Medication administration quiz 4

Subcutaneous injection angle

45 or 60 degrees

Intramuscular injection angle

72-90 degrees

A nurse is teaching a newly licensed nurse about incident reports. The nurse should include that which of the following events requires an incident report?

A client has an allergic reaction to an antibiotic: The nurse should discontinue the antibiotic, check the client's vital signs, and report the findings to the provider. A client vomits their morning medications:The nurse should check for evidence of the medication in the vomitus and report the event to the provider. An IV medication is administered via an oral route:

Generic information

A generic medication is essentially the same product as a brand name medication. Giving a generic medication is not one of the most common causes of medication errors.

Lipid lowering medications

A lipid-lowering medication is a non-time-critical medication that can be administered 1 to 2 hr late or early without adverse effects.

medication instilling solution

After each medication is correct. Instilling water after each medication promotes flow and prevents clogging and chemical mixing of the medications within the tube. After instilling medications, the nurse should use sterile water to flush the tube because chemicals in tap water could interact with some medications. Before aspirating gastric contents is incorrect. Adding water prior to aspirating stomach contents would yield a falsely high volume and alter the pH. When the flow of the medication by gravity slows is incorrect. When the flow of medication into the stomach slows, the nurse should raise the syringe to allow gravity to help propel the fluid into the stomach.Prior to administering each medication is correct. Instilling water through the tube before administering medications clears the tube of remaining stomach contents after aspiration and helps keep the tube patent. Before instilling medications, the nurse should use sterile water to flush the tube because chemicals in tap water could interact with some medications. After giving multiple medications is correct. After administering several medications via the gastrostomy tube, the nurse should instill another 15 to 30 mL of warm water to clear the tube.

Ayruveda

Ayurveda is an Indian medical system that is based on establishing balance between the body, mind, and spirit to cleanse the body of substances that can cause illnesses.

bioenergetic therapies

Bioenergetic therapies involve manipulation of human energy to promote health and well-being. These include acupuncture, magnets, light therapy, and therapeutic touch.

biological thearpies

Biological therapies include herbal and nutritional supplements, vitamins, and minerals.

Calculations rationales

Calculation in the metric system moves the decimal either to the left or to the right. When converting from smaller to larger, move the decimal to the correct number of places to the left. When converting from larger to smaller, move the decimal the correct places to the right. in the metric system, liters is a unit of measurement for volume. Meters is a unit of measurement for distance. The metric system uses decimals rather than fractions to precisely measure dosages. Grains is a measurement of weight used in the apothecary system.

circulatory overload

Crackles, shortness of breath, and dependent edema are manifestations of circulatory overload.

Functional

Functional medicine focuses on the root cause of a disease.

Homepathy

Homeopathy uses diluted substances to stimulate the body to heal itself. It is a medical approach that suggests a substance that can cause a disease can also cure the disease.

phlebitis

Localized pain, heat, and swelling are manifestations of phlebitis.

The nurse should use simple terms when assisting with teaching a client to promote understanding.

Locating the center of the arm does not give the nurse specific location for injecting the vaccine. Place one finger across the acromion process and measure 3 fingerbreadths below to the midpoint and center of the lateral aspect of the upper arm.

The nurse should not discard medication unless he has drawn an incorrect amount of medication into a syringe or is wasting excess medication.

MSO4 is incorrect. This abbreviation is incorrect because it can be confused with other medications, such as morphine sulfate, or magnesium sulfate. The nurse should write medication names out to reduce the risk for error. bid is correct. This abbreviation is acceptable. 30 mL is correct. This abbreviation is acceptable. .2 mg is incorrect. Doses less than 1.0 should have a leading zero (0.2 mg), and doses should not have trailing zeros (2.0 mg) because of the potential for making dosage errors (giving 2 mg instead of 0.2 mg, and giving 20 mg rather than 2.0 mg). Q.D. is incorrect. This abbreviation is listed on the "do not use" list. This abbreviation is intended to mean "every day." It is incorrect because it is confused with Q.O.D., which is intended to mean "every other day." Write "daily" to reduce the risk for error.

