Registry Review Exam 1 (Pharmacology)

T/F The patient has the right to refuse medication

T

What should you do if a patient refuses medication

Consult with their physician immediately

What are the 5 rights of drug administration

Right patient, right drug, right amount, right time, right route

What is the most common, safest, most economical, most convenient, and the preferred drug route

Oral

Which drug route allows for the easiest retrieval of a drug in overdose situations

Oral

What drug route is this? The drug is placed under the tongue for dissolution and absorption

Sublingual

What drug route gains access to the general circulation without traversing the liver or being affected by gastric and intestinal enzymes

Sublingual

What drug route is this? The drug is placed in the mouth in the pocket between gums and cheek for local dissolution and absorption

Buccal

Nitroglycerin tablets are an example of a drug given through what route

Buccal

What route is this? The application of a drug directly onto the skin or mucous membrane, the drug is diffused through the skin or membrane and absorbed into the bloodstream

Topical

__ meds are applied for the following effects: astringent, antiseptic or bacteriostatic, emollient, cleansing, and antihistamines

Topical

The __ route is used when the stomach is nonretentive or traumatized, when meds has an objectionable taste or odor, or when meds can be changed by digestive enzymes

Rectal

What is a reasonable convenient and safe method of giving drugs when the oral method is unsuitable

Rectal route

__ includes all forms of drug injection into body tissues or fluids using a syringe and needle or catheter and container

Parenteral

Drugs given __ must be sterile, readily soluble and absorbable, and relatively nonirritating

Parenterally

What are the 4 most common parenteral routes

Intradermal, subcutaneous, intramuscular, intravenous

What is the most hazardous route to give a drug and errors are not easily corrected

Parenteral

Injection is made into the upper layers of the skin almost parallel to the skin surface, amount of drug given is small, absorption is slow

Intradermal or intracutaneous

What drug method is used mostly in testing for allergic reactions and for giving small amounts of a local anesthesia

Intradermal or intracutaneous

What drug method is beneath the layers of the skin, yet above the muscle

Subcutaneous

Subcutaneously injected meds are limited to what 2 things

1) Drugs that are highly soluble and nonirritating

2) Solutions of limited volume (no more than 1 ml)

Subcutaneous drugs have a limited volume of no more than __ mL

1

Injection through the skin and subcutaneous tissue, given when a drug is too irritating to be given subcutaneously

Intramuscular method

Intramuscular drugs can have larger doses up to __ mL

5

Intramuscular drugs may be given in what 3 solutions and suspensions

Aqueous solution, aqueous suspension, and solution or suspension of oil

What are 3 intramuscular injection sites

Gluteal region of lower back, deltoid area, anterolateral thigh

What is the best place to place an IV

Antecubital space

What are the 3 veins in the antecubital fossa

Median cubital vein, cephalic vein, basilic vein

Technologist errors associated with drug administration are often __

Litigated

__ assist patients through a number of respiratory problems (mechanical ventilation and oxygen delivery, aspiration, upper airway obstruction, administration of epinephrine)

Endotracheal tubes (intubation)

__ are catheters inserted into a large vein to administer drugs, manage fluid volume, transfuse and analyze blood, and monitor pressures within the heart

Central venous lines

What is the most common insertion site for central venous lines

Subclavian vein

Swan-Ganz catheters are also called

Pulmonary arterial lines

Specialized CV lines that incorporate a small electrode at the distal end used to monitor pulmonary arterial pressure

Pulmonary arterial lines

IV means

Intravenous

h, hr means

Hour

OTC means

Over the counter

PO means

By mouth, orally

q means

Every

pt means

Patient

ET means

Endotracheal

CV means

Central venous

SC means

Subcutaneous

T/F An intradermal injection would be used during a TB test

T

T/F A good placement of an IM injection would be in the deltoid area

T

T/F An emollient is for the removal of dust, dirt, debris, secretions, and crust

F

T/F Sublingual is considered a parenteral route of drug administration

F

T/F A Swan-Ganz catheter is considered to be a central venous line catheter

F

The percutaneous puncture of a vein for withdrawal of blood or the injection of a solution such as a contrast medium

Venipuncture

Before contrast medium is withdrawn from any vial or bottle, confirmation of what 4 things must be attained

Correct contents of the container, route of administration, amount to be administered, and expiration date

