EAQ Ch. 32 Medication Administration

The nurse is preparing a medication ordered by the physician. The physician ordered 250 mg of Tylenol to be given to the patient. The medication comes from the pharmacy in dosage strength of 1 gram of Tylenol in 2 mL. How many mL should the nurse administer? Record your answer using one decimal place.

0.5

A patient has to be given a bladder irrigation with 100 mL of medicated solution with 1/1000 dilution. How much of the medication should the nurse dissolve in 100 mL of solvent? Record your answer using a whole number.

1/1000 solution indicates the presence of 1 gram of medication in 1000 mL of solution. This means that each mL of the solution contains 1 mg of the medication. Because the nurse has to prepare 100 mL of the solution, the nurse should dissolve 100 mg of medication in 100 mL of solvent.

The nurse has been asked to prepare a 1% solution of medication in distilled water. How much of the medication should the nurse dissolve in 100 mL of distilled water? Record your answer using a whole number, and, please note, no comma is needed.

1000mg A 1% solution contains 1 gram of the medication dissolved in 100 mL of the solution. Because the unit is mg, and 1 gram is 1000 mg, the nurse should dissolve 1000 mg of the medication in 100 mL of water.

The primary health care provider prescribes lorazepam (Ativan) 1 mg IV to a patient who is about to undergo an MRI scan. Which type of prescription order has been given by the primary health care provider? Prn order Now order STAT order Single order

Single order

While assessing a patient, the nurse observes raised, irregularly shaped skin eruptions with red margins. Which mild allergic reaction does the nurse document in the medical record? Rash Hives Rhinitis Pruritus

Hives Hives, or urticaria, is a mild allergic reaction that is characterized by raised, irregularly shaped skin eruptions with red margins. Rash is a mild allergic reaction that is characterized by small, raised vesicles that are usually reddened all over the body. Inflammation of the mucous membrane lining the nose mucosa is referred to as rhinitis. Pruritus is a mild allergic reaction that involves itching of the skin that accompanies rashes.

Which drug is administered with the STAT order of prescription? Cetrizine Hydroalazine Vancomycin Paracetamol (over-the-counter analgesic)

Hydroalazine

A registered nurse is teaching a nursing student about medications in patients with renal disease. Which statements, if made by the nursing student, indicate a need for further teaching? "Renal failure may lead to drug toxicity in the body." "Adequate fluid intake promotes proper elimination of medications through the kidneys." "Most drugs undergo biotransformation in the kidney before they are excreted." "Health care providers should decrease the medication dose in patients with renal disease." "Enemas will accelerate excretion of the drug through the kidneys in patients with renal failure."

"Enemas will accelerate excretion of the drug through the kidneys in patients with renal failure." "Most drugs undergo biotransformation in the kidney before they are excreted." Most of the drugs undergo biotransformation in the liver before they are excreted through kidneys. Enema, which increases the rate of peristalsis, will accelerate the excretion of medication through feces. Renal failure may result in drug toxicity due to improper excretion of the drug from the body. Adequate fluid intake promotes proper elimination of medications through kidneys. Drug doses should be minimized in patients with renal disease to avoid the risk of drug toxicity.

The registered nurse is teaching the right route of drug administration to nursing students. Which of a nursing student's statements indicates a need for further teaching? "The medication should be labeled after preparation." "Enteral syringes should not be used to prepare oral medications." "Failure to remove the cap before administering the oral medication may result in aspiration." "Administration of oral products through intravenous route may result in the formation of a sterile abscess."

"Enteral syringes should not be used to prepare oral medications." Enteral syringes can be used for preparing oral medications, because they have a different color from the parenteral syringe and will be clearly labeled for oral or enteral use. Any prepared medication should be labeled soon after its preparation to prevent any adverse effects of the unlabeled drug. Removing any caps from the tip of an oral syringe before administering the medication will help in preventing aspiration. Administration of oral preparations through parenteral route may result in the formation of a sterile abscess and may also result in fatal consequences.

The nurse is teaching a nursing student about parenteral routes. Which statement made by the nursing student indicates a need for correction? "The intraperitoneal route is used to administer insulin." "Intraarterial medication administration is managed by the nurse." "Epidural medication is used to administered medicine in the spinal canal." "Intrapleural administration is common in toddlers who have poor access to intravascular space."

"Intrapleural administration is common in toddlers who have poor access to intravascular space."

