Module 11
When administering oral medications, why does the nurse wipe the lip of the bottle with a tissue or paper towel after pouring? 1. Allows for better visualization 2. Prevents contamination 3. Prevents medication leakage 4. Promotes better absorptionPrevents transfer of bacteria
2. Prevents contamination
The nurse is preparing to administer an oral medication to an infant. In which position should the nurse place the infant? 1.Prone 2.Semi-Fowler's 3.Trendelenburg's 4.Dorsal recumbent
2.Semi-Fowler's The nurse should administer oral medications with the infant sitting in an upright position to prevent aspiration if the infant cries or resists. Semi-Fowler's is an upright position. Trendelenburg's position is on the back with the head lowered, and prone is on the abdomen. Oral medications could not be administered to an infant in either of these positions. Dorsal recumbent means on the back and flat, so there would be a risk of aspiration with this position.
A hospitalized patient's medical record contains the following medication orders. The patient's name is stamped on the order sheet. Which order is complete? 1) Furosemide 40 mg IV daily 2) 5/26/10—digoxin 0.25 mg IV daily, G. Horowitz RN 3) 5/28/10—0930—K-lor 40 mEq PO now, James Carp MD 4) 5/29/10—metopropol 5 mg IV q 6 hours, Robert Young DO
3) 5/28/10—0930—K-lor 40 mEq PO now, James Carp MD Medication orders must contain the patient's full name, date and time the order was written, name of the medication, drug dosage, route of administration, and signature of the prescriber with credentials.
The nurse is teaching parents ways to give oral medication to their child. Which action would they implement to improve compliance? 1)Crush time-release capsules to put in his favorite food. 2)Give medication quickly before he knows what is happening. 3)Allow the child to eat a frozen pop before receiving the medication. 4)Mask the flavor of medication in a toddler cup with orange juice.
3)Allow the child to eat a frozen pop before receiving the medication.
What term is used to describe the time it takes for drug concentration to reach a therapeutic level in the blood? 1)Peak action 2)Duration of action 3)Onset of action 4)Half-life
3)Onset of action
Medication system that is kept in individual containers at patient beside 1. Stock supply 2. unit dose 3. self administration 4. automated dispensing system
3. self administration
The nurse is providing medication instructions to a parent. Which statement by the parent indicates a need for further instruction? 1."I should cuddle my child after giving the medication." 2."I can give my child a frozen juice bar after he swallows the medication." 3."I should mix the medication in the baby food and give it when I feed my child." 4."If my child does not like the taste of the medicine, I should encourage him to pinch his nose and drink the medication through a straw."
3."I should mix the medication in the baby food and give it when I feed my child."
The nurse is preparing to administer medication through a nasogastric tube that is connected to suction. To administer the medication, the nurse should take which action? 1.Position the client supine to assist in medication absorption. 2.Aspirate the nasogastric tube after medication administration to maintain patency. 3.Clamp the nasogastric tube for 30 to 60 minutes following administration of the medication. 4.Change the suction setting to low intermittent suction for 30 minutes after medication administration.
3.Clamp the nasogastric tube for 30 to 60 minutes following administration of the medication.
What is the window for administering a medication?
30 mins before or after the scheduled medication dose. In this scenario, it would be either 8:30 or 9:30 am.
How high should the container of enema be elevated above the client's hips?
30-45 cm above hip level to deliver a slow, steady installation of the plane enema solution, which will decrease cramping and increase patient ability to retain the solution.
When you completely finish administering enteral medications, how much water do you completely flush the line with?
30-60 mL
Which nursing action would the nurse implement to reduce medication errors? 1) Check to be sure pediatric medication is ordered using dose per pound of body weight. 2) Administer prescribed medication if you note it is not documented on the MAR. 3) Administer medication before the patient goes to sleep when it is ordered "hs." 4) Draw up liquid suspension in an oral syringe with a bulb or plunger and no needle.
