffering |
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Term
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Definition
| study of toxic substances |
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Term
| Complimentary and alternative therapies |
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Definition
| natural plant extracts, herbs, vitamins, dietary supplements (These may be utilized with acupuncture, hypnosis, biofeedback, and massage) |
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Term
| What are the 4 Sources of drugs? |
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Definition
Animal- insulin, serums, antivenom
Plant- cocaine, morphine, digoxin
Mineral- iodine, aluminum hydroxide, calcium
Synthetic- manmade drugs, antibiotics, chemotherapeutic agents |
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Term
| What are the different names for drugs? |
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Definition
Chemical Name- Standard nomenclature established by the international Union of Pure Applied Chemistry (IUPAC
Generic Name- drug name assigned by the US adopted Name council. Less complicated easier to remember than chem.
Trade name or proprietary name- name assigned by the company marketing the drug. Also called brand name or product name |
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Term
| What are the types and forms of drugs? |
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Definition
Enteral Drug -Takes advantage of the vast absorptive surfaces of the oral mucosa, stomach or small intestine (Tablet, capsule, or liquid; sublingual, buccal, nasogastric & gastrostomy
Topical Drug Admin- Applied to skin or membranous linings; dermatologic preparations, instillations and irrigations, inhalations (Transdermal, Orthalmic otic nasal drops vaginal rectal)
Parenteral Drug Admin- Dispensing of med by routes other than oral or topical (Intradermal, IM, Sub-Q, IV) |
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Term
| what are the different classifications of drugs? |
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Definition
Indicates the effects of the drugs on a body system
Indicate the symptoms it relieves
Indicates the drugs desired effects
Each class contains drugs that are prescribed for similar health problems
A drug may be part of more than one class |
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Term
| What are the organizations that govern drugs and how does each organization govern drugs? |
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Definition
FDA- Food and Drug Administration- determine the safety of drugs before they are marketed. Protects the public, determines drugs to be available OTC
Center for Drug Evaluation and Research (CDER)- facilitates the availability of safe, effective drugs, keep unsafe drugs off the market, provides clear info to the public for safe use
FTC- Federal Trade Commission, control advertising of drugs, look at false or misleading info
DEA- Drug Enforcement Administration, enforces the Controlled Substance Act. Researches dangerous drugs and monitors for drug abuse |
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Term
| What is the Controlled Substance Act? |
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Definition
| Designed to regulate drugs into 5 categories according to potential for abuse. Provides strict controls on both the dispensing and administration of these meds. |
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Term
| What are the different drug schedules under the Controlled Substance Act and what do they mean? |
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Definition
I. High Potential for Abuse: not for medicinal use in USA lacks accepted safety (LSD, marijuana, peyote, heroin)
II. High Potential for Abuse: accepted use in USA. Abuse may lead to psychological and physical dependency.(amphetamines, morphine, meperidine, etc)
•III. High potential for Abuse, less than group I or II: accepted medicinal use. Low to moderate physical dependency (Tylenol with codeine, etc)
IV. Low Potential for Abuse: accepted medicinal use, limited dependency (valium, chloral hydrate, etc)
V. Low Potential for Abuse, less than group IV: accepted medicinal use, limited dependency (terpin hydrate with codeine, lomotil, etc) |
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Term
| How does the Controlled Substance Act affect practice? |
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Definition
• Physicians have a registration number allows for ordering and restricts amount of drugs prescribed
• In facilities these drugs are kept where they are locked up. “Controlled Drugs” |
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Term
| What are the Client Rights to Medication Admin? |
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Definition
• Informed of med name, purpose, action, side effects
• Right to refuse (ask 3 times)
• To have qualified staff to assess hx, allergies, use of herbals
• Advised of experimental nature of therapy and give written consent
• Received labeled meds with regards to six rights
• Receive supportive therapy
• Right to receive unnecessary medications
• Informed if meds are part of a research study |
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Term
| What are the 6 rights to med admin? |
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Definition
• Pt
• Med
• Route
• Dose
• Time
• Documentation (double document of PRN, omit/refuse follow up 30 min-hr) |
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Term
| What are the Ten Nursing Responsibilities with medication preparation and administration? |
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Definition
o Medication History
o Check the med order
o Know the drug and the patient
o Use safety measures with preparation
o Transport safely
o Identify the patient
o Administer the drug
o Chart
o Manage omitted or refused drugs
o Manage med errors |
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Term
| Describes the action of a drug as it moves thru the body. (Four components of Pharmacokinetics) |
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Definition
Absorption: the process in which the medication enters the bloodstream. The rate of absorption is affected by: Route of administration,Acid-Base Environment, Drug solubility, Permeability,Site of administration