A patient develops sudden onset of bronchiolar constriction, edema of pharynx and larynx, and shortness of breath following administration of a medication. Which type of allergic reaction is the patient experiencing? Rhinitis Medication allergy Anaphylactic reaction Idiosyncratic reaction

Anaphylactic reaction The sudden onset of bronchiolar constriction, edema of pharynx and larynx, and shortness of breath indicate the severe form of allergic reaction called anaphylactic reaction. Rhinitis is a minor form of allergic reaction that manifests as sneezing, swelling, and clear nasal discharge. Medication allergy is a nonspecific term and encompasses rhinitis, rash, urticaria, and pruritus. Idiosyncratic reaction is the onset of an unpredictable response in a patient.

The nurse takes a medication to a patient, and the patient refuses to take it and tells the nurse to take it away. What is the nurse's next action? Ask the patient's reason for refusal. Explain that she must take the medication. Take the medication away and chart the patient's refusal. Tell the patient that her physician knows what is best for her.

Ask the patient's reason for refusal.

Which nursing actions are appropriate for safe narcotic administration? Making a note of a discrepancy in the record Obtaining the signature of the witness nurse in the paper record Storing the medication in the drawer near the patient Disposing of the unused part in the presence of another nurse Dispensing wasted parts of medications in sharps containers

Disposing of the unused part in the presence of another nurse Obtaining the signature of the witness nurse in the paper record

The nurse is responsible for the storage and safe usage of drugs. Which guidelines should the nurse follow for the safe use of narcotics? Store narcotics in locked containers. Preserve unused portion of the drug. Frequently count narcotics, especially during shift change. Do not report discrepancies in narcotic count. Document and record patient details.

Document and record patient details. Frequently count narcotics, especially during shift change. Store narcotics in locked containers.

Which route is used for the administration of regional analgesia for surgical procedures? Epidural Intrapleural Intraosseous Intraperitoneal

Epidural

The nurse is attending to a patient with a pulmonary infection. The healthcare provider prescribes antibiotics for the patient. Which instructions should the nurse give to the patient regarding antibiotic treatment? Emphasize taking the full prescription. Explain that improper treatment may worsen the patient's condition. Emphasize discontinuing the treatment once the patient attains symptomatic relief. Explain that improper treatment may cause development of bacterial resistance. Emphasize continuation if the condition does not improve with a full course of medication

Explain that improper treatment may cause development of bacterial resistance. Emphasize taking the full prescription. Explain that improper treatment may worsen the patient's condition.

Medications undergo vigorous testing before they are made available to the public. Which regulatory agency is responsible for ensuring this process? Medicare program National Formulary United States Pharmacopeia Food and Drug Administration

Food and Drug Administration The Food and Drug Administration ensures that all medications available in the market undergo vigorous testing to ensure their safety and efficacy. The Medicare program does not ensure testing of drugs. The United States Pharmacopeia and the National Formulary set standards for medication strength, quality, purity, packaging, safety, and dose form.

The nurse is educating a diabetic patient about how to administer insulin. Which statements pertaining to use of insulin are appropriate? The insulin vial should be shaken well before drawing the injection. Insulin should not be mixed with any other medication. Insulin detemir should not be mixed with any insulin. Insulin glargine should be mixed only with regular insulin. Rapid-acting insulin mixed with NPH insulin should be given along with meals.

Insulin should not be mixed with any other medication. Insulin detemir should not be mixed with any insulin Insulin should never be mixed with any other medication, because it can hamper the effectiveness of the insulin. Mixing insulin detemir with any other insulin can make it ineffective. Shaking an insulin vial can form bubbles that can interfere with correct dosage. Insulin glargine should not be mixed with any other insulin. Rapid-acting insulin mixed with NPH insulin must be given 15 minutes before meals for maximum benefit.

The nursing instructor is talking to nursing students about the unit-dose system used in medication distribution. Which statements accurately describe the unit-dose system? It uses carts for distribution. It has labeled drawers. It has controlled substances kept in foil. It does not contain prn and stock medication. It includes ordered doses of medication for a full course.

It uses carts for distribution. It has labeled drawers. he unit-dose system uses a cart with drawers with a 24-hour supply of medications for each patient. The drawers are labeled with the patient's name. Controlled substances are not kept in the patient's drawer; they are kept separately in locked drawers. The cart also has prn and stock medications. The carts have the ordered dose of medication for each patient for 24 hours, which may not be the full course.

The primary health care provider prescribes pain medication to a patient with the notation "prn" in the prescription. What should the nurse interpret from the prescription? The medication should be taken as needed. The medication should be taken every hour. The medication should be taken before meals. The medication should be taken twice each day.