4) Draw up liquid suspension in an oral syringe with a bulb or plunger and no needle. Oral medications should be drawn up into an oral syringe to avoid inadvertent IV administration. Pediatric medication should be ordered using dose per kilogram of body weight, not pounds. The Joint Commission also advises nurses to weigh patients in kilograms to avoid errors in administering drugs based on weight; Kilograms is the standard metric for pediatric prescriptions, medical records, and staff communication. Mistakes can occur as a result of poor documentation. For example, one nurse administers a medication yet fails to record it immediately afterward. A second nurse checking the patient's chart thinks the drug has not been given so administers a dose. The patient receives a double dose. The Institute for Safe Medication Practices published a Dangerous Abbreviations list. Among numerous abbreviations, acronyms, and symbols, neither HS nor hs should be used on a medication order or prescription. HS can be mistaken for "taken at bedtime," and "hs is often confused with "half-strength." In this example, the nurse would not know whether the prescriber intended the medication to be given at "hour of sleep" or in half-strength.
What is the preferred site of intramuscular injection for children who are walking? 1) Dorsogluteal 2) Rectus femoris 3) Vastus lateralis 4) Ventrogluteal
4) Ventrogluteal
The nurse accidentally provides a patient with 10 mg of warfarin instead of 5 mg as prescribed. Which action should the nurse take? 1)No action is necessary because an extra 5 mg of warfarin is not harmful. 2)Call the prescriber and ask her to change the order to 10 mg. 3)Document on the chart that the drug was given and indicate the drug was given in error. 4)Complete an incident report according to the facility's policy.
4)Complete an incident report according to the facility's policy.
Which action should the nurse take immediately after administering a medication through a nasogastric tube?1)Verify correct nasogastric tube placement in the stomach. 2)Auscultate the abdomen for presence of bowel sounds. 3)Immediately administer the next prescribed medication. 4)Flush the tube with water using a needleless syringe.
4)Flush the tube with water using a needleless syringe.
Which are the rights of medication administration? 1)right patient, right room, right drug, right route, right dose, and right time. 2)right drug, right dose, right route, right time, right physician, and right documentation. 3)right patient, right drug, right route, right time, right documentation, and right equipment. 4)right patient, right drug, right dose, right route, right time, and right documentation.
4)right patient, right drug, right dose, right route, right time, and right documentation.
Medication system that is in a password-accessible cart, has computerized tracking, and can combine stock and unit doses 1. Stock supply 2. unit dose 3. self administration 4. automated dispensing system
4. automated dispensing system
The nurse is preparing to administer an intramuscular injection of pain medication to a new postoperative client. When the nurse walks into the client's room, the client asks why he is receiving an intramuscular form of the medication instead of the oral form. What is the nurse's best response with regard to the absorption of the medication? 1."Your primary health care provider wants you to have it this way." 2."Are you saying that you are not going to take this medication?" 3."Medications given this way have fewer side effects than those given orally." 4."Medications given this way are absorbed more quickly than by other routes."
4."Medications given this way are absorbed more quickly than by other routes."
The nurse is providing instructions to a client who will be self-administering eye drops. To minimize systemic absorption of the eye drops, the nurse should instruct the client to take which action? 1.Eat before instilling the drops. 2.Swallow several times after instilling the drops. 3.Blink vigorously to encourage tearing after instilling the drops. 4.Occlude the nasolacrimal duct with a finger after instilling the drops.
4.Occlude the nasolacrimal duct with a finger after instilling the drops.
The nurse is teaching a mother to instill drops in her infant's ear. The nurse explains that to give the ear drops correctly, the mother needs to take which action? 1.Pull up and back on the earlobe and direct the solution toward the eardrum. 2.Pull down and back on the auricle and direct the solution toward the eardrum. 3.Pull up and back on the auricle and direct the solution toward the wall of the canal. 4.Pull down and back on the earlobe and direct the solution toward the wall of the canal.
4.Pull down and back on the earlobe and direct the solution toward the wall of the canal.
most narcotic prescriptions are in effect for how many days?
7
A prn order:
A prn prescription requires the nurse to determine, in collaboration with the patient, when the medication is to be given. The prescription states the condition for which the medication is to be used and the minimum amount of time between doses. The medication cannot be given more frequently than prescribed, even if the symptoms persist (e.g., pain, antiemetics, laxatives, those that treat nausea)
what is stock supply?