Distribution: the process of delivering the medication to the target cells and the tissue. Bioavailability: a measurement of the extent of a therapeutically active drug that reaches the systemic circulation and is available at the site of action (One way to measure bioavailability is peak and tough levels)
Metabolism: drug metabolism is the alternation of a drug by the body. Biotransformation/metabolism synonymous. Chemical changes occur to convert the drug to a less active form that is easier to excrete. Liver is the primary site of drug metabolism, although kidneys and cells of the intestinal tract have high metabolic rates
First-pass effect: large number of oral drugs is inactivated by hepatic metabolic reactions.
Excretion: the process by which the byproducts of metabolism are eliminated from the body. Metabolites are the byproducts of the drug (Organs for excretion=liver, kidneys, skin, lungs) |
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Term
| How do drugs work in the body? (3 ways) |
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Definition
| inhibit, stimulate, and replace |
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Term
| What are therapeutic effects? |
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Definition
| desired or intentional effects of a particular drug. Can be local or systemic |
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Term
| What variables affect desired outcome? |
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Definition
• Clients physical condition
• Length of time the med has been taken
• Interactions with other meds of foods
• Side effects: also called adverse affects, are unintentional or usually harmless. Some side effects may be undesirable and then cause noncompliance
• Educate the patient to side effect |
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Term
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Definition
| a substance that tends to nullify the action of another, as a drug that binds to a cell receptor without eliciting a biological response |
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Term
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Definition
| building up of the drug affect. Client is unable to metabolize the drug before the next dose is given |
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Term
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Definition
| the patient is unusually sensitive. Requires not much of the drug to severe side effects |
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Term
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Definition
| when a person exhibits an abnormal or particular response to a drug, it is called an idiosyncratic response to that drug |
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Term
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Definition
| occurs when two drugs are taken together and one of them intensifies the action of the other |
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Term
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Definition
| similar to potention. If two drugs are taken together that are similar in action, such as barbiturates and alcohol, which are both depressants, an effect exaggerated out of proportion to that of each drug taken separately at the given dose may occur |
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Term
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Definition
| to a drug develops when the response to the same dose of the drug decreases with repeated use |
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Term
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Definition
| the systemic effect of drug that are related to the overall level of medication in the blood stream |
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Term
| what factors affect drug action? |
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Definition
• Age: very young, very old
• Circulation
• Gender
• Genetics
• Organ function
• Pregnancy
• Psychological state
• Route
• Time
• Tissue condition
• Weight |
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Term
| How does a nurse prevent reactions with the elderly? |
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Definition
o Weigh the patient, prepare by weight if necessary
o Check dose carefully
o Realize dose is/ may be smaller that norm for an adult
o Check labs for renal function (creatnine level)
o Monitor effects or poly pharmac |
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Term
| How does a nurse prevent reactions with children? |
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Definition
o Age, some meds are not given under a specific age
o Developmental considerations, pills vs. liquid games
o Metabolic rate
o Weigh the patient, prepare by weight if necessary
o Check dose carefully
o Realize dose is/ may be smaller that norm for an adult
o Check labs for renal function (creatnine level)
o Monitor effects or poly pharmac |
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Term
| How are drug orders written? |
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Definition
o Name the drug
o The dosage
o Route
o Frequency |
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Term
| What are the different types of drug orders? |
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Definition
o Standing orders (if patient needs them the nurse can utilize them)
o PRN order: as needed
o One-Time order (given only once)
o Routine order (scheduled)
o Stat order
o Telephone and verbal order (ask dr. to write order for verbal; give physician direction, get order and document as: phone order Dr. Smith/S. Sharpe PNS)
o Written orders/Computer orders |
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Term
| what factors does a nurse need to assess before administering meds? |
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Definition
o Know your client allergies
o Know your drug, look it up! Never give a drug that you do not know what it is
o Recognize the reason why this drug is to be used for the client
o Be familiar with therapeutic effect, usual dose, anticipated changes in lab values, side effects
o Do you know how to administer the drug?
