Medication administration
Ways medications are excreted
Kidneys, intestines, lungs, or exocrine glands
local anesthetic
Lidocaine (Xylocaine)
Intravenous Injection
May use hypodermic needle, butterfly set, or IV catheter 1.Wash hands, prepare med 2.Tourniquet is placed above possible injection site 3.Put on gloves 4.Have pt make a fist, 5.Cleanse site
Allergic reaction
you are sensitized to the drug
Intramuscular
90 degree angle, 22 gauge Given in deltoid, gluteal, or lateral thigh
When giving an I.M. injection, the nurse should insert the needle into the muscle at an angle of:
90 degrees.
The physician prescribes meperidine (Demerol), 75 mg I.M. every 4 hours as needed to control a client's postoperative pain. The package insert reads: "Meperidine, 100 mg/ml." How many milliliters of meperidine should the client receive?
0.75
A 64-year-old client has just had total hip replacement surgery. The physician orders heparin 8,000 units to be administered subcutaneously. The label on the heparin vial reads: "Heparin 10,000 units/ml." How many milliliters of heparin should the nurse draw up in the syringe to administer the correct dose?
0.8
5 Rights of Medication Administration
1) Right dose 2) of Right Medication 3)for Right Patient 4) at the Right Time 5) by the Right Route
The label of a drug package reads "hydralazine (Apresoline), 20 mg/ml." How many milliliters would the nurse give a client for a 25-mg dose?
1.25
Intradermal Subcutaneous
45 degree angle, 23-25 gauge
The physician prescribes 60 mEq of potassium chloride liquid as a one-time dose. The pharmacy supplies a liquid containing 20 mEq/15 ml. How many milliliters of solution should the nurse administer?
45 ml
A client is prescribed clozapine (Clozaril) 250 mg by mouth daily. How many tablets should the nurse administer if each tablet contains 100 mg?
2.5
Most common IV Injection Sites
Anterior forearm Posterior hand Radial aspect of wrist Antecubital - not for long term use
Enteral Route
Applies to sublingual, rectal, and oral Absorbed into blood and immediately available w/o having to be digested and absorbed Oral most common Give rectally if unable to swallow
The nurse is calculating the proper dosage of medication for a child. What parameters should this calculation be based on?
Body weight
A nurse must verify a client's identity before administering medication. The safest way to verify identity is to:
Check the client's identification band and ask the client his name.
When preparing to give a client a prescribed drug, the nurse realizes that the drug is one the nurse has never administered before. No drug references on the nursing unit contain information about the drug in question. What should the nurse do?
Contact a pharmacist to obtain information about the drug.
Why would the nurse be interested in a client's dietary history when administering drugs?
Dietary intake can alter the effectiveness of some drugs.
Before administering the evening dose of a prescribed medication, the nurse on the evening shift finds an unlabeled, filled syringe in the client's medication drawer. What should the nurse do?
Discard the syringe to avoid a medication error.
The nurse administers an I.M. injection. Afterward, the nurse should:
Discard the uncapped needle in a puncture-proof container.
IM injection sites
Dorsogluteal muscle Deltoid muscle Vastus lateralis muscle
A drug must enter the bloodstream before it can act within the body. Which parenteral administration route places a drug directly into the circulation, requiring no absorption?
I.V.
Topical Route
Patch Cream
Which of the following must be included in a medication order?
Physician's signature
The nurse knows that many drugs can be administered by more than one route. Which administration route provides the most rapid response in a client?
Sublingual
The nurse is teaching a client how to rotate insulin injection sites. What is the purpose of rotating injection sites?
To prevent the formation of hard nodules
Medication Pump
Used for pt controlled pain meds Parenteral nutrition Continuous med administration IV bag or bottle should always be 18-20 inches above vein
Which I.M. injection site is appropriate for a 6-month-old infant?
Vastus lateralis muscle
Infiltration (Extravasation)
When the injection goes into the tissues surrounding the vein
Therapeutic effect
desired predicted response
Parenteral Route
dispensation of medications via a needle into the skin layers
Excretion
elimination of drugs after metabolism
Intrathecal
intraspinal, directly into subarachnoid Myelography performed by physician, surgical asepsis needed
Side effects
may or may not be harmful
Distribution
means by which a drug travels from absorption site to site of action
Analgesics
pain relievers w/o loss of consciousness Morphine, codeine, demerol
Intra-arterial
performed by physician Angiography - need surgical asepsis
Metabolism
process by which the body transforms drugs into an inactive form for excretion
Absorption
process by which the drugs enter the systemic circulation
When teaching a client how to take a sublingual tablet, the nurse should instruct the client to place the tablet:
under the tongue.
Toxic effect
when drug accumulates in body due to inadequate excretion, overdose, or drug sensitivity
The physician prescribes 250 mg of a drug. The drug vial reads 500 mg/ml. How much of the drug should the nurse give?
½ ml