Pharm 3 - Chapters 6, 7, 8, and 9
What does the nurse need to document to identify how effective medications are? (Select all that apply.) (80)
Noting any nausea and vomiting after giving oral medicationsMonitoring the patient's vital signsChecking blood sugar after insulin administrationSpecific assessments such as lung sounds
The nurse was aspirating the patient's NG tube to check the contents. What can the nurse expect for results if the contents are gastric fluid?
PH of 3, green with sediment
Which information is recorded in the nurse's notes if a medication error occurs?
Patient assessments related to adverse effects of the error The only information recorded in the nurse's notes are the clinical observations of the patient related to the occurrence. These will serve as a baseline for future comparisons. Circumstances surrounding the error, the fact that an error has occurred, and the fact that an incident report has been completed are not recorded in the nurse's notes.
Which instruction does the nurse include when teaching a patient to take a sublingual or buccal medication?
"Allow the medication to dissolve where it is placed and hold saliva in the mouth until the tablet is dissolved."The medication should be completely dissolved in the area where it is placed. Holding the saliva in the mouth works to provide the patient as much medication as possible. A dry mouth decreases the absorption process. A sublingual or buccal medication should never be chewed; this will not help it dissolve faster. A sublingual or buccal medication should never be swallowed; this will dilute the medication, some of which will be swallowed with the water and will decrease the effectiveness of the medication because of first-pass effect.
Which information does the nurse provide regarding administration when educating a patient about use of a metered-dose inhaler ?
"Hold your breath and exhale slowly following medication administration." Holding the breath and exhaling slowly allow the medication to settle in the pulmonary tissue. Deep breathing before administration is irrelevant in relation to the use of a metered-dose inhaler. The patient should rinse the mouth with water following medication administration. The inhaler should be horizontal to the mouth, not held at a 45-degree angle.
A patient with hay fever who has been given a prescription for a timed release antihistamine asks why a timed release tablet has been ordered. Which answer is most appropriate for the nurse to provide?
"It decreases the required frequency of administration."Timed release preparations provide a gradual but continuous release of a drug because different parts of the preparation dissolve at different rates. The advantage of this delivery system is that it reduces the number of doses administered per day. Enteric-coated tablets are designed to prevent the drug from irritating the stomach lining. The blood level of the drug and the therapeutic index of the drug are irrelevant to the question.
Which information should the nurse exclude when providing education to a patient scheduled for patch testing for allergens?
"Plan to remain at the clinic for 4 hours after the test for an initial reading of the result."No antiinflammatory or antihistamine medications should be taken for 24 to 48 hours before patch testing because of the risk of a false negative result. The patient will not need to wait for the results because they are read at 24, 48, and 72 (sometimes more) hours. Actions that cause sweating as well as hot baths or showers should be avoided during the testing period. Itching and burning are side effects that may occur; wheezing indicates a severe allergic reaction.
Which direction does the nurse give to a patient who has just used a steroid inhaler?
"Rinse your mouth with water."After using a steroid inhaler, the mouth must be rinsed with water to remove any remaining drug and prevent fungal overgrowth. Taking five or six slow, deep breaths is unrelated to the use of a steroid inhaler. Bronchodilators should be used before the steroid so the airways are maximally open to allow the steroid to enter deep into the lung. Blowing the nose has no relevance to the use of steroid nebulizers.
Which instruction does the nurse include when teaching a patient how to self-administer nitroglycerin ointment?
"You may use measuring paper to apply the next dose."The use of measuring paper will prevent the absorption of the medication through the fingertips when applying the medication, and will help in measuring the correct dose. The site should be rotated to decrease skin irritation from the medication. This ointment should not be rubbed into the skin, just placed on the skin surface. The ointment should not be placed on a hairy area of the skin because this will decrease the medication's absorption.
The nurse is preparing to administer an IM injection to a toddler. Which is the maximum volume in milliliters (mL) the nurse can administer at one site for this patient?
1 In small children and older infants, the maximum volume for an IM injection at one site is typically 1 mL. In small infants, the muscle mass may only be able to tolerate a volume of 0.5 mL. Levels of 1.5 and 2 mL are too much to inject at one site for a toddler.
The nurse is preparing an IM injection of 0.5 mL of influenze vaccine for an average adult patient and will be using which needle length and syringe size when administering the dose?