The medication should be taken as needed.

Which statement about medication names requires correction? The trademark for generic names is indicated by the superscript "TM." United States Adopted Names Council approves generic names of drugs. The nonproprietary name of a medication is the generic name given to the drug. The Institute for Safe Medication Practices publishes a list of medications that are frequently confused with another.

The trademark for generic names is indicated by the superscript "TM." Brand names of any drug are indicated by the trademark of superscript "TM." The United States Adopted Names Council approves the generic name of the drug released into the market as the first trade name. The nonproprietary name of a medication is the generic name given to the drug. The Institute for Safe Medication Practices publishes a list of medications that are frequently confused with another medications.

Which nursing intervention avoids aspiration in children? Using liquid medication form Using a straw for medication administration Offering juice after medication administration Avoid mixing a large amount of medication into foods

Using liquid medication form

The registered nurse is teaching a nursing student about the various factors that affect drug absorption. Which statement if made by the nursing student indicates a need for further teaching? "Patients with malnutrition and liver disease are at risk of drug toxicity." "The larger the surface of drug absorption, the less the drug is absorbed." "Drugs given through the intravenous route are absorbed faster than the oral route." "The tablet form of medication is more readily absorbed than the solution form." "The greater the blood supply to the site of administration, the faster the drug is absorbed."

"The tablet form of medication is more readily absorbed than the solution form." "The larger the surface of drug absorption, the less the drug is absorbed." The larger the surface of drug absorption, the more the drug is absorbed. The solution form of medication is more readily absorbed by the body than the tablet form of medications. Patients with malnutrition and liver disease are at risk of drug toxicity. Drug absorption is faster through the intravenous route (IV) than the oral route, as the IV route facilitates the direct infusion of medication into the blood. The greater the blood supply to the site of administration, the faster the absorption of the drug is.

The registered nurse is teaching a nursing student about time-critical medications. Which statement if made by the nursing student indicates effective learning? "The Institute for Safe Medication Practices (ISMP) determines time-critical medications." "Time-critical medications should be administered within 1 hour of the scheduled time." "Time-critical medications should be administered within 30 minutes of the scheduled time." "Subtherapeutic responses do not occur with delayed administration of time-critical medications."

"Time-critical medications should be administered within 30 minutes of the scheduled time." Time-critical medications are medications that should be administered within 30 minutes before and after the scheduled time. Hospitals have the responsibility of deciding time-critical medications. Non-time-critical medications should be administered within 1 hour of the scheduled time. Delayed administration of time-critical medications cause harm or subtherapeutic responses.

Which statement is true regarding systems of medication measurement? The metric system is most familiar to people. The apothecary system is used infrequently today. Household measurements allow the use of teaspoons and cups. The metric system of measurement is officially adopted by the U.S. Congress.

The apothecary system is used infrequently today.

After administering a medication, the nurse finds that a medication error has occurred. Which action by the nurse is most appropriate in this situation? Preparing and filing an incident report Reporting the incident to the manager Reporting the incident to the supervisor Assessing and examining the patient's condition

Assessing and examining the patient's condition

Which statements are true regarding routes of medication administration? Parenteral route causes anxiety in patients. Inhalational routes have higher absorption rates. Medications are absorbed slowly through the skin. Oral route is avoided in patients with gastrointestinal disorders. Oral route is used in patients with reduced gastrointestinal motility.

Medications are absorbed slowly through the skin. Oral route is avoided in patients with gastrointestinal disorders. Parenteral route causes anxiety in patients. Medications are absorbed slowly through the skin due to the makeup of the skin. The oral route of administration is contraindicated in patients with gastrointestinal disorders. The administration of medications through the parenteral route often causes anxiety in patients, especially in children. The intramuscular and intravenous routes have higher absorption rates. The oral route is contraindicated in patients with reduced gastrointestinal motility.

A patient is transitioning from the hospital to the home environment and obtains a home care referral. Which is priority for the discharge nurse in relation to safe medication administration? Set up the follow-up appointments with the physician for the patient. Ensure that someone will provide housekeeping for the patient at home. Ensure that the home care agency is aware of medication and health teaching needs. Make sure the patient's family knows how to safely bathe the patient and provide mouth care.

Ensure that the home care agency is aware of medication and health teaching needs. A nursing responsibility is to collaborate with community resources when patients have home care needs or difficulty understanding their medications. Setting up follow-up appointments, ensuring that someone will provide housekeeping for the patient, and making sure the patient's family knows how to safely bathe the patient are not the priority for the discharge nurse in relation to medication administration.