manual therapies

Manual therapies focus on bodily structures and systems. These include hands-on therapies, such as massage, chiropractic, osteopathy, and reflexology.

massage therapy

Massage therapy can cause blood clots, nerve injury, and bone fractures in older adult clients. but it can relieve depression back pain arthritis and headaches

contributions to Medication errors rationale

Medication administration outside of prescribed time intervals contributes to medication errors, also known as wrong-time errors. Wrong-time errors are one of the most common causes of medication errors. The nurse failing to administer a medication to a client is one of the most common causes of medication errors. Administering the incorrect dose to a client is one of the most common causes of medication errors.

Nonpharmacologic Therapies that decrease stress

Meditation can promote relaxation and decrease stress. Yoga combines deep breathing, meditation, and physical movements to decrease anxiety, reduce stress, and promote sleep. Biofeedback is a mind-body practice in which a client uses an electronic device to regulate physiological functions. It is used to reduce stress, relieve headaches, and decrease pain.

Mind body thearpies

Mind-body therapies focus on connections between the mind and body to improve physical health, such as relaxation, meditation, biofeedback, and hypnosis.

Naturopathy

Naturopathy is a medical system that is based on the principle that healing can be achieved through diet, supplements, and traditional Chinese medicine.

Medication admin for children

No Gluetus maximus lays too close to the sciatic nerve Infants: Vastus lateralis, 0.5-1, 1 inch from 1 month to 1 year 90 degree angle 18 months: Deltoid muscle can be used, max 2mL Preschoolers, school age, adolescents: ventrogluteal

Subcutaneous administration

No more than 1.5 mL Needle size: ⅜ to ⅝ inch length 25 to 27G For insulin, use a 28 to 31G insulin syringe. Pinch the skin and insert at a 45° to 90° angle. Use a 90° angle for clients who are obese. Rotate sites.

Giving medication STAT

PRN, or as needed medications, are administered when the client experiences specific manifestations, wheras STAT medications are to be administered within 30 min of the health care provider prescribing the medication. Routine medications are ordered at specific times until the health care provider discontinues the medication or the medication is automatically discontinued. STAT medications are to be administered within 30 min of the health care provider prescribing the medication. STAT medication prescriptions should be given immediately and usually one time. STAT prescriptions should be administered within 30 min of the health care provider prescribing the medication.

infiltration

Pain, swelling, cool temperature, taut skin, and leaking of IV fluid are manifestations of IV infiltration. The nurse should stop the IV infusion, elevate the affected extremity, and report the incident to the provider.

decongestion drops

Tell the client to blow her nose gently before the instillation. Prior to instillation, the nurse should instruct the client to blow her nose gently. This action will help remove any secretions or crusts that could interfere with the distribution and absorption of the medication. The nurse should assist the client to lie supine for a nasal instillation. The nurse should hold the dropper 1 cm (1/2 in) above each naris before instilling the drops. The client should stay in the same position for 5 min to make sure the drops do not run out when the she sits or stands up.

timing or routes of medication

The intramuscular route has a faster absorption rate when compared to oral route, and therefore has a quicker onset of action. The oral route, while convenient and most preferred by clients, has a slow onset of action. The buccal route, between the cheek and gum line, has a quick absorption rate and bypasses the first pass effect. Therefore, it has a quick onset of action. The intravenous route provides a rapid onset of action as it is administered directly into the vascular system.

MDI medication

The nurse should ask the client to inhale the medication slowly for 3 to 5 seconds to promote absorption of the medication. The nurse should shake the MDI briskly for 2 to 5 seconds to aerosolize the medication particles. the nurse should ask the client to hold their breath for 5 to 10 seconds after inhalation to promote absorption of the medication. The nurse should not wash the MDI canister because this can damage the valve mechanism. The nurse should remove the mouthpiece from the canister and rinse it with warm water once each day.

providing education

The nurse should check to determine what the client already knows about the medication when beginning to reinforce teaching. The nurse should build on the client's existing knowledge to provide effective teaching. . Finding out whether the client is able to pay is not the nurse's responsibility when assisting with teaching a client about their medication. The nurse should determine the client's ability to perform the skill of applying the patch. The nurse should ask the client to provide a return demonstration to determine whether the client is able to perform the procedure. The nurse should check the client's reading comprehension level to make sure they can read and understand any written material. The nurse should use simple terms when assisting with teaching a client to promote understanding.