o Why is it important to know and obtain history regarding client allergies? |
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Term
| what are the nurses responsibilities with a drug error? |
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Definition
o Check and assess the patient
o Notify the charge nurse
o Notify the physician
o Document
o Variance report |
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Term
| What does a nurse document about med admin in a pt's MAR? |
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Definition
o Document one pt at a time
o Document as you set-up (PIP)
o Documentation includes: time, route, site, initials, and signature
o Document all PRN’s on MAR and nurses notes plus response to the medication (reassess in 30-45”)
o Document side effects
o Document if not given and why |
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Term
| What info about a newly prescribed drug is covered with a client? |
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Definition
o Drug interactions (with other drug or with food)
o Timing
o Alcohol use
o Smoking
o Follow-up lab work
o Renewing prescription
o Allergies
o When and where to seek additional information |
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Term
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Definition
severe allergic reaction, potential for vascular collapse
Treatment: epinephrine, antihistamines, steroids, IV fluids |
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Term
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Definition
| capable of killing bacteria |
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Term
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Definition
| limits the production of bacteria, slows the growth |
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Term
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Definition
| covers a wide variety of bacteria activity |
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Term
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Definition
| lesions of the skin caused by a drug, urticaria or hives most predominant type. |
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Term
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Definition
| decreased # of WBC, may be drug induced |
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Term
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Definition
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Term
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Definition
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Term
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Definition
toxic to the kidneys, ie: gentamicin, toramycin
Monitor renal function with creatinine every 3 days (1.8 or less than 2) |
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Term
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Definition
toxic to the acoustic nerve, ie: ASA, vancomycin, streptomycin
Monitor hearing/balance with audiometer and EENT specialist
Aspirin causes tinnitus (ringing in ears, may be permanent) |
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Term
| What are the percations when setting up special meds with group medications? |
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Definition
• Separate all meds needing assessment such as AP/BP
• Separate buccal or sublingual routes
• Utilize notepad for gathering VS, don’t rely on memory |
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Term
| What are the 3 checks of med set-up? |
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Definition
Check the drug when pulling from the drawer
Check when preparing the drug
Check the drug when returning stock back into the drawer |
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Term
| What are special considerations when administering meds to children? |
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Definition
Use of spoon
Use of syringe (allows accuracy with dosage)
Use dropper
Place medicine in the cheek and hold mouth closed until swallows
Allow parent to administer while you observe
Use appropriate play
Always tell children you have medicine, not candy |
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Term
| what are special considerations when administering meds to the elderly? |
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Definition
Assess the ability to swallow
Access liquid form if possible
If crushing of pills, ask yourself can these pills br crushed?