1 inch, 3mL
The nurse was preparing to administer a dose of the antibiotic cefepime (Maxipime). Place the steps in the order that the nurse will follow to ensure the right drug is administered. (76-79)
1. Check the precription 2. Triple check that the drug name and dose are correct prior to administrtion 3. Identify the patient using two patient identifiers 4. Administer the medication via the correct route 5. Document the drug
When nitroglycerin ointment is prescribed, how long is the typical recommended drug free period?
10 - 12 hours off every 24 hours
Fentanyl patches do not usually achieve a sufficient blood level for pain control until how many hour after their initial application?
12 hours
The nurse was preparing to give an injection into her patient's abdomen for his early morning insulin dose. Which needle length and gauge are appropriate to use?
25 gauge, 5/8 inch
What size needle does the nurse use for an obese patient who requires an IM injection?
3 inches A longer-than-average needle is needed to inject medication into the muscle of an obese patient. A 3-inch needle should be sufficient. The other needle lengths listed are too short to inject medication into the muscle of an obese patient.
Which assessment finding indicates a positive patch test reaction?
A 3- to 5-mm wheal with flareA positive reaction is noted with the development of a wheal and should be considered clinically significant. Redness, bruising, and skin color change may occur but do not indicate a positive reaction.
What does the ward stock system refer to? (68)
A system used in very small hospitals
Prior to any medication administration, the nurse must be able to do what? (Select all that apply.) (61)
Accurately calculate the drug doseDocument the patient's response to the medica- tionExplain to the patient the expected actions of the medicationExplain to the patient why the medication is prescribed
When should PRN medications be administered? (73)
After the patient asks for it and the nurse determines it can be safely administered.
After administering a dose of the oral antihistamine fexofenadine (Allegra), the nurse noticed the patient had already received a dose 2 hours before. What is this type of error called? (74)
An administration error
Which action does the nurse take when a new medication order written at 8 AM by the physician reads: Demerol 75 mg stat?
Clarifies the order with the physician The medication should not be administered because the order is incomplete—it does not specify the route of administration. The order should be clarified with the physician before administration. The medication should not be administered right away. The medication would not be administered with the 9 AM medications because it is a stat or give immediately order. The pharmacist would be consulted about the dose only in special circumstances, such as if information about the standard dosage ranges for the ordered drug were not available.
Which statement about percutaneous drug administration is true?
Percutaneous administration refers to the application of medicine to the skin or mucous membranes for absorption.The percutaneous route uses the skin or mucous membranes as administration sites. By localizing the application, there is reduced incidence of systemic side effects using percutaneous administration. Percutaneous administration requires frequent reapplication because it has a short duration. Topical applications have a short duration of action.
Which medication distribution system is identified as the safest system in current use?
Computer-controlled dispensingThe computer-controlled dispensing system is the safest system of drug distribution available today because, among other safeguards, it limits access to medications and has checks and alarms for errors related to time of administration, dose, and patient. The floor stock system is the least controlled and therefore presents the greatest opportunity for error. The unit dose system and individual prescription systems are safer than the floor stock system but do not have as many checks and controls as the safest distribution system does.
A patient is to receive a medication via the buccal route. Which action does the nurse plan to implement?
Place the medication inside the pouch between the patient's lower molar and the cheek
When preparing to administer a medication to a patient, the nurse is not able to verify that the medication prescription is appropriate. What actions does the nurse take? (Select all that apply.) (75-76)
Contacts the healthcare provider who prescribed the drugIf the prescriber cannot be contacted, notifies the nursing supervisor on duty
Technology is being used to help prevent medication errors by which methods? (Select all that apply.) (74)
Programs that have computerized provider order entry systemsSmart pumps for controlled administration of controlled medicationsBarcoded labeling of medications for administration
Which action related to medication administration is outside the scope of basic nursing practice?
Deciding the best route of administration of medicationsThe route of administration is part of the medication order and is determined by the prescriber. The nurse may give input into the decision at times or may request a change in route, but cannot make the decision. The nurse is responsible for knowing the actions and side effects of medications given and for assessing the patient's response to them. The nurse is responsible for providing the patient with information on medications.
When removing a parenteral medication from an ampule, what must the nurse do?
Use a filter needle or filter straw to ensure that no glass parties are drawn into the syringe
A patient complains to his nurse about heartburn. The nurse notes in the medication profile that an antacid has been ordered PRN. What will the nurse need to do next?
Verify the last time that the drug was given and determine whether it is appropriate to give the dose now.