Insulin administration rationales

The nurse should document the administration of the insulin after it is administered to promote safe and effective care. However, there is another action the nurse should take first. The nurse should assist with teaching the client about the insulin to promote safe and effective care. However, there is another action the nurse should take first. The first action the nurse should take is to have a second nurse confirm the insulin dose to reduce the risk for a medication error. All forms of insulin are considered high alert medications that require a second nurse to confirm the dosage prior to medication administration. The nurse should monitor the client for adverse effects of the insulin to promote safe and effective care. However, there is another action the nurse should take first.

Preparing medications to a preschooler

The nurse should encourage the client to ask questions to facilitate an active role in their own care and promote an understanding of the education. Unless otherwise reported, preschoolers should be able to take capsules. Preschoolers should not receive the same amount of medication as adults. Medication dosages are calculated by kilograms of weight. The deltoid muscle can be used to administer intramuscular injections in preschoolers as well as in adults.

medication reconciliation Rationales

The nurse should include the medication reconciliation with the transfer documents to provide an accurate, up-to-date list of the client's medications and reduce the risk of medication error. The nurse should reinforce teaching about medications with the client upon discharge to promote safe and effective care. The nurse should not include medications that the client no longer requires in the medication reconciliation. . The nurse should include all medications the client currently takes, including over-the-counter medications, herbal supplements, and vitamins. The medication reconciliation process involves the comparison of the client's home medications against prescribed discharge medications. The nurse should note any duplications or discrepancies.

deltoid muscle

The nurse should inject the medication at a 90° angle to reduce the risk of injecting the medication into subcutaneous tissue. The nurse should inject 0.5 to 1 mL of solution into the deltoid muscle to reduce the risk of tissue injury and pain. The nurse should inject the medication at 5 cm (2 in) below the client's acromion process to reduce the risk of tissue injury. The nurse should use a 23- to 25-gauge needle to reduce the risk for tissue damage and pain.

Intradermal injection angle

The nurse should insert the needle at a 5° to 15° angle about 1/8 inch under the skin and observe for the tip of the needle, which would indicate that the needle is in the intradermal layer of the client's skin.

Antibiotic Administration

The nurse should instruct the client to monitor for and report a rash, which is a manifestation of an allergic reaction to the medication. The provider should discontinue the medication and prescribe a different antibiotic to treat the infection. The nurse should instruct the client that some natural supplements, such as probiotics, can interact with certain antibiotics. The nurse should instruct the client that antibiotics are prescribed to treat bacterial infections. The nurse should instruct the client to complete the entire course of the antibiotic prescription, even if they are feeling better, to eradicate the infection.

Greatest risks for developing medication toxicity

The nurse should monitor the client who has a respiratory infection for medication toxicity. However, there is another client who has a greater risk. The nurse should monitor the client who has rheumatoid arthritis for medication toxicity. However, there is another client who has a greater risk. The nurse should identify that the client who has impaired kidney function is at the greatest risk for medication toxicity because many medications are excreted by the kidneys, A decrease in function of the kidneys can result in a buildup of medication metabolites. The nurse should monitor the client who has hyperthyroidism for medication toxicity. However, there is another client who has a greater risk

ophthalmic medication

The nurse should not instill the medication directly on the client's cornea because this can cause pain, irritation, and increased systemic effects. The nurse should instill the ophthalmic medication on the client's conjunctival sac. The nurse should clean from the inner canthus to the outer canthus to reduce the risk of infection. The nurse should apply gentle pressure to the client's nasolacrimal duct after instillation to prevent the medication from entering the systemic circulation. The client should gently close their eyes shut after the instillation to allow for absorption of the medication. Tightly squeezing the eyes shut can cause the medication to drain out of the eyes.

