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Semester 2 Year 1 Revision
Define the terms medicine and drug and state the difference between them.
A medicine is a substance taken to help the body either physically or mentally, to prevent, treat or cure diseases. A drug is a wider term including alcohol, tobacco and illegal substances.
Name 3 different types of prescriptions.
Stat
PRN
Regular medication order
Emergency phone order
What is the difference between generic and brand medications?
Generic medications are cheaper, have an active ingredient and usually a chemical name. Brand medications are more expensive and have a different name for marketing purposes.
Define pharmacodynamics.
How a medication affects the body.
Define pharmacokinetics and name the 4 components of pharmacokinetics.
The movement of the drug throughout the body.
Absorption - How the drug gets into the bloodstream (blood flow, route of administration, ability to dissolve and form of medication)
Distribution - Transportation from the site of absorption to the site of action where it is needed.
Metabolism - Transformation process into inactive/less inactive forms.
Excretion - How the drug leaves the body (eg. urine, sweat)
Explain the difference between side effects and adverse effects.
Side effects - Known or secondary reactions to the drug (eg. nausea or fatigue)
Adverse effects - Unintended or unexpected reactions to the drug (eg. allergic reaction)
Describe some nursing assessments related to the use and administration of medications.
Does it need to be withheld (eg. antihypertensive for a low BP)
Do you need to check vitals (eg. PRN pain medication)
Determine which PRN is necessary (mild or extreme pain)
Determine if the patient is having an adverse effect to the drug
Evaluate the drug’s effectiveness (eg. if BGL returns to normal ranges)
Name the 6 rights of medications.
Right dose
Right drug
Right documentation
Right time
Right patient
Right route
Name 4 strategies for correct medication passes.
Tallman lettering
Barcode scanning
Using the right label colours
Medication knowledge
Critical thinking (why is it needed)
Describe some things that you need to know about a medication before you administer it to a patient.
Contraindications
Side effects and adverse effects
Route of administration
Maximum dose
Preparation instructions
Special administration instructions
Name some lifespan considerations regarding medications for both paediatric and geriatric patients.
Paediatric - Height, weight, age and surface area affect drug calculations.
Geriatric - Polypharmacy, drug interactions, rate of adverse effects and frailty.
Name 4 abbreviations used to describe modified release medications and what they stand for.
EC = enteric coated
MR = modified release
LA = long acting
SR = slow release
CR = controlled release
Name 4 types of high risk medications.
Antiarrhythmics, insulin, potassium and narcotics.
Describe 4 factors to consider before crushing a medication.
Is there a liquid form?
Can it be crushed?
Can it be dissolved?
Is the medication scored?
Describe 4 considerations for medication storage.
They must be stored in the same container as received from Pharmacy
They must be stored in a locked cupboard or room when not in use (other than the MET trolley)
The medication key must be kept separate from all other keys
They must be stored in a manner that minimizes medication errors.
They must be stored at the correct temperature (eg. fridge meds)
Describe cold chain management and common breaches.
Cold chain management is the process of transporting and storing fridge meds (usually vaccines) within the correct temperature range which must be strictly maintained throughout the process to avoid damage to the product.
Common breaches include the fridge being left open or faulty, power outages and vaccines being left out of the fridge for too long.
Define enteral and parenteral nutrition and give an example of each.
Enteral - Nutrition given via a tube that is inserted nasally or orally terminating in different regions (eg. nasogastric tube).
Parenteral - Nutrition given directly intravenously to bypass the entire digestive tract (eg. through peripheral veins or the central vein to the heart).
Describe some management principles for enteral tubes.
Aspirate and check pH levels
Check tube markings and tape to ensure it hasn’t moved
Check for coughing or irritation to ensure it hasn’t moved
Describe some “best practices” when administering enteral medications.
Give one medication at a time and flush in between each one
Flush before and after each use of the tube
Flush at regular intervals even when not in use
Elevate the head of the bed so the patient is upright
Define VTE, DVT and PE.
Define key parts and key sites and give 2 examples of each.
Key parts - Parts of equipment or products that come into direct contact with other pieces of equipment or with key sites (eg. sterile gauze or the tips of forceps).
Key sites - A portal of entry for microorganisms that needs to be contacted aseptically (eg. IM injection sites or open wounds).
Describe the 4 intramuscular injection regions and one consideration or piece of information about each region.
Deltoid - Upper arm injection, very small mL injection amount can be given here.
Vastus lateralis - Recommended site for children, side of the thigh.
Dorsogluteal - Upper outer side of the buttocks, not commonly used because you can damage the sciatic nerve.
Ventrogluteal - On the side of the buttocks, much safer gluteal injection route.
List the 8 schedules of medication and give examples wherever possible.
Intentionally left blank
Pharmacy medicine (eg. paracetamol)
Pharmacist-only medicine (eg. cough and cold medications)
Prescription-only medication (eg. blood pressure medication)
Caution - often for domestic purposes (eg. acetone)
Poison - often for agriculture or industrial purposes
Dangerous poison
Controlled drug (eg. morphine)
Define the 4 levels of medication classification.
Main anatomical or pharmacological groups (eg. urinary system)
Anatomical or therapeutic subgroup (eg. diuretic)
Chemical, pharmacological or therapeutic subgroup (eg. loop diuretic)
Chemical substance (eg. furosemide)
Describe how the respiratory system is impacted by immobility and 2 nursing interventions.
When patients are immobile, they have a decreased respiratory output as gas exchange is impaired and often an increase in mucous viscosity.
Incentive spirometry
Deep breathing and coughing exercises
Elevate the head of the bed to sit the patient upright
Ambulate and avoid general immobility
Describe how the urinary system is impacted by immobility and 2 nursing interventions.
Patients become incontinent over time, experiencing urinary stasis and increased calcium excretion. This causes moisture-related pressure injuries.
Monitor fluid balance
Elevate to Fowler’s when on bedpans
Ambulate and promote weight-bearing exercises to reduce excessive calcium production
Describe how the musculoskeletal system is impacted by immobility and 2 nursing interventions.
Immobility causes a significant loss in muscle mass over time and deterioration of both bone and muscle, causing a decreased range of motion.
Ambulate and promote weight-bearing exercises
Exercises to promote and maintain range of motion
Exposure to sunlight every day
Describe how the nervous system is impacted by immobility and 2 nursing interventions.
A decrease in activity causes boredom, lack of stimulation, depression withdrawal and exaggerated responses as a result of frustration.
Promote social interactions
Engage them in activities that support their hobbies/interests
Spend time with them (active listening)
Describe how the gastrointestinal system is impacted by immobility and 2 nursing interventions.
Immobility leads to poor digestion, nausea, gas, constipation, dehydration and a lack of appetite, causing anorexia in severe cases.
Administer enemas
Remove hard faeces with a lubricated glove
Ambulate to toilet rather than using bedpans and urine bottles
Describe how the integumentary system is impacted by immobility and 2 nursing interventions.
Pressure injuries develop over time as a result of immobility, especially over bony prominences. Blood flow is also reduced over time, causing swelling.