A stock supply remains on the nursing unit for use in an emergency or so that a nurse can give a medication without delay. Some facilities use automated medication-dispensing systems, which contain frequently used medications for that unit, any as-needed (PRN) medications, controlled medications, and emergency medications
When administering eye ointment, why does the nurse pull the lower lid down to expose the conjunctival sac?
Allows for better visualization
if your patient is prescribed eye drops and eye ointment, which should you apply first?
Apply drops before ointment
how would you ask your patient to position themselves when receiving eye drops?
Ask patient to lean head back for administration (except if they have a head/neck injury)
what parts of the eye should you avoid during administration?
Avoid cornea Avoid touching eyelids w droppers or tubes to decrease risk of infection; don't touch tip of med container Use only in affected eye
what are the 3 checks of medication administration?
Before you pour, mix, draw up med After med is prepared and before returning container to med cart or discarding anything At the bedside before actually administering it
which inhaler does Release depends on strength of pt breath?
Breath actuated metered dose inhalers
Where is buccal medication administered? Where is a sublingual medication administered?
Buccal medication administration is placed inside the mouth on the cheek area. Teach patients that they cannot swallow the medication or chew it, just allow it to dissolve into their cheek. Sublingual medications are administered under the tongue and held there until completely dissolved.
What do you do if a client states he/she has trouble swallowing tablets?
Check if the medication can be crushed and sprinkled into foods. If not, call the pharmacy to see if they have a liquid version.
how should we prep the skin to administer a topical medication?
Clean skin first to remove tissue and crusting before administering medication Apply ointments and pastes evenly across skin area Follow directions for each type of med Watch for local side effects (redness, swelling, heat, etc.)
how would you clean the eye ball before medication administration?
Cleanse the edges of the eyelid from the inner-outer canthus before administration
When using enteral feedings, how would you correctly administer the medications into the NG tube?
Dissolve medication in 15-30 mL warm sterile H2O to then add to the NG tube
what if there is drainage from my patients ear?
Drainage may indicate eardrum rupture
how would you drop the medication into the ear?s
Drop medication along side of ear canal and not directly onto eardrum
which inhaler is activated by pt breath?
Dry powder inhalers
How much water do you flush in between administering medications for enteral feedings?
Flush tube w 15-30mL
after administering a rectal suppository to a child, what should you do?
For peds: gently hold the buttocks together for 5-10 minutes after administration
How do you facilitate the flow of medication after installation of ear drops?
Gently tug on the external ear after the drops are instilled
how should the patient be positioned during enteral feedings?
HOB should be above 30 degrees, always check NG tube placement
once you completed administering eye drops, what would you educate your patient to do?
Have pt close gently eyes for 2-3 minutes after admin to facilitate medication absorption. Warn him that blurry vision may occur but its temporary.
how should the patient be positioned after a rectal suppository?
Have pt lay in sims position for 5-10 min and have them try to retain it
how should you position a patient receiving ear drops?
Have pt sitting somewhat upright and turn head so meds don't fall out or side lying position with affected ear facing up
after ear drops, how should the patient be positioned?
Have pt stay on side or w head tilted for 5-10 min after administration
Explain the special steps required when administering enteral medications to a patient who is receiving continuous tube feedings.
If the patient is receiving a continuous tube feeding, (a) disconnect the tube before giving the medications and (b) leave the tube clamped for a few minutes after administering the medication according to agency protocol.
if the NG tube is on suction, what should you do to administer the medication?
If to suction, clamp tube for 30 min
if you make a medication error, what is the first thing you do?
Immediately assess the patient's vital signs
Which finger do you use to insert the suppository? How far do you insert the suppository?
Index finger of dominant hands 1-3 inches in adult
what side of suppository is inserted first?
Insert the suppository with the rounded end first to east administration
What do you do if you drop a medication?
It cannot be used
What is the correct client position when inserting a rectal suppository?
Lefts SIM position with right leg up
Before medication administration, the RN must assess the client's:
Measure vital signs. Assess whether the patient's general condition is appropriate for the medication. Evaluate your knowledge of the medication. Identify biological factors that affect drug metabolism
what is the problem with the pressurized metered dose inhaler?