Timing of medication and when to give

The nurse should not leave the medications at the client's bedside. The nurse should administer the medication to the client to ensure the correct dose is taken by the client and to monitor the client for adverse effects. The nurse should not prepare the medication to administer later as this can lead to a medication error. The nurse should prepare the medication at the client's bedside to reduce the risk of errors. The nurse should document the medication was given after it is administered to reduce the risk of error. The nurse should wait for the client to finish in the bathroom or come back in a few minutes to administer the medication to ensure the medication is safely administered. The nurse should stay with the client until the medication is completely administered via the correct route.

Enteral feeding tube medication

The nurse should not mix the medication with the client's feeding infusion because this can result in altered absorption or an interaction between the formula and the medication. The nurse should flush the tube with 30 mL of water prior to and following administration of any medications to reduce the risk of clogging the feeding tube. The nurse should administer the medication in a liquid form to reduce the risk of clogging the feeding tube. The nurse should consult with the pharmacist to determine which medications are available as a liquid and which can be crushed and mixed with water prior to administration. The nurse should elevate the head of the client's bed to a semi-Fowler's or high-Fowler's position to reduce the risk of aspiration.

needle stick injury

The nurse should not recap a needle after administering a medication. If an approved sharps container is unavailable, the nurse should use one hand to recap the needle to reduce the risk of a puncture injury. The nurse should not bend or break needles on syringes because this can increase the risk of a needlestick injury. The nurse should replace sharps containers when they are full to reduce the risk of a puncture injury. The nurse should place used razors and other sharps into puncture-proof disposal containers to reduce the risk of a puncture injury.

collecting data on a patient who has a rash on there neck chest and back when giving medication

The nurse should notify the client's provider to inform them of the client's condition. However, there is another action the nurse should take first. The greatest risk to the client is injury from an acute allergic reaction. Therefore, the first action the nurse should take is to stop the infusion of the vancomycin to reduce the risk of further injury. The nurse should administer diphenhydramine as prescribed to treat the allergic reaction. However, there is another action the nurse should take first. The nurse should document the incident in the client's chart to alert other members of the care team of the possible allergy and to reduce the risk of the incident recurring. However, there is another action the nurse should take first.

Medication errors rationales

The nurse should recommend marking the area around the automated medication dispensing system to stop people from interrupting the nurse working in the labeled area. Interruptions while dispensing medications can result in medication administration errors. The nurse should recommend not to use cell phones while dispensing medications as this can result in an error. Interruptions while dispensing medications can result in medication administration errors. The nurse should recommend not to override the automated medication dispensing system, even during an emergency, as this can result in an error. The nurse should recommend providing the nurse administering medications with a vest to indicate they should not be interrupted. Interruptions while dispensing medications can result in medication administration errors. The nurse should recommend to double check dosages and calculations for high-alert medications with a second nurse to reduce medication errors.

TELEPHONE PRESCRIPTIONS

The nurse should repeat verbal prescriptions to clarify and to ensure client safety. This is done with telephone prescriptions, or prescriptions received in an emergency situation. The nurse should clarify any prescription that she does not understand or that might be incorrect. It is the nurse's responsibility to ensure that all prescriptions are correct. Failure to clarify questionable prescriptions can result in client harm. The nurse should transcribe the prescription to the provider's prescription form on the client's medical record. It is important for the nurse to transcribe the prescription promptly and in the correct place in the medical record. The provider should sign the telephone prescription as possible. While regulations vary from institution to institution, it is common that hospitals require verbal and telephone prescriptions to be signed within 24 hr of receipt.