What are the benefits of use CPOE technology for healthcare providers?
It checks for potential drug interactions it checks associated laboratory values it checks for the appropriateness of the drug dosages
The nurse assesses the patient for the treatment effectiveness of the percutaneous medication nitroglycerin, and documents which assessment findings?
Blood pressure Pulse Pain relief location of patch
A nurse is having difficulty reading a physician's order for a medication. The nurse knows that the physician is very busy and does not like to be called. What does the nurse do next?
Calls the physician to have the order clarified.
An older patient who is prescribed acetaminophen (Tylenol) caplets for knee pain asks how the caplets differ from the tablets. Which explanation does the nurse provide to the patient?
Caplets are more easily swallowed.A caplet is a tablet that has an elongated shape and a smooth coating like a capsule. The smooth coating facilitates swallowing. A capsule is designed to hide unpleasant taste. Rate of dissolution and dosage are unrelated to the characteristics of a caplet.
The nurse is administer several medicaitons to the patient via an NG tube. What is the nurse's first action?
Check for the placement of the tube
List in order what steps the nurse takes when preparing and administering a patient's morning medications
Check the order to verify the medication is correct Obtain the medications for administration from the medication room triple check that the correct medication was prepared Identify the patient using two patient identifiers before administration Document the administration of the medications.
What is the most effective method the nurse uses for identifying a pediatric patient for medication administration?
Checking the child's identification bracelet
The nurse is preparing to give an oral narcotic drug to a patient. As the medication package is opened, the tablet falls onto the floor. Which action does the nurse implement?
Destroys the tablet in front of another nurse, and both nurses sign the narcotic control recordNarcotic control systems require that when any controlled substance is discarded, a second nurse witnesses the discard and both nurses sign the inventory control sheet, either manually or electronically. Contaminated drugs are not routinely returned to the pharmacy. A narcotic is a controlled substance, and a second nurse is required to witness the discard of this type of medication. A tablet dropped on the floor would not be given to a patient because the floor is a contaminated area.
A nurse was preparing to administer 3 mg of mor- phine (a controlled substance) orally to a patient. The medication came in 4 mg/4 must the nurse take when giving this medication? mL. What steps (Select all that apply.) (71)
Determine the correct amount to give (3 mL).Ask another nurse to verify the dose and any wasted medication.Check the time interval since the last dose was given.Complete the documentation after administration. checking
Medication reconciliation is a process designed to reduce medication errors and involves which steps? (Select all that apply.) (75)
Developing a list of prescribed medications Developing a list of current medications being taken by the patient Comparing the lists of current medications with prescribed ones
After the nurse has administered an appropriate dose of a medication that has been prescribed, the nurse must now do what? (79)
Document in the medication administration record the date and time given.
Immediately after administering morning medications for a patient, the nurse is expected to perform which action next?
Document the medications administered.
What does the nurse need to do when determining the therapeutic effectiveness of a medication ?79
Document the patient's response and notify the healthcare provider when appropriate. nurse
Pyxis system refers to what drug dosage system? (69)
Electronic medication dispensing system
Which type of medication errors could a nurse make when administering a drug? (Select all that apply.) (74)
Errors of omission (missed dose)Errors of duplication (extra dose given)Errors of wrong time
What nursing action causes most medication errors to occur?
Failing to follow routine procedures
The nurse was teaching a patient how to apply the prescribed powder under a skinfold for a yeast infection. The nurse knows that further teaching is needed after the patient made which statement?
I can sprinkle this power all over to prevent the infection from spreading
The nurse was teaching a patient how to use an inhaler prescribed for asthma. The nurse knows that further teaching is needed after the patient made which statement?
I will take a slow deep breath and let it out quickly
Which guideline does the nurse follow when giving a liquid oral medication?
If giving by oral syringe, place tip between the cheek and gum halfway back in the mouth. When giving medication using an oral syringe, the tip of the syringe should be placed between the cheek and the gum halfway back in the mouth to decrease the risk of the medication being spit out. The medication should be given slowly to allow for swallowing and to prevent choking. Medications should never be diluted unless the order specifies this is to be done. The medicine cup is inaccurate for the measurement of doses smaller than 1 tsp, not 1 mL; a syringe of appropriate size should be used for amounts smaller than a teaspoon. A medicine dropper is used for selected small pediatric doses; it is not appropriate for all medications for all pediatric patients.