Need sufficient hand strength to use it
what if my patients ear canal is occluded?
Never occlude ear canal or force meds into occluded ear canal
Can you delegate medication administration (including topicals) to a PCA/CNA?
No
Which arm usually tested for TB screening?
Non dominant arm
Where do you place the cap of a multi-dose bottle when you begin to pour out the dose?
Often with multi-dose bottles, you will place the bottle cap flat side down on the counter and then pour the liquid medication in the cap.
what are the components of the medication order?
Patients full name Date and time prescription was written Medication name, dose, and route of administration Time the medication was administered Name, address, and telephone number of prescriber, including relevant credentials and legal registration number Provider signature Patient response to drug
what position should we place a patient in for a vaginal suppository?
Place in dorsal recumbent position (supine with knees flexed) or sims position
how do you know when to stop inserting the rectal suppository?
Place past internal anal sphincter to prevent expellation but dont force (approximately 1-3 inch) Try to have the medication in contact with feces Try to put on rectal wall
what are the types of inhalers:
Pressurized metered dose inhalers Breath actuated metered dose inhalers Dry powder inhalers
When administering oral medications, why does the nurse wipe the lip of the bottle with a tissue or paper towel after pouring?
Prevents contamination
When administering ear drops, why does the nurse place a cotton ball, or a piece of one, loosely at the opening of the auditory canal for 15 minutes?
Prevents medication leakage
what is the purpose of an inhaler? what effects may occur?
Produce local effects like bronchodilation, can also create serious systemic side effects (this is why it is important to rinse mouth out after administration)
what is the procedure for using an inhaler?
Pt sitting, standing, or in high fowlers Have pt rinse mouth and spit to help prevent transfer of bacteria from mouth → inhaler Shake inhaler and remove cap Have pt breath out slowly and completely Have pt seal lips around spacer or on MDI Press on canister to release one puff of meds Have pt inhale slowly and hold breathe for 10 seconds or as long as possible Wait at least 1 min before admin another puff
how do you pull pinna for adults vs children less than 3 years old?
Pull pinna down and back for children less than 3 years old, pull pinna up and back for children over 3 years old
what position should we place a patient in when receiving an enema?
Put pt in left sims
how should you position your patient receiving a rectal suppository?
Put pt in left sims position (L side w R hip and knee flexed)
When, as a rule, are rectal medications contracted
Rectal medications are contraindicated when there is active rectal bleeding. (Note that a disadvantage of this route is possible pain and embarrassment, but those are not contraindications.
how would we prep the skin for a transdermal patch?
Remove old patch before applying new; switch spots each time Patch should be placed on clean, dry, non hairy skin Before applying a new patch, cleanse the skin of traces of old medication patch
what should you do after you assess a patients vital signs when you make a medication error?
Report findings to the primary care provider. Notify the nurse manager of your unit and report the events surrounding the event. Document on the chart that the medication was given, but do not indicate that it was given in error. Complete incident report according to facility policy.
What are the six rights of medication administration?
Right drug Right dose Right time Right route Right patient Right documentation Other (right reason, right to know, right to refuse)
How do you clean an inhaler?
Rinse the spacer, mouthpiece, and cap with water.
whats the difference between a side effect, adverse effect, and toxicity?
Side effects are unintended, often predictable, physiological effects of the medication to which patients usually adapt. They occur at the usual prescribed dose. Dry mouth is among the most common side effects (nausea, vomiting, diarrhea, dizziness, drowsiness, abdominal distention or distress, and constipation). Adverse reaction: Harmful, unintended, usually unpredicted reactions to a drug administered at the normal dosage. More severe than side effects and often require discontinuation of the drug (e.g., rash, thrombocytopenia) Toxic reaction: Dangerous, damaging effects to an organ or tissue. More severe than adverse reactions, sometimes even causing permanent damage or death (e.g., respiratory depression from excessive morphine, hypoglycemia from too much insulin, tinnitus caused by aspirin, hearing loss caused by aminoglycoside antibiotics, drug-induced cancers)
What is the correct client position when administering an enema?
