Med Admin
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93 Terms
What are the Six Rights of Medication Administration?
Right client, right medication, right dose, right route, right time, and right documentation.
What is the right client?
Verify the client's identity using two identifiers.
What is the right medication?
Confirm the medication name and form are correct.
What is the right dose?
Check the medication against the provider's order in the medical record.
What is the right route?
Confirm the correct route such as IV, IM, or SC.
What is the right time?
Confirm when the drug should be given and when it was last administered.
What is the right documentation?
Document the time given and any pertinent remarks.
What is the patient's right to refuse?
The client has the right to refuse any medication.
What is the right assessment?
Confirm the medication is appropriate for the client's condition.
What is the right education?
Educate the client on the medication name, benefits, and side effects.
What is the right response/evaluation?
Observe and evaluate the client's response after administration.
What are the three medication safety checks?
Check the medication when removing from Pyxis/MAR, during preparation, and immediately before administration.
What is medication reconciliation?
Reviewing a client's medications to identify omissions, duplications, or errors.
When is medication reconciliation performed?
Whenever care is transferred between providers or locations.
Why is medication reconciliation important?
It ensures continuity of care.
What angle is used for IM injections?
90 degrees.
When should aspiration be performed during IM injections?
Only if facility policy requires it; never aspirate vaccines.
What is the maximum volume for a deltoid IM injection?
1 mL.
Which IM site is preferred for infants and toddlers?
Vastus lateralis.
Which IM site is considered the safest for adults?
Ventrogluteal.
How much medication can be given in the ventrogluteal site?
Up to 3 mL.
What angle is used for subcutaneous injections?
45–90 degrees depending on body size.
What are common subcutaneous injection sites?
Abdomen, upper arm, and thigh.
What is the maximum amount for a subcutaneous injection?
1 mL.
What needle size is used for subcutaneous injections?
25–27 gauge, 3/8–5/8 inch.
What angle is used for intradermal injections?
10–15 degrees.
What should form during an intradermal injection?
A bleb.
What are intradermal injections commonly used for?
TB and allergy testing.
What should be assessed during IV therapy?
Infiltration, phlebitis, and infection.
When should IV tubing be changed?
Usually every 72–96 hrs for continuous fluids and every 24 hrs for TPN/lipids per policy.
When should IV lines be flushed?
Before and after medication administration.
What is pharmacodynamics?
The study of how drugs work and how the body responds.
What is peak plasma level?
The highest concentration of a drug in the bloodstream.
What is a trough level?
The lowest concentration of a medication before the next dose.
What is the nurse's role in medication administration?
Carry out provider orders safely and accurately.
What is the Swiss Cheese Model?
A model showing how errors occur when multiple safety barriers fail.
Who is ultimately responsible for safe medication administration?
The nurse administering the medication.
What is a serious adverse drug event (ADE)?
A life-threatening reaction requiring intervention to prevent death or disability.
Why are serious ADEs reported to the FDA?
To improve safety, revise warnings, and remove dangerous drugs if necessary.
What is a Black Box Warning (BBW)?
The strongest FDA warning for drugs with potentially serious or fatal effects.
What happened in the RaDonda Vaught case?
A medication error led to criminal charges and loss of nursing license.
What is an allergic reaction to medication?
An immune response where the body treats the medication as an allergen.
What chemical is released during allergic reactions?
Histamine.
What are symptoms of a penicillin allergy?
Hives, wheezing, difficulty breathing, swelling of mouth/throat, and anaphylaxis.
What is anaphylaxis?
A severe life-threatening allergic reaction causing dyspnea, hypotension, and tachycardia.
What is Stevens-Johnson Syndrome (SJS)?
A potentially fatal drug reaction causing fever, rash, respiratory distress, and blisters.
What are side effects?
Excessive expressions of known drug effects occurring at recommended doses.
What is drug toxicity?
An exaggerated pharmacologic effect caused by excessive drug levels.
What are drug interactions?
Unusual effects caused by two or more drugs interacting.
What is teratogenesis?
Medication-induced fetal defects.
What is pharmacokinetics?
The study of absorption, distribution, metabolism, and excretion of drugs.
What determines medication dissolution?
The medication's physical state and route of administration.
Why do oral medications absorb more slowly?
Because they pass through the GI tract before entering circulation.
What is distribution?
Movement of a drug to target tissues and organs.
What is metabolism?
Converting drugs into forms that can be excreted.
Which organ metabolizes most drugs?
The liver.
What other organs contribute to metabolism?
Kidneys and small intestine.
What is a prodrug?
An inactive drug that becomes active after metabolism.
What is the first-pass effect?
Oral drugs are metabolized by the liver before entering systemic circulation.
What is excretion?
Removal of drugs from the body.
Which organ is primarily responsible for excretion?
The kidneys.
What other organs can excrete medications?
Skin, lungs, intestines, and exocrine glands.
When does drug toxicity develop?
When the body cannot metabolize or excrete drugs effectively.
What information should be included in a medication order?
Client name, date/time, drug name, dosage, route, frequency, indication, and provider signature.
What does the right reason mean?
The medication is appropriate for the client's condition and assessment findings.
What assessments should nurses perform before giving medications?
Check labs, blood sugar, blood pressure, heart rate, allergies, and medication history.
Why is dimensional analysis important?
It helps calculate medication dosages accurately.
Which medications require an independent double-check?
Insulin, heparin, opioids, chemotherapy, and other high-risk medications.
Which tablets should never be crushed?
Enteric-coated and extended-release tablets.
What are high-alert medications?
Drugs with a higher risk of causing serious harm if administered incorrectly.
What are examples of high-alert medications?
Insulin, opiates, IV heparin, and injectable potassium chloride.
What safety strategy is used for high-alert medications?
Independent double-checks by two nurses.
What are the three major routes of medication administration?
Enteral, topical, and parenteral.
What is the enteral route?
Medication administered through the GI tract.
What is the topical route?
Medication applied to the skin or mucous membranes.
What is the parenteral route?
Medication administered by injection.
What are time-critical medications?
Medications that must be given within 30 minutes before or after the scheduled time.
What are non-time-critical medications?
Medications that can be given 1–2 hours early or late without harm.
What are provider responsibilities in medication administration?
History, physical exam, diagnosis, prescribing, monitoring therapy, and modifying prescriptions.
What are nurse responsibilities in medication administration?
Prepare/administer meds, evaluate responses, maintain knowledge, report errors, and safeguard medications.
How should medications be administered through an enteral feeding tube?
Crush and administer medications one at a time.
Which medications should not be crushed for feeding tubes?
Enteric-coated, capsules, sustained-release, and immediate-release medications.
How much water is used to flush feeding tubes before and after medications?
3–60 mL.
How much water is used between feeding tube medications?
15–30 mL.
What can cause a feeding tube to clog?
Medication residue and formula buildup.
What are examples of enteral feeding tubes?
Nasogastric tubes and gastrostomy tubes.
How is NG tube placement confirmed?
Chest or abdominal x-ray is the gold standard.
What should the nurse do if a patient questions a medication?
Hold the medication and recheck the order.
What should the nurse do with illegible medication orders?
Clarify the order with the provider.
How are pediatric medication doses calculated?
Using the child's weight in kilograms.
What should nurses do before a blood transfusion?
Verify with another RN.
How long should the nurse stay with a patient after starting a blood transfusion?
The first 15 minutes.
What IV solution is compatible with blood transfusions?
Normal saline only.