transdermal patch

The nurse should rotate the application of the transdermal patch to reduce the risk of irritation to the client's skin. The nurse should remove the old transdermal patch before applying a new patch to reduce the risk for medication toxicity. The nurse should expect the transdermal medication to absorb slowly over an extended amount of time. The nurse should wear clean gloves to apply the transdermal patch to protect the nurse from accidentally absorbing the medication. The client should apply the transdermal patches to the trunk, lower abdomen, lower back, or buttocks. It is also important to apply the patches to skin that is free of hair so the medication comes in direct contact with the skin. The use of lotion on irritated skin can interfere with the absorption of the medication. have clean dry skin

communication during a discharge

The nurse should use open-ended questions to promote communication and to determine the client's understanding of the education. The nurse should provide educational material at a 6th-grade reading level to promote understanding of the education. The nurse should use active listening when assisting with teaching the client to promote communication and to determine the client's understanding of the education. The nurse should encourage the client to ask questions to facilitate an active role in their own care and promote an understanding of the education.

Pharmacokinetics

The process by which drugs are absorbed, distributed within the body, metabolized, and excreted. Rationales The nurse should include that the age of the client affects the rate of absorption of medications. In older adult clients, delayed gastric emptying can slow the absorption rate of oral medications. The first-pass effect affects the metabolism of a medication, rather than the absorption. . The lipid solubility of a medication affects the rate of absorption. A medication that is highly lipid soluble has a higher rate of absorption than one that has low lipid solubility. The nurse should include that the route of administration affects the rate of absorption of medications. Oral or enteral medications are absorbed at a slower rate than intravenous medications. Metabolism is the process where drugs are chemically changed to a form that allows for excretion. It does not affect the rate of absorption of a medication.

Automated dispensing system

The use of automated dispensing systems has produced a reduction of medication errors because these systems assist nurses in organization, provide an easier method of obtaining medications, and provide record keeping.

giving oral medication to a client what is acceptable client identifiers

These can include the client's full name, an identification number assigned by the facility, and a telephone number.

Homeopathy uses diluted substances to stimulate the body to heal itself. It is a medical approach that suggests a substance that can cause a disease can also cure the disease.

This is impractical on a busy nursing unit, plus the nurse cannot confirm the security of the medications. The nurse guarding them might also have to respond to a client's urgent need. The nurse may only administer medication he has prepared himself for the client. No one else should have access to or administer medications the nurse has prepared. Securing them and returning later to finishing preparing and administering them decreases the risk of medication errors. The nurse should not discard medication unless he has drawn an incorrect amount of medication into a syringe or is wasting excess medication.

intradermal

Ventral aspect of forearm: 0.1 mL Needle size: ¼ to ⅝ inch length 25 to 27G Use a 1-mL TB syringe. Insert at a 5° to 15° angle. Insert the needle with the bevel up. A small bleb should appear.

Intramuscular

Ventrogluteal: 3 mL Deltoid: 2 mL Vastus lateralis: 1 to 3 mL Needle size: 1½ inch length 18 to 25G The ventrogluteal site is a relatively safe site because of the lack of major nerves. The deltoid site is used frequently for immunizations in adults due to its easy access. Injections should be given at a 90° angle. The length of the needle may need to be adjusted depending on the client's weight/size.

final medication check

at the patients bedside

Mantoux tuberculin skin test

is the standard method of identifying exposure to Mycobacterium tuberculosis. The nurse should inject 0.1 mL of purified protein derivative (PPD) intradermally on the inner aspect of the forearm until a bleb forms. The bleb should measure 6 to 10 mm (1/4 to 4/10 in) in diameter, resembling a mosquito bite. The bleb confirms that the PPD entered the dermis. The nurse should apply gentle pressure, not massage, after the injection. Massage can disperse the testing substance beyond the bleb or cause it to leak out of the puncture site. For an intradermal injection, the nurse should stretch the skin at the injection site until it is taut. When the nurse inserts the needle through the epidermis into the dermis, the outline of the needle's bevel should be visible.

Find the center of the anterior aspect of the thigh.

rectus femoris site

Locate the middle third of the anterior thigh between the greater trochanter of the femur and the lateral femoral condyle.

vastus lateralis site

first and second medication check

where the nurse obtained the medication