When does the drug prescribed using the term stat need to be given?
Immediately and one time only.
The prescribed has changed the route of the patient's medication from an intravenous route to an oral route. What effect (in general) does the change in route have on the drug dosage and the absorption time?
Increased dosage and decreased absorption time
Which physician's order does the nurse carry out when giving medications at 8 AM?
Irbesartan (Avapro) 150 mg PO dailyDaily means once per day. In the absence of further specification, a drug ordered daily can be given at 8 AM. The Toprol XL should be given at bedtime. PRN means as needed, so every 4 hours as needed would not necessarily be at 8 AM. PC means after meals, so the medication should not be given at 8 AM.
Why is the oral route the preferred route for medications? (Select all that apply.)
It is convenient. The oral form of a medication is usually cheaper than other forms. Most medications (or a comparable medication) are available in oral form. It is more convenient to give medications orally when available. The oral route is one of the safest routes of drug administration. However, the oral route has the slowest and least dependable rate of absorption due to frequent changes in the gastrointestinal environment. It is safe.The oral form of a medication is usually cheaper than other forms. Most medications (or a comparable medication) are available in oral form. It is more convenient to give medications orally when available. The oral route is one of the safest routes of drug administration. However, the oral route has the slowest and least dependable rate of absorption due to frequent changes in the gastrointestinal environment. It is relatively economical.The oral form of a medication is usually cheaper than other forms. Most medications (or a comparable medication) are available in oral form. It is more convenient to give medications orally when available. The oral route is one of the safest routes of drug administration. However, the oral route has the slowest and least dependable rate of absorption due to frequent changes in the gastrointestinal environment. Most medications are readily available in oral dose forms. The oral form of a medication is usually cheaper than other forms. Most medications (or a comparable medication) are available in oral form. It is more convenient to give medications orally when available. The oral route is one of the safest routes of drug administration. However, the oral route has the slowest and least dependable rate of absorption due to frequent changes in the gastrointestinal environment.
A student licensed practical nurse is recalling the different types of parenteral dose forms. Which statements accurately describe a vial? (Select all that apply.)
Its rubber diaphragm is sealed with a metal lid.The mouth of a vial is covered with a thick rubber diaphragm through which a needle is passed to draw the medication. The rubber diaphragm is sealed with a metal lid to ensure that the medication remains sterile. The medication in the vial may be either in solution form or in sterile powder form that is reconstituted just before administration. In mix-o-vials, the upper chamber contains the solvent and the lower chamber contains the solute. An ampule is a glass container of medication that is opened by snapping its neck just before use. CORRECT It contains medication either in solution form or in sterile powder form.The mouth of a vial is covered with a thick rubber diaphragm through which a needle is passed to draw the medication. The rubber diaphragm is sealed with a metal lid to ensure that the medication remains sterile. The medication in the vial may be either in solution form or in sterile powder form that is reconstituted just before administration. In mix-o-vials, the upper chamber contains the solvent and the lower chamber contains the solute. An ampule is a glass container of medication that is opened by snapping its neck just before use. Its mouth is covered with a thick rubber diaphragm. The mouth of a vial is covered with a thick rubber diaphragm through which a needle is passed to draw the medication. The rubber diaphragm is sealed with a metal lid to ensure that the medication remains sterile. The medication in the vial may be either in solution form or in sterile powder form that is reconstituted just before administration. In mix-o-vials, the upper chamber contains the solvent and the lower chamber contains the solute. An ampule is a glass container of medication that is opened by snapping its neck just before use.
The nurse is assessing the patient's pH of aspirate after inserting an NG tube. Which value would the nurse expect if the NG tube is correctly placed?
Less than 3If an NG tube is correctly placed in the stomach, the stomach pH would measure less than 3. A pH reading of 4 to 5 is acidic but is usually not a low enough reading for stomach contents unless the patient is receiving H2 antagonists, which would affect the aspirated fluid pH. Intestinal pH is typically 6 to 7. Respiratory pH is typically greater than 7.
What process is used to eliminate medication errors in the healthcare environment as patients transition from one clinical setting to another?
Medication reconciliation
Why is it important not to crush medications that are considered long acting?
Medications that are crushed release the drug immediately, inactivating the long acting effect and potentially causing an orderdose.
Which scale is labeled on a medicine cup?
MetricThe metric scale is labeled on a medicine cup. The centimeter and millimeter are not scales but units of measurement. A kilogram is a unit of measurement to measure weight.