Sims (with right leg up)
Prior to using an inhaler, what should a client first do?
Sit high fowler's position and rinse out mouth before using the inhaler Shake inhaler then remove mouth piece
how high do we hang the bag when administering an enema?
The higher bag is hanging, it is the faster the enema will flow into the rectum A medium height is best
What is the best way to determine if a metered-dose inhaler is empty?
The only reliable method for determining the number of doses remaining in a canister is to subtract the number of doses used from the number available. Some devices are equipped with counters. Floating MDIs in water is not accurate for assessing remaining doses and often will clog the valve.
Written order:
The order applies without a renewal date until the prescriber writes a prescription to alter or discontinue the medication or indicates on the original prescription how long it is to be given or a specific stop date. (e.g., amoxicillin 500 mg three times a day for 7 days)
Standing order:
These are officially accepted sets of prescriptions to be applied routinely by nurses for the care of patients under certain conditions or under certain circumstances, such as drug allergies or sensitivities. (e.g., diphenhydramine or epinephrine)
If the client is using a corticosteroid inhaler, what should the client do after administration?
They should rinse out their mouth with water and spit out the rinse. Prolonged exposure of this medication can be irritating to the oral mucosa and can lead to thrush.
Automatic "stop" date:
This is a protocol that hospitals use for discontinuing medications after a certain length of time. (e.g., most narcotic prescriptions are only approved/in effect for 7 days without being rewritten). If medication needed after that automatic stop date, the care provider must write a new prescription
STAT order:
This means that a single dose of medication is to be given immediately and only once.
Most of the following routes are used for both local and systemic effects. Which one is used only for medications intended for systemic absorption (that is, which one is not used to for local effects): lotions, creams, ointments, transdermal patches, or irrigations?
Transdermal patches are used only for medications intended for systemic absorption.
how should you administer a rectal suppository?
Use gloves Separate buttocks with nondominant hand and ask pt to take deep breaths in and out thru mouth Insert lubricated suppository w dominant hand (lubricate your finger and the suppository)
what PPE is required to administer ointments onto skin?
Use gloves and applicators bc we can absorb meds too if it touches us
how long do we want the enema to remain in the rectum?
Want enema to stay in for 10-15 min; have pt stay in side position
what should the temperature of the ear solution be?
Warm meds in hand b/c ear is sensitive to temp
describe how we would administer a vaginal suppository
always wear gloves Clean perineal area before and after admin Use lubricant or applicator to apply May need pad to collect drainage
what if my patient is unable to sit up to take the sitting up?
assist patient into side lying position and offer a straw to take water with capsule or tablet
how should i care for my patient who is an older adult and is to receive medication through an enteral tube?
check LOC, mentation and alertness. check for potential aspiration risk by checking patients swallowing and gag reflexes.
what if my patient is NPO?
check with the prescriber to determine whether the medication should be given by another route or can be given with small sips of water
what are the advantages to oral medications?
convenient, easy to admin, produces local or systemic effects, may or may not be given w food, most common route
Rinse mouth out if using _____________ inhaler
corticosteroid
what if the prescribed dose of the suppository is only half?
cut the suppository lengthwise with a clean, single-edge razor blade
what if your patient refuses to take the prescribed medication?
discuss with the patient his concerns about the medication. Hold the dose and notify the prescriber of the patients refusal and explain the patients concerns.
what should you do if your patients medication is not available from the pharmacy at the time the dose is due?
do not borrow medication from another patients supply. Administer only medication prescribed for that particular patient. Notify the pharmacy of the need to immediately dispense the medication.
what if the patient tells you the tablet you are ready to give him is a different color from what he normally takes of a certain prescribed medication?
double check the MAR
what if my patient rolls over so most of the otic medication flows back out of the ear?
estimate the amount that was lost and try again
patient education for rectal suppository
explain there will be a cool feeling from the lubricant and feeling pressure during the insertion deep breathing during the procedure helps relax the anus after administration use call bell device and use bedpan if necessary
what are the types of medication orders?
handwritten, preprinted, oral/verbal, by telephone (spell out drug name)
how should the patient be positioned after enteral medication is administered?
