clinical nursing skills med admin

If a subcutaneous injection is to be given at a 90 degree angle, you should choos a needle that is ____ inches in length.

1/2

If a subcutaneous injection is to be given at a 45 degree angle, you should choos a needle that is ____ inches in length.

5/8

Therapeutic response

enough of a drug to produce the desired physiological response, but not enough to cause toxicity.

All _____ should be stored in a locked cabinet.

narcotics

narcotics should be _____ frequently, during the opening of narcotic drawers, and/or shift change.

counted

report discrepancies in narcotic counts _______.

immediately.

If you give only ____ of a premeasured dose of a controlled substance, a ____ nurse witnesses' disposal of the unused portion. ____ nurses sign their names on the required form.

part/second/Both

_____ is the passage of medication molecules into the blood from the site of administration.

Absorption

After a medication is absorbed, it is ______ to tissues and organs and finally to the site of drug action.

distributed

The rate and extent of distribution depends on _____ , cell membrane ______, and protein binding. When there is poor perfusion, as in the case of heart failure, this ____ medication distribution.

circulation/permeability/alters

After a medication reaches its site of action, it becomes ______ into a less active or inactive form.

metabolized

Most biotransformation occurs in the _____, although the lungs, kidneys, blood, and intestines also play a role.

liver

Patients (e.g., older adults and those with chronic disease) are at risk for ________ if their organs that metabolize medications do not function correctly.

medication toxicity

The final aspect of pharmacokinetics is ______, the process of medications exiting the body through the lungs, exocrine glands, bowel, kidneys, and liver.

excretion

A medication's _____ determines the organ of excretion. For example, gaseous and volatile compounds, such as alcohol and nitrous oxide, exit through the _____.

chemical makeup/lungs

en medications exit through sweat glands, you provide ______ to reduce skin irritation.

hygiene

You must know if a drug is excreted through the ______, because the administration of laxatives or enemas increases ______, accelerates excretion, and thus lessens the time for drug effects.

intestines/peristalsis

When patients have reduced renal function, they are at risk for medication toxicity.

renal

It is important to know the exact _______ for which a medication is prescribed so you can properly _____ patients about a medication's intended effect and to accurately evaluate the medication's desired effect.

therapeutic effect/teach

Sometimes a single medication has many therapeutic effects. For example, _____ relieves pain and reduces fever and tissue inflammation.

aspirin

________ are predictable and often unavoidable secondary effects produced at a usual therapeutic drug dose.

Side effects

some antihypertensive medications cause _______ in male patients.

impotence(side effect)

If the side effects are serious enough to outweigh the _____ of a medication's therapeutic action, the prescriber will likely _____ the medication.

benefits/discontinue

Patients commonly _____ taking medications because of side effects such as anorexia, nausea, vomiting, dizziness, drowsiness, dry mouth, constipation, and diarrhea.

stop

_____ drug effects are unintended, undesirable, and often unpredictable.

Adverse

Unfortunately, although ADEs are sometimes immediately apparent, they often take ___ or ____ to develop.

weeks/months

_____ recognition and reporting of ADEs will prevent serious injury to patients.

Prompt

_____ develop after prolonged intake of a medication, when a medication accumulates in the blood because of impaired metabolism or excretion, or when too high a dose is given.

Toxic effects

toxic levels of morphine, an opioid, cause severe _________ and death.

respiratory depression

Medications often cause unpredictable effects such as an _______ _______, in which a patient _______or _______to a medication or has a reaction different from normal.

idiosyncratic reaction/overreacts/underreacts

Predicting which patients will have an idiosyncratic response is _______.

impossible

Ativan, an antianxiety medication, when given to an older adult may cause ___________.

agitation and delirium(idiosyncratic reaction)

__________ also are unpredictable responses to a medication. Exposure to an initial dose of a medication causes a patient to become sensitized _______.

Allergic reactions/immunologically

The medication acts as an ____, which causes _______ to be produced. With repeated _________, the patient develops an allergic response to the drug, its chemical preservatives, or a metabolite.

antigen/antibodies/administration

Among the different classes of medications, ________ cause a high incidence of allergic reactions.

antibiotics

__ is fastest, directly into the blood stream.

IV

__ is second fastest, injected into muscle then absorbed into the bloodstream.

IM

__ is third fastest, injected into subcutaneous tissue, then absorbed slower than IM.

SQ

__ is slowest, swallowed by the patient, then goes through the stomach, then the first pass effect, then absorbed by the Digestive tract.

PO

The highest serum concentration (_____ concentration) of a medication usually occurs just before the body absorbs the ____ of the medication.

peak/last

With _________ infusions, the peak concentration occurs quickly, but the serum level also begins to fall ______.

intravenous (IV)/immediately

The point at which the lowest amount of drug is in the serum is the ______ concentration.

trough

A patient's trough level is drawn as a blood sample ________ before administering the drug, and the peak level is drawn whenever the drug is expected to reach its peak _____.

30 minutes/concentration

the 6 rights of medication

1The right medication, 2The right dose, 3The right patient, 4The right route, 5The right time, 6The right documentation