Which statements about parenteral injections are true? (Select all that apply.)
Needleless systems for medication and fluid administration are required by the Occupational Safety and Health Administration (OSHA).Under new OSHA regulations, needleless systems are required for: (1) the collection of body fluids or withdrawal of body fluids after initial venous or arterial access is established; (2) the administration of medication or fluids; or (3) any other procedure involving the potential for occupational exposure to blood-borne pathogens as a result of percutaneous injuries from contaminated sharps. There is ongoing research for safer and efficient methods of parenteral medication administration. The Centers for Disease Control and Prevention (CDC) estimate that 62% to 88% of sharps injuries can be prevented by using medical devices. The blunt access device (spike) is a safety innovation that is used when drawing liquid from a rubber-diaphragm-covered vial. Blunt access devices do not have a stainless steel needle suitable for injection. Skill and special care are required when administering drugs parenterally because of the trauma at the puncture site, possibility of infection, and chance of allergic reaction. CORRECT A needleless jet injection system that delivers subcutaneous injections of liquid medication through the skin is in development.Under new OSHA regulations, needleless systems are required for: (1) the collection of body fluids or withdrawal of body fluids after initial venous or arterial access is established; (2) the administration of medication or fluids; or (3) any other procedure involving the potential for occupational exposure to blood-borne pathogens as a result of percutaneous injuries from contaminated sharps. There is ongoing research for safer and efficient methods of parenteral medication administration. The Centers for Disease Control and Prevention (CDC) estimate that 62% to 88% of sharps injuries can be prevented by using medical devices. The blunt access device (spike) is a safety innovation that is used when drawing liquid from a rubber-diaphragm-covered vial. Blunt access devices do not have a stainless steel needle suitable for injection. Skill and special care are required when administering drugs parenterally because of the trauma at the puncture site, possibility of infection, and chance of allergic reaction.
Which is a basic safety measure related to medication administration?
Never leave a medication on a bedside table for the patient to take later.The nurse should never leave a medication to be taken later. The nurse should watch the patient take the medication; medication should not be left with the patient. If left on the bedside table, the medication might be destroyed or hoarded by the patient, or taken by someone else. If taken by the patient for whom it is intended, the time taken is not known. The patient should be asked his or her name, not be addressed by it. The label on liquid medications should be covered so spills do not obliterate it. It is not necessary to have the dose of every medication that is to be injected and checked by a second person.
When admiistering an intermittent enteral feeding to an adult patient, the nurse finds that the residual aspirate obtained is coffee ground in color. What does the nurse do?
Notifies the healthcare provider
The nurse is preparing to administer a patient's 8 AM medications and notes that the dose for the drug raloxifene (Evista) is only 20 mg and not 40 mg. What will the nurse need to do next?
Notify the pharmacy that the drug dose is in error.
Which nursing action should be implemented when a patient suddenly stops taking his or her prescribed heart medication?
Record the patient's refusal of the medication in the nurse's notes and notify the prescriber. Because this is a heart medication, the prescriber should be notified because the patient may experience changes in their condition. The nurse should determine why the patient refuses the medication, but should be sensitive to reasons why. In cases where there may be adverse effects if the patient does not take the medication, the nurse should document the patient's refusal of the medication and notify the prescriber. Patient teaching should already have been performed by this point.
Which step does the nurse instruct the patient to do after administration of vaginal medication?
Remain supine with hips elevated for 5 to 10 minutes.The patient should remain supine with hips elevated for 5 to 10 minutes to keep the instilled medication in contact with the vaginal mucosa. If there is vaginal discharge when the patient rises, the patient should wipe front to back when cleansing. Lying on the left side is incorrect because the medication tends to pool. Warm water may be used to cleanse the perineum, if needed, but it is not essential.
A patient refuses an essential heart medication that has been prescribed. What does the nurse do next?
Seeks patient reasons
Which instruction does the nurse include when teaching a patient to use a nebulizer?
Sit up to use the nebulizer. Nebulizers are used with the patient in a sitting position to allow maximum lung expansion. Before using the nebulizer, the patient should exhale through pursed lips. The lips are placed around the mouthpiece but are not completely sealed. The patient activates the nebulizer, inhales to capacity, exhales through pursed lips, waits a minute, and then repeats the cycle until the medication is used up.