have patient sit for 30 mins after medication is given
what if my patient who I am supposed to administer eye drops wears contact lenses?
have the patient remove contact lenses before administering the medication and wait at least 15 minutes after instilling eye drops before restarting the lenses
what do you do if you cannot understand the prescriber's handwritten medication prescription?
hold dose and contact HCP
single (or one-time) prescription
indicates that the medication is to be given only once at a specified time, usually before surgery or diagnostic procedures.
how do you administer Buccal medications?
inside mouth on cheek area, do not swallow or chew, do not eat or drink till medication has dissolved, may need to change to other side periodically
What do you do if the medication is expired?
it cannot be used
What is the purpose of a spacer?
it helps the medication reach the lungs used in children and elderly helps avoid mouth fungus, nervousness and other side effects
can another patient use a different patients eye meds?
no
can a medication be administered whole via enteral feeding?
no If a medication cannot be crushed, check with pharmacy if the same medication in same dose can be prescribed in a liquid form
what if my patient vomits shortly after taking the oral medication?
notify HCP about instructions whether to repeat the dose
what should you keep in mind if you are administering a suppository to an older adult?
older adults may have difficulty retaining a suppository because of poor sphincter control. You may need to put the bedpan under the patient while you are inserting the suppository.
do we use sterile technique to apply skin ointment?
only if patient has an open wound
what kind of oral tablets can be broken apart?
only scored medications
what should the patient do before a suppository in the vagina or rectum?
patient should either void or defecate before the medication administration
where should you place your dominant hand when administering eye drops?
place dominant hand with eyedrops on forehead gently and use nondominant hand to pull down lower lid
how would you administer eyedrops?
place dominant hand with eyedrops on forehead gently and use nondominant hand to pull down lower lid and apply drops in there; press on inside corner of eye to dec risk of systemic absorption
how do you administer sublingual medication?
placed under tongue, shouldn't eat/drink till medication is dissolved; don't swallow or chew
why do you NOT document on the EHR that there was a medication error?
poses lawsuits, just say ______ medication was given but do not say it was an error. instead just fill out an incident report.
how should the patient be positioned after the vaginal suppository is inserted?
remain in position for 5-15 minutes
what if my patient is cognitively impaired?
request the patient open his mouth to see whether he has swallowed the medication, look under the tongue or side pocket near the inside of the cheek
What are enemas used for?
severe constipation
whats the difference between stock supply and unit dose?
stock supply is a medication system that is kept in bulk quantity, in a central location, and is non-client specific. unit dose is a medication system that is individually packaged, kept in client-specific drawers, and hold a 24-hours supply
how would you administer a medication on an empty stomach?
stop the feeding 30 minutes before giving the drug and after giving the drug
When a prescription is given may be given by phone but must be followed by a cosign within 24 hours
telephone prescription
what if my patient is a child and wont open their eyes for eye drops?
try distracting the child by turning on the TV or offering an age appropriate toy in view, or ask a family member help you gain cooperation of the child
what if my patient has difficulty drinking from a cup?
use a syringe without a needle to place medication in patients mouth as the patient is sitting upright or in a side lying position. place the syringe between the gum and cheek in back corner of mouth and slowly push the plunger to administer the liquid.
what if my patient is a child who is to receive medication through an enteral tube? - what position should the patient be in?
use only medication in liquid form to prevent occluding the tube. place infant in prone, side lying, sitting position for 30 mins following medication administration.
what is my patient is on fluid restriction?
use the smallest amount of water needed to swallow or dissolve tablets and flush enteral tubes
what are filter needles used for?
used to trap rubber or glass fragments when drawing up a medication from a vial or ampule
When a prescriber may give a verbal to an RN and the RN will write the prescription and sign it with the provider's name followed by their name and credentials
verbal prescription
what if my patient has too much ear wax to instill the ear medication?
you can use special drops to soften the earwax to remove it easier
After medicating patients, assess:
Ø Effectiveness of the drug Ø Side effects Ø Signs of adverse reactions or toxicity
While administering medications, the nurse should assess:
Ø Mental status Ø Coordination Ø Ability to self-administer the drug Ø Swallowing (for oral medications)
Two ways to ensure an accurate dosage when pouring liquid medications.