__ contrast medium is used for radiographic examinations of the urinary system

Water-soluble, iodinated

Water-soluble iodinated contrast medium can be administered by __ or _

Bolus injection or drip infusion

A __ is one in which the entire volume of contrast medium is injected into the venous system at one time

Bolus injection

What injection method is typically used for maximum contrast enhancement

Bolus injection

A __ is a method whereby contrast medium is introduced into the venous system via connective tubing attached to the IV site

Drip infusion

A specified amount of contrast medium is introduced over a specified period. This explains what type of contrast injection

Drip infusion

If the technologist believes a child may become combative or move suddenly during needle insertion, who should be asked to help keep the child calm and immobilize the limb

The guardian or other personnel

For venipuncture, veins found within the __ are ideal

Antecubital fossa

Leaking of contrast medium from a blood vessel into the surrounding tissue

Extravasation

Veins found within the antecubital fossa include

Median cubital vein, cephalic vein, and basilic vein

Other common IV access sites include

Cephalic vein on the lateral wrist and veins on the posterior hand or lower forearm such as the cephalic or basilic veins

Technologists should avoid veins that are __, __, or _

Sclerotic (hardened), tortuous (twisted), or overused

T/F It is okay to use areas of vein bifurcation or veins that lie directly over an artery

False

T/F You should not inject into a shunt, central line, or vascular catheter

T

A __ will not be pulsatile and most likely will be close to the skins surface

Vessel

For bolus injections of 50-100 mL of contrast medium into adults, a __ gauge needle is generally used

18 to 22 gauge

The size of the needle is determined by what

The size of the vein

The length of the needle may vary between __ and _ inches

1 and 1 ½ inches

For pediatric patients, a smaller __ to _ gauge needle is often used

23-25 gauge

What are the 6 steps of the venipuncture procedure

Wash hands and put on gloves

Apply a tourniquet, select site, cleanse the site

Initiate puncture

Secure access

Proceed with injection

Needle or catheter removal

A tourniquet should be placed how far above the site

3-4 inches

With the bevel facing upward, approach the vein at an angle between __ and _ degrees

20 and 45 degrees

Once there is flashback, decrease the angle of the needle to run parallel with the vein while advancing the needle slightly further into the vein, approximately __ inch

¼ inch

__ compounds are commonly used for vascular imaging

Iodine based

__ is generally used for gastrointestinal imaging

Barium sulfate

Iodine atomic number

53

The structure of all iodinated contrast agents is derived from a __, containing _ iodine atoms and referred to as tri-iodinated contrast agents

Six-sided benzene model, three

A monomer contains how many tri-iodinated benzene rings

One

A dimer contains how many tri-iodinated benzene rings

2

What is the element used in intravenous contrast media?

Iodine

How many iodine atoms are in a tri-iodinated contrast agent?

Three

Ionic iodinated contrast agents contain a positively charged side chain element called a

Cation

The cation is a __, usually consisting of what?

Salt, sodium, meglumine, or a combination of both

The cation is combined with a negatively charged component called the

Anion

The number of dissolved particles in a solution

Osmolality

An ionic tri-iodinated monomer can greatly increase the osmolality of plasma and is considered a __

High osmolar contrast media (HOCM)

Nonionic contrasts contain the same tri-iodinated opacifying elements but contain no positively charged __

Cations

In the 1980s, a nonionic tri-iodinated monomer was developed. This agent slightly increases the osmolality of plasma and is considered a __

Low osmolar contrast media (LOCM)

T/F Patients are less likely to have contrast medium reactions when a LOCM is used

T

__ are now the recommended contrast agent for use as intravenous contrast injections

LOCM

What are 2 common side effects that may occur after an IV injection of iodinated contrast medium

Temporary hot flash or metallic taste in mouth

What are 2 diagnostic indicators of kidney function

Creatinine and BUN

Normal creatinine levels

0.6 to 1.5 mg/dL

Normal BUN levels

8 and 25 mg/100 mL

Normal GFR

60mL/min or greater

Who is responsible for ensuring that the emergency drug cart is stocked and available in the room

The technologist

What is the most common premedication protocol

Antihistamine or prednisone given over a period of 12 or more hours before the procedure

__ reactions are those that affect only the specific region of the body at which the contrast medium has been injected into the venous system

Local

Examples of local reactions

Extravasation (infiltration), phlebitis

__ reactions are those that do not affect the site of the injection, but rather the entire body or a specific organ system

Systemic