The prescriber writes an order to administer cefazolin sodium (Ancef) 500 mg every 6 hours × 2 doses. Which type of medication order does this describe?
Standing order A standing order indicates that a medication is to be given for a specified number of doses. A stat order is used generally on an emergency basis; the drug is to be administered as soon as possible, but only once. A single order means that the drug is administered at a certain time, but only once. A PRN order means administer as needed.
Which accurately identifies dried, powdered drugs that have been compressed into small disks?
TabletsTablets are small compressed disks derived from dried, powdered drugs. Lozenges, or troches, are flat disks containing a medicinal agent in a suitably flavored base. Capsules are small cylindrical gelatin containers that hold dry powder or liquid medicinal agents. A pill is an obsolete dose form that is no longer manufactured as a result of the development of capsules and compressed tablets. However, the term is still used to refer to tablets and capsules.
The rules and regulations established by the state boards of nursing are in place to ensure what? (61)
That there are guidelines in place to practice nursing
When reconstituting a medication to be administered, the nurse needs to clearly label it with what? (Select all that apply.) (78)
The correct doseThe proper concentrationThe name of the drug
What are the advantages of the prefilled cartridge-nnedle units and syringes?
The diminish the chance of contamination of the medication They save the nurse time it takes to prepare the injection They contain a standard amount of medication
List in order the steps necessary to mix two medications in one syringe
Wipe off the tops of both draw air into the syringe to equal amount of medication to be withdrawn from vial (i.e. 1 mL) insert syringe into vial 1 and inject the air. Do not let the needle touch the medication. Then remove the needle Draw air into the syringe to equal the amount of medication to be withdrawn from vial 2 (i.e. 0.5 mL) Insert new needle into vial 1, invert vial and withdraw desired amount of medication (ex. total volume would be 1.5 mL)
Which are reasons for administering a medication via the parenteral route? (Select all that apply.)
The duration of the drug is generally shorter.A quick onset of drug action needed, the duration of the drug being generally shorter, and the smaller dosage amount of medication being administered are all reasons for giving a parenteral medication. There is no first-pass effect with parenterally administered medications. The cost of drug therapy is often greater when using parenteral administration. CORRECT The amount of medication administered is often at smaller doses.A quick onset of drug action needed, the duration of the drug being generally shorter, and the smaller dosage amount of medication being administered are all reasons for giving a parenteral medication. There is no first-pass effect with parenterally administered medications. The cost of drug therapy is often greater when using parenteral administration. CORRECT A quick onset of drug action is needed.A quick onset of drug action needed, the duration of the drug being generally shorter, and the smaller dosage amount of medication being administered are all reasons for giving a parenteral medication. There is no first-pass effect with parenterally administered medications. The cost of drug therapy is often greater when using parenteral administration.
Which system used to dispense medications provides the advantage of fewer inpatient prescription return of medications? (68-69)
The floor or ward stock system
A patient is ordered to have eyedrops administered daily to both eyes. Into which part of the eye are eyedrops instilled?
The lower conjunctival sac
The nurse preparing the narcotic hydromorphone (Dilaudid) needs to get assistance from another licensed healthcare provider when what occurs?
The medication is delivered in a dose that is more than the amount ordered.
When removing narcotics from a narcotic control system, what must be recorded at the time of removal? (Select all that apply.) (71)
The name of the patientThe time the medication was removedThe name of the nurse who removed the medication
What are the legal responsibilities for correctly preparing and administering medications to patients?
The nurse must enusre that the patient fully understands all the effects of the medication. The nurse must understand that patient's diagnosis and symptoms correlating to the medication. The nurse must be accurate in calculating and preparing medications the nurse must administer all medication orders without questions
The nurse gave an antiemetic medication 30 minutes ago and is checking on the patient to determine the effectiveness. Which scenario indicates the medica- tion worked? (79)
The patient states he feels a lot less nauseated.What does the nurse need to document to identify how effective medications are? (Select all that apply.) (80)
While checking the narcotics count at the end of shift the nurse notes a discrepancy regarding the oral doses of hydromorphone (dilaudid) what needs to be needs to be done next ?71-72
The patients' charts need to be reviewed for proper documentation.
As part of the plan of care for an elderly woman newly diagnosed with glaucoma, the nurse is teaching the patient's daughter to administer the prescribed ophthalmic drops. Which observation by the nurse during the return demonstration indicates that the patient's daughter requires additional instruction?
