ATI Medication Administration 2
On discovering that the patient is allergic to a product, it is the nurse's responsibility to do what?
-alert all personnel by documenting the allergy in the medical record -appropriately labeling patient records and the medication administration record (MAR). -An appropriate, agency-approved bracelet should be placed on the patient to alert all caregivers. -Information related to drug allergy must be communicated to the health care provider and pharmacist so the medication regimen can be evaluated for cross-sensitivity among various pharmacologic products.
A student nurse is preparing medications for the patient. When checking the medication administration record against the drug found in the patient's medication cassette, the student nurse notes that hydroxyzine has been ordered for the patient, but hydralazine has been dispensed from the pharmacy. What should the student nurse do?
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Anaphylaxis
A life threatening, acute allergic reaction in which cells release histamine- like substances is called _____ ? ( bee sting)
Which of the following patients is exhibiting drug tolerance?
A. A patient continues to take a medication despite harmful effects B. A patient requires an increased dose of a medication to achieve continued therapeutic benefit C. A patient exhibits signs of withdrawal when a medication is discontinued D. A patient develops an intense craving for a drug Answer: B - As tolerance develops to a medication, a patient requires higher and higher doses of that medication to achieve the desired effect
A nurse will be administering several medications to a patient who is receiving enteral feedings through a small bore nasogastric tube. The nurse administers the medications correctly by
A. Adding crushed medications to the enteral tube feedings and infusing via an electric pump B. Infusing each medication by gravity and flushing with water before and after instillation C. Administering medications through a large bulb syringe D. Lowering the syringe to promote instillation of medication ANSWER B: Infusing each medication by gravity and flushing with water before and after instillation Rationale: Medications should be instilled via gravity, flushing before and after with water
A nurse is caring for a patient who has been prescribed a fluticasone propionate inhaler with a spacer. The patient asks the nurse why a spacer is needed. Which of the following responses by a nurse is correct?
A. By using a spacer you can take the medication with out any spills B. You can inhale 5 or more puffs in 1 min when using a spacer C. By using a spacer you eliminate the need for mouth rinsing after administration D. More medication is delivered to lungs when you use a spacer. Answer: D. more medication is delivere to the lungs when you use a spacer
Which of the following should a nurse assess before administering medications through a nasogastric tube?
A. Correct placement by inserting air into tube while auscultating at gastric fundus B. areas of tympany and dullness by percussing abdomen C. Amount of residual volume in stomach D. Ability of patient to cooperate with instructions Answer: C. Checking residual volume prevents putting medications into an already full stomach
For which of the following inhalation medication delivery methods is it important for the nurse to asses the patients ability to inhale deeply before medication?
A. Dry powder inhaler B. Nasal spray C. metered dose inhaler with attached spacer D. Nebulizer via a mask Answer: A. This method has no propellant and requires a deep inhalation to trigger release of medication
A nurse is preparing to put ear drops into a toddlers ear. Which of the following techniques should the nurse use?
A. Have the patient maintain side-lying position for 30 minutes after administration of ear drops B. Pull the patients auricle down and back to open the canal when administering ear drops C. The nurse should don sterile gloves prior to administering ear drops D. Insert the tip of the dropper into the ear canal when administering ear drops Answer: Pull the patients auricle down and back to open the canal when administering ear drops - The auricle should be pulled down and back for young children and up and out for adults
A nurse educator is teaching a module on safe medication administration to newly hired nurses. Which of the following statements by a newly hired nurse indicate understanding of the nurse's responsibility when implementing medication therapy? Select all that apply.
A. I will observe for medication side effects. B. I will monitor for therapeutic effects. C. I will prescribe the appropriate dose. D. I will change the dose if adverse effects occur. E. I will refuse to give a medication if I believe it is unsafe. Answer: A,B,E Rationalle: A/B= the nurse is responsible for observing for medication side effects/monitoring for therapeutic effects E= Responsible for recognizing if a medication could harma client and it is within scope of practice to administer medication and contact the provider CD are wrong because Nurses don't prescribe doses nor do they change doses
A nurse is working with a newly hired nurse who is administering medications to clients. Which of the following actions by the newly hired nurse indicates an understanding of medication error prevention.