- Measure the dosage with the calibrated cup at eye level - Read the dosage where the lowest part of the concaved surface (meniscus) of the fluid is on the line.
what are some considerations for medication administration in children?
- labeling each bottle to make them distinguishable - warn child if medication has unpleasant taste -tablets that can be crushed can be mixed with soft foods - to prevent choking or aspiration when giving liquids to infants and toddlers, hold the child in a sitting position and use the medicine dropper between gum and cheek. - give child a frozen fruit bar or ice pop before medication to numb taste buds if medicine tastes bad. - always praise child after he swallows the medication - be aware that young children may not be able to swallow tablets and capsules
what are some considerations for medication administration in older adults?
- the older adult usually requires smaller dosages of drugs and physical responses to some medications are unpredictable. - The nurse must address swallowing difficulties. - Must also accommodate slower reflexes and reasoning ability. - try to reduce polypharmacy - assess urinary status - assess for fall risks - offer nonpharmacological interventions -assess patients self-care ability, can they administer the drug to themselves?
How long should the client wait between puffs if another puff is required?
1 minute
A physician's order reads "diltiazem (Cardiazem) 5 mg IV now." Which type of order did the physician write? 1) STAT 2) Single 3) PRN 4) Standing
1) STAT
An adult patient is prescribed a unit of packed red blood cells. Which gauge needle should be inserted to administer this blood product? 1)18 gauge 2)22 gauge 3)24 gauge 4)26 gauge
1)18 gauge
The healthcare provider telephones the care area to provide a verbal medication prescription for a client. What action should the nurse take? Select all that apply. 1)Repeat the prescription to the provider. 2)Tell the provider that verbal orders are not permitted. 3)Ask the unit secretary to write the prescription in the medical record. 4)Remind the provider that verbal orders need to be signed within 1 week. 5)Sign the prescription with the provider's name followed by the nurse's name.
1)Repeat the prescription to the provider. 5)Sign the prescription with the provider's name followed by the nurse's name.
The nurse manager wants to reduce the number of medication errors made on a care area. What can be implemented to improve the safety of medication administration? Select all that apply. 1)Smart pumps 2)Automated dispensing cabinets 3)Unit dose administration system 4)Bar code medication administration 5)Computerized prescriber order entry (CPOE)
1)Smart pumps 2)Automated dispensing cabinets 4)Bar code medication administration 5)Computerized prescriber order entry (CPOE)
The nurse needs to provide a medication to a child. What should the nurse recall when calculating the dosage of this medication? Select all that apply. 1)Use Clark's rule. 2)Convert mg to mEq. 3)Refer to a nomogram. 4)Recall that 1 mL is equal to 100 units. 5)Convert the child's weight to kilograms.
1)Use Clark's rule. 3)Refer to a nomogram. 5)Convert the child's weight to kilograms.
How far do you insert the tubing into the rectum for an enema?
1-2 inches
how much do we insert the tip of the enema into the rectum?
1-2 inches
During the administration of a metered-dose inhaler, when should the nurse instruct the client to rinse her mouth? Select all that apply. 1. Directly after the dose has been administered for certain medicines 2. During the administration of the dose 3. An hour after the dose has been administered 4. An hour before the dose is administered 5. Directly before the dose is administered
1. Directly after the dose has been administered for certain medicines 5. Directly before the dose is administered
Medication errors are common in healthcare. What are some frequently reported reasons for errors to occur? Select all that apply. 1. Lack of knowledge 2. Fatigue 3. Poor handwriting 4. Labeling errors 5. Inadequate staffing
1. Lack of knowledge 2. Fatigue 3. Poor handwriting 4. Labeling errors 5. Inadequate staffing
Why Do Medication Errors Occur
1. Lack of knowledge about drug 2. Faulty communication (written/verbal) 3. Equipment Errors 4. Calculation & measurement errors 5. Patient identity not checked 6. Nurse fatigue 7. Inadequate lighting
As Cynthia talks to Mrs. Steinhart about the medications to be delivered, what information should the nurse share? Select all that apply. 1. Name of medication 2. Reason for medication 3. Pharmacokinetics of the medication 4. Who ordered the medication 5. Dose of medication
1. Name of medication 2. Reason for medication 4. Who ordered the medication 5. Dose of medication
The nurse prepares a client for ear irrigation as prescribed by the primary health care provider. Which action should the nurse take when performing the procedure? 1. Warm the irrigating solution to 98.6º F (37.0º C). 2. Position the client with the affected side up following the irrigation. 3. Direct a slow, steady stream of irrigation solution toward the eardrum. 4.Assist the client to turn his or her head so that the ear to be irrigated is facing upward.
