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