A. Taking all medications out of the unit- dose wrappers before entering the clients room B. Checking with the provider when a single dose requires administration of multiple tablets C. Administering a medication, then looking up the usual dosage range. D. Relying on another nurse to clarify a medication prescription. Answer: B Rationale: If a single dose requires multiple tablets, it is possible that an error has occurred in the transcription of the medication. This action could prevent a medication error.
A nurse is administering aspirin 82 mg PO daily as prescribed. The medication is scheduled for 0800 hours. Which of the following demonstrates one out of six rights of medication administration?
A. The nurse performs the first check at patients bedside B. Nurse ids patient by stating name as written on medication administration record C. Nurse documents that asprin was given at 0825 D. Nurse opens 82 mg aspirin unit dose package prior to entering patients room Answer: C The nurse documents that the aspirin was given at 08:25
A nurse is preparing to administer digoxin to a client who states, " I don't want to take that medication. I do not want one more pill. " Which of the following responses by the nurse is appropriate in this situation?
A. Your physician prescribed it for you, so you really should take it B. Well, lets just get it over quickly then C. Okay, Ill just give you your other medications D. Tell me your concerns with taking this medication Answer: D. Rationale: It is correct to determine reason for refusal by asking about concerns, and then provide information based on their decision.
A nurse prepares an injection of morphine to administer to a client who reports pain. Prior to administering the medication, the nurse is called to another room to assist another client onto a bedpan. She asks for a second nurse to give the injection. Which of the following actions should the second nurse take?
A. offer to assist the client needing the bedpan B. Administer the injection prepared by the other nurse. C. Prepare another syringe and administer the injection D. Tell the client needing the bedpan she will have to wait for her nurse. Answer: A Rationale: The second nurse should offer to assist the client needing the bedpan. This will allow the nurse who prepared the injection to administer it.
Category XFDA Drug risk classification
Animal and human studies have shown fetal abnormalities. The drug is contraindicated in women who are or may become pregnant.
Category B
CAtEgory B Animal-reproduction studies have not shown a fetal risk or adverse effect. Risks have not been confirmed in controlled studies in women.
A nurse is preparing to administer a medication to a client. The medication was scheduled for administration at 0900. Which of the following are acceptable administration times for this medication?
Check all that apply A. 0905 B. 0825 C. 1000 D. 0840 E. 0935 Answer: A, D Rationale: - Medication should be administered within 30 minutes of scheduled time
Acceptable identifiers for a patient
Clients name, assigned id number, telephone number, birth date, or other person specific identifier bar code scanners
Category A FDA Drug risk classification
Controlled studies in women fail to show a risk to the fetus and the possibility of fetal harm appears unlikely.
Category C FDA Drug risk classification
Either studies in animals have revealed adverse effects on the fetus and there are no controlled studies in women or studies in women and animals are not available.
How do you administer eye drops in to a patients eye
Pull down lower eyelid and drop medications inside. This will allow medication to be distributed evenly across the eye with less discomfort
Category D FDA Drug risk classification
There is confirmation of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used).
3 checks
check medication before. check medication after drawing it up or pouring it. Check at the bedside before administration.
6 rights
drug, dose, route, time, patient, documentation
Common Causes for Medication Errors
■Incomplete patient information (e.g., incomplete or missing patient information such as allergies or current medications in use; lack of previous diagnoses or lab results) ■Unavailable drug information (e.g., black box or other warnings issued by the FDA) ■Miscommunication of drug orders (e.g., inappropriate abbreviations, use of metric and other dosing units, similar drug names) ■Lack of appropriate labeling when a drug is prepared and repackaged into smaller units ■Distracting environmental factors (e.g., interruptions during preparation for medication administration) As the often final health care provider in the chain