FUNDS TEST 2

generic name example

acetaminophen

trade name example

Tylenol

therapeutic effect

expected/predicted physiological response

side effect

predictable, unavoidable secondary effect

toxic effect

accumulation of medication in bloodstream

idiosyncratic reaction

over/under/different reaction from normal; opposite of expected effect

medication interactions

when one medication modifies the action of another

therapeutic range

medication gets to constant/steady range in blood

trough level normally taken when

30 mins before next dose

how do you verify oral orders

read back the order

standing/routine order

given until dosage is changed or another med is prescribed

single (one-time) order

given one time only for a specific reason; NOT an emergency

now order

med needed right away but not STAT; NOT an emergency; more specific than one-time order

prn order

as needed; given when client requires it

STAT order

given immediatey in an EMERGENCY

prescription order

medication to be taken outside of hospital

how long is the window for a standing order

+/- 30 minutes

what is the mat in front of the pixis

quiet zone; so nurse can focus

seven rights of med admin

medication, dose, client, route, time, documentation, indication (what/why)/education (med and effect)

oral routes

prolonged effect; wait 45 mins to an hour before checking therapeutic effects

pour liquid meds how

pour liquid away from side with the label; make sure medication cup is on flat surface

use what to administer less than 5mL

syringe for accuracy

topical administration

applied directly; has local effect

intraocular route

contact lenses applied to conjunctival sac; can leave for up to a week

skin applications

discs/patches that last a few hours up to a week; have systemic effect; USE GLOVES

types of nasal instillation

spray, drops, tampons

ear drops instilled at what temperature

room temp

ear instillation

pull adult ear pinna UP AND OUT to straighten ear canal; use STERILE solutions and make sure tip doesn’t get contaminated; check for eardrum rupture

why do you rinse your mouth when taking a steroid inhaler

to prevent yeast growth

parenteral routes of injection

intradermal, subcutaneous, intramuscular, intravenous

three most common types of syringes

hypodermic syringe, insulin syringe, tuberculin syringe

hypodermic syringe

2, 2.5, 3 mL sizes; marked in 0.1 mL

insulin syringe

measured in units; 50 or 100 units

needle length/gauge depends on

site of injection, age/size of patient, medication

tuberculin syringe

used for TB and allergy tests; normally 27 gauge needle; good for pediatric or small doses; up to 1mL

blood products require what needle gauge

at least 20 gauge

example of med that needs to be refrigerated

insulin

insulin must be verified by how many nurses

2 RNs

subcutaneous injection sites

outer posterior upper arm, anterior upper thigh, 2in away from belly button, between scapula, muffin top area

subcutaneous dose range

0.5-1.5mL

intradermal injection angle

5-15 degrees

gauge for deltoid in children

25-30 gauge

gauge for deltoid in adults

18-25 gauge

intradermal injections

25-27 gauge; no scarring/tattoo/minimal hair

where are O2 and nutrients exchanged

capillary beds

coronary arteries

supply heart with blood; where a heart attack occurs

S1/lub

SYSTOLE; mitral/bicuspid and tricuspid valves; ventricles contract

systole loudest where

apex of heart

S2/dub

DIASTOLE; aortic and pulmonic valves; atria contract and ventricles refill

diastole loudest where

base of heart

upper extremity peripheral arteries

brachial, radial, ulnar

lower extremity peripheral arteries

femoral, popliteal, posterior tibial, dorsalis pedis

electrical conductivity route

SA node, atrial myocardium, AV node, Bundle of His, Bundle Branches, Purkinje fibers

precordium

anterior chest overlying the heart; 2nd-5th intercostal space; assess for heave/lift

how to assess PMI

patient lying on left side

rubbing heart sounds caused by

inflammation of pericardial sac around the heart

clicks normally indicate what

mechanical valves

S3 (ventricular gallop)

ken-TUCK-y; doesn’t change with respirations; abnormal in adults and elderly; normal in kids/teens/athletes/pregnancy

S4 (atrial gallop)

TEN-nes-see; rarely normal; often seen with heart failure

S3 and S4 best heard

at apex with bell

SCRIPT (for heart murmurs)

site, character, radiation, intensity, pitch, timing

normal peripheral pulse grade

2+ (0-3+)

normal edema grade

0 (0-4+)

venous insufficiency skin changes

reddish brown pigmentation around ankles

arterial insufficiency skin changes

thin, shiny skin; decreased hair growth; thickened nails

peripheral artery warning signs

pain, pallor, pulselessness, paresthesia, paralysis

P wave

atrial contraction; impulse sent from SA node through atria

PR interval

delay of impulse at AV node

QRS complex

ventricular contraction and atrial relaxation

T wave

ventricular relaxation

dysrhythmias

electrical impulses that don’t originate from SA node; irregular HR

respiratory acidosis signs and symptoms

decreased LOC, dysrhythmias

respiratory alkalosis signs and symptoms

numbness and tingling of fingers/toes, increased rate/depth of respirations

metabolic acidosis signs and symptoms

decreased LOC, dysrhythmias, abdominal pain

metabolic alkalosis signs and symptoms

numbness and tingling of fingers/toes, muscle cramps

fluid volume deficit causes hematocrit to what

increase; also increased BUN

normal K values

3.5-5 mEq/L

normal Ca values

8.2-10.2 mEq/L

normal Mg values

1.6-2.2 mEq/L

normal Na values

135-142 mEq/L

normal phosphate values

3-4.5 mg/dL

normal Cl values

95-102 mEq/L

hyperkalemia can cause which heart issue

cardiac arrest

IV catheters provide access to what

direct access to patient’s cardiovascular system

phlebitis

inflammation of the vein; redness, pain, warmth; STOP INFUSION OR START A NEW LINE

infiltration

when IV becomes dislodged or vein ruptures and IV fluids enter subq tissue; redness, swelling, pain, tenderness, cold skin; ELEVATE EXTREMITIES AND APPLY WARMTH

extravasation

tissue damage because of inflammation; blanched or edematous skin; often caused by high-risk medications; stop immediately

ice volume

half

cup to oz

8oz in 1 cup

oz to ml

30 mL in 1 oz

flow rate

total volume in mL / number of hours

drip factor

(total amount of fluid / time in minutes) * gtt per mL of IV set

how many mcg in a mg

1000 mcg in 1 mg

how many drops in a mL

15 gtt in 1 mL

AC

before meals

ad lib

as desired

BID

twice each day

PC

after meals

when is a hernia dangerous

if it is incarcerated; trapped at the surface

transillumination

light through scrotum; light shines through fluid-filled mass but doesn’t with other masses (cancer)