1. Warm the irrigating solution to 98.6º F (37.0º C).
The nurse is reviewing the instillation technique for both eye ointment and eye drops with the parent of a pediatric client diagnosed with bacterial conjunctivitis. Which statement made by the parent would indicate that learning has taken place? 1."I will be careful not to touch the eye or eyelid during administration." 2."I will place my child on the left side to administer drops in the right eye." 3."I will administer the eye ointment and then wait 5 minutes and administer the eye drops." 4."I will have my child blink after the instillation to encourage thorough distribution of the eye drops."
1."I will be careful not to touch the eye or eyelid during administration."
how high should you hold the eye dropper above the eye during medication administration?
1.5-2 cm
A client is prescribed an eye drop and an eye ointment for the right eye. How should the nurse best administer the medications? 1.Administer the eye drop first, followed by the eye ointment. 2.Administer the eye ointment first, followed by the eye drop. 3.Administer the eye drop, wait 15 minutes, and administer the eye ointment. 4.Administer the eye ointment, wait 15 minutes, and administer the eye drop.
1.Administer the eye drop first, followed by the eye ointment.
The nurse is preparing to administer medication using a client's nasogastric tube. Which actions should the nurse take before administering the medication? Select all that apply. 1.Check the residual volume. 2.Aspirate the stomach contents. 3.Turn off the suction to the nasogastric tube. 4.Remove the tube and place it in the other nostril. 5.Test the stomach contents for a pH indicating acidity.
1.Check the residual volume. 2.Aspirate the stomach contents. 3.Turn off the suction to the nasogastric tube. 5.Test the stomach contents for a pH indicating acidity.
A client is in the bathroom when the nurse arrives at his room with his scheduled medications. The client calls to the nurse, "Just leave my medication on the bedside table like the rest of the nurses, and I will take it when I get finished." What is the nurse's best action? 1.Tell the client that he or she will be back when he is finished. 2.Leave the medication at the bedside as the client requested. 3.Let another nurse who is not busy give the client his medication when he is finished. 4.Tell the assistive personnel to give it to the client when he is finished.
1.Tell the client that he or she will be back when he is finished.
The nurse is preparing to administer eye drops. Which interventions should the nurse take to administer the drops? Select all that apply. 1.Wash hands. 2.Put gloves on. 3.Place the drop in the conjunctival sac. 4.Pull the lower lid down against the cheekbone. 5.Instruct the client to squeeze the eyes shut after instilling the eye drop. 6.Instruct the client to tilt the head forward, open the eyes, and look down.
1.Wash hands. 2.Put gloves on. 3.Place the drop in the conjunctival sac. 4.Pull the lower lid down against the cheekbone.
How long should a client hold their breath after activating the inhaler?
10 seconds
How many forms of identification does a nurse use to verify a client's identification?
2 patient identifiers (check ID band and ask them their name and date of birth)
A patient is prescribed the narcotic hydromorphone (Dilaudid). Where should the nurse expect to retrieve this drug for administration? 1)Cabinet in the patient's room 2)Double-locked medication drawer 3)Stock supply cabinet 4)Portable medication cart
2)Double-locked medication drawer
The nurse must administer hepatitis B immunoglobulin 0.5 mL intramuscularly to a 3-day-old infant. Which injection site should the nurse choose to administer this injection? 1)Ventrogluteal 2)Vastus lateralis 3)Deltoid 4)Dorsogluteal
2)Vastus lateralis