Mixing crushed meds with small amounts of pudding, jelly, ice cream
If a pill becomes stuck, offer soft food |
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Term
| What are special considerations when administering buccal meds? |
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Definition
• Pertains to the cheek, not a common form
• Place in the cheek or under the upper lip at gum line
• Do not chew
• Allow to dissolve completely before swallowing
• Remain with pt to determine has dissolved
• Offer water, if desires |
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Term
| What are special considerations when administering sublingual meds? |
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Definition
• Frequent use with nitroglycerine
• Place under the tongue
• Do nt chew, swallow or move tablet around with tongue
• Allow to dissolve completely before swallonging
• Remain with patient to determine has dissolved
• Offer water, if desires |
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Term
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Definition
| a small sterile glass container that contains a single dose of a drug solution |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| sterile glass cartridge with needle to be placed into a cartridge holder |
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Term
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Definition
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Term
| Vial: glass container with a metal-enclosed rubber seal |
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Definition
| glass container with a metal-enclosed rubber seal |
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Term
What is parenteral?
Routes include:
Why give med via parenteral route?
Disadvantages of giving medications parenterally?
Equipment needed for administration of parenteral meds: |
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Definition
Medications injected or infused into the body
Route: ID, Subq, IM, IV
Advantages: Absorbs more completely, Faster onset,Avoid destruction of meds in the stomach
Disadvantages: Impaired skin integrity, Altered comfort, High risk for immediate reaction, More expensive
Equipment: Medication, Syringe and needle, Alcohol prep, Gloves |
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Term
Intradermal injections
• Medications given:
• Types of syringe and needle
• Medication amount
• Angle of needle parellel to 15°
• Sites |
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Definition
skin tests (TB, mumps, histoplasmosis, allergy testing)
1 ml syringe with 25-27 gauge needle
0.1 ml or less
parellel to 15°
Forearm, upper back, or subq site |
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Term
Subcutaneous injections
• Medications given:
• Types of syringes
• Medication amount
• Angle of the needle
• Sites (upper arm, abdomen, thighs)
• Special considerations with Subq injections: |
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Definition
insulin, Heparin, Lovenox, some immunizations
insulin or 1 ml with 25-27 gauge needle
1 ml or less
45-90 degrees
upper arm, abdomen, thighs
• Always check blood values or lab work such as blood sugar for insulin and PTT for anticoagulants
Absorption rates differ per area
Abdomen (fastest) – upper arm (slow)- thighs (slowest)
Rotate within site area
Abdomen is the preferred site for anticoagulants as there is less vessels and more adipose
Do not aspirate with insulin or anticoagulants |
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Term
• Intramuscular Injections
• Medications given :
• Types of syringes:
• Medication amount:
• Angle of the needle
• Intramuscular injection sites: |
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Definition
(antibiotics, Analgesic, Rhogam, Immunization)
(3-5 ml syringe with 18-23 gauge needle, 5/8-2 inch needle)
(less than 1 ml to 5 ml dependent upon muscle size
(90 degrees, and aspirate with all IM injection)
Ventrogluteal, Vastus Latralis, Dorsal Gluteal |
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Term
| • Vastus Latralis landmarks: |
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Definition
• Vastus Latralis. Landmarks:
o Greater trochanter
o Superior edge of patella
o Middle 1/3rd section |
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Term
Dorsal Gluteal. Landmarks:
Pediatric considerations:
Special techniques: |
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Definition
Dorsal Gluteal. Landmarks:
Posterior superior iliac spine and
Greater trochanter
Draw an imaginary line between points
Mid point on line and 1 inch above
Injection is perpendicular to bed surface
Client must be able to be supine with toes rotated internally
Pull skin taut before piercing the skin
Always aspirate with IM injections
Bunch up skin with the elderly or very thin clients
Z-track with irritating or staining medications (vastril, iron)
Pediatric considerations:
Vastus lateralis for all injections for children, until 2 or 3
Deltoid and ventrogluteal are under-developed
Always have injections ready to give before you tell the child
Secure children |
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Term
| • Ventrogluteal. Landmarks: |
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Definition
Place hand over the greater trochanter with waist parallel to the femur
Thumb toward groin
Index finger toward anterior iliac femur
Extend middle finger back along iliac crest toward buttock |
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