The tip of the dropper gently touched the patient's inner eyelid. To prevent pathogens from being placed in the eye, the tip of the dropper or bottle should never be touched or come into contact with the eye or the face. Having the patient look up facilitates placing the drop in the conjunctival sac. Eyedrops are never dropped directly against the eyeball; dropping medication into the conjunctival sac is the correct way to instill drops. After instilling the drops, gentle pressure is applied to the inner corner of the eyelid on the bone for 1 to 2 minutes to prevent the medication from entering the lacrimal canal and being absorbed through the nasal mucosa, which coul
Which parts of the syringe and needle are considered sterile?
The tip of the needle The plunger tip of the syringe The luer lok end The inner barrel of the syringe
The floor stock system of dispensing medications available medications, used in small hospitals has the advantage of readily but also what disadvantage?select all that apply
There is increased potential for medication errorsThere is the potential misappropriation of medication by hospital personnel.There is a need for larger stocks and frequent drug inventories.
What are advantages of the unit-dose system? (69)
There is less waste and misappropriation of medications.
Which statements about safe medication administration are true? (Select all that apply.)
There must be a clear policy statement that authorizes the act of administering medicines. Medication administration is covered under the nurse practice acts. Therefore, a current license is required. A policy statement that authorizes medication administration by the nurse must be present in order for the nurse to safely and legally administer drugs. The nurse, not the pharmacist, assumes responsibility for verification and safety of the medication order. Although bar coding and handheld devices have helped streamline medication administration practices, the nurse still must use standard procedures such as checking all aspects of the drug order, right patient, right drug, right time, right dose, right route, and document drug response. The nurse should not record any medication until after it has been given, because the patient may refuse to take the medication. The nurse must have a current license to practice. Medication administration is covered under the nurse practice acts. Therefore, a current license is required. A policy statement that authorizes medication administration by the nurse must be present in order for the nurse to safely and legally administer drugs. The nurse, not the pharmacist, assumes responsibility for verification and safety of the medication order. Although bar coding and handheld devices have helped streamline medication administration practices, the nurse still must use standard procedures such as checking all aspects of the drug order, right patient, right drug, right time, right dose, right route, and document drug response. The nurse should not record any medication until after it has been given, because the patient may refuse to take the medication.
When performing a patch test for allergens, the nurse knows what is important?
To recognise when a wheal has formed to cleanse the area for testing with alcohol before applying the patches to have an emergency equipment available in case of an anaphylactic response To ask the patient if he or she has taken any antihistamines or antiinflammatory agents
The nurse is teaching the patient how to prepare to 10 units of regular insulin and 5 units of NPH insulin for injection. List in the correct order the proper sequence for preparation that the nurse will describe to the patient
Wipe the tops of the insulin vials with alcohol inject appropriate volumes of air into the NPH vial and the regular insulin vial withdraw 10 units of regular insulin into the syringe withdraw 5 units of NPH insulin into the syringe mix with the regular insulin inject the insulin in the proper subcut site
After the patient returns from an elective procedure, the healthcare provider writes a prescription that states resume all prepprocedure medications. What is this known as?
a blanket order
With regard to the administration of oral medications put the following actions in chronologic order
check all aspects of the medication order identify the patient sit the patient upright give the patient water to drink document the administration
Policy statements that are made by nurse practice acts related to medication administration include: (Select all that apply.) (61)
educational requirements necessary to have prescriptive privileges.abbreviations approved for use to avoid medi- cation errors.medications that the nurse can start with IV solutions.when to claim unfamiliarity with any nursing responsibilities.
When administering a rectal suppository, the patient needs to be in which position?
left side lying
When administering vaginal medications, the nurse knows the patient needs to be in which position?
lithotomy position
A nurse is preparing to administer eardrops to a 5 year old child. What is the proper technique to use for this patient?
pull the earlobe upward and back
The nurse is reviewing an prescription that states "nifedipine 30 mg SL now." This is an example of what type of order? (73)
single order
What type of drug prescription indicates that nurses are to administer the medication for a specific number of doses ?(73)
standing orders
Which of these routes are classified as parenteral administration
subcutaneous, intramuscular, intradermal, intravenous
Which of the following nursing principles apply to administering guaifensin syrup to a 5 year old
the correct amount of liquid should be measured in a medicine cup by reading the meniscus at eye level Use a syringe that compares closely to the volume to be measured A syringe can be used when giving an infant medications