The nurse is explaining to a patient about the side effects of a prescribed drug. Which terms describe side effects? Predictable Often unavoidable Occur after prolonged intake Occur at usual therapeutic dose Caused by defective drug excretion

Occur at usual therapeutic dose Predictable Often unavoidable

The registered nurse is teaching pediatric drug dosages to a nursing student. Which statement if made by the nursing student indicates a need for further teaching? "Drugs such as vancomycin should be administered to infants with caution." "Most pediatric medications are ordered in milligrams per kilogram dosage." "A child's age, weight, and maturity of body systems affect the drug dosage. " "After the dose calculation as per the age, most of the doses are rounded to the nearest tenth."

"After the dose calculation as per the age, most of the doses are rounded to the nearest tenth." Most pediatric medications are not rounded to the nearest tenth decimal. They are rounded to the nearest thousandth, to prevent drug overdose. Ototoxicity is the reported adverse effect of vancomycin. Therefore, it is challenging to administer this drug to infants who cannot talk. Unlike the adult drug regimen, most pediatric medications are ordered in milligrams per kilogram (mg/kg) of body weight. A child's age, weight, and maturity of body systems affect the ability to metabolize and excrete medications.

The registered nurse is teaching a nursing student about prescription orders. Which statement if made by the nursing student indicates the need for further teaching? "Only emergency medications are prescribed in STAT prescription orders." "Administration of hydralazine is an example of a now order prescription." "Administration of lorazepam is an example of a prn order of prescription." "A single order prescription necessitates the administration of medication at one specific time." "A prn order is prescribed when the drug should be administered to the patient as and when required."

"administration of hydralazine is an example of a now order prescription." "Administration of lorazepam is an example of a prn order of prescription." Hydralazine is an emergency drug that should be administered as per the STAT order of prescription that is written in emergencies when a patient's condition changes suddenly. Lorazepam is an example of a drug that is administered following a one-time prescription order. A single order prescription necessitates the administration of medication at one specific time. A prn order prescription necessitates the administration of medication only when a patient requires it.

The nurse is administering a sustained-release capsule to a new patient. The patient insists that he cannot swallow pills. What is the nurse's next best course of action? Ask the prescriber to change the order. Crush the pill with a mortar and pestle. Hide the capsule in a piece of solid food. Open the capsule and sprinkle it over pudding.

Ask the prescriber to change the order. Enteric-coated or sustained-release capsules should not be crushed or opened; the nurse should contact the prescriber to change the medication to a form that is liquid or can be crushed. The nurse should not hide the capsule in a piece of solid food, because it could put the patient at risk for choking.

Which interventions should the nurse perform when administering medications to a patient through a nasogastric tube? Dissolve the different medications separately. Draw all the medications together in a syringe. Use a pigtail vent after connecting the syringe to the tube. Flush the tube before and after administration of the medication. Contact the health care provider if the patient resists the administration.

Dissolve the different medications separately. Flush the tube before and after administration of the medication. Contact the health care provider if the patient resists the administration. When administering medication through a nasogastric tube, all the medications should be dissolved separately in suitable solvents. The nasogastric tube should be flushed prior to drug administration and following administration of each drug to prevent blockage. If the nurse encounters resistance while administering the medication, the health care provider should be notified. Each medication should be separately dissolved and administered to prevent mixing of medications. The nurse should not use a pigtail vent after connecting the tube to the syringe, because it can cause air to escape into the digestive tract.

A primary health care provider prescribed an antihistamine to a pediatric patient and informed the caretakers that the child may become drowsy after taking this medication. However, on the contrary, the child became extremely agitated and excited after taking the medication. What is this reaction called? Toxic effect Allergic reaction Therapeutic effect Idiosyncratic reaction

Idiosyncratic reaction Idiosyncratic reaction is any unpredictable drug reaction. Therefore, the child exhibits an idiosyncratic reaction. The toxic effect often develops after prolonged intake of medication or when a medication accumulates in the blood because of impaired metabolism or excretion. Allergic reactions are sudden onset immunological reactions seen after a drug intake. The therapeutic effect is a reaction that is the expected or predicted physiological response caused by a medication.

Which statement about anaphylactic reaction requires correction? Anaphylactic reactions may cause pharyngeal edema. Anaphylactic reactions may be life threatening. Anaphylactic reactions are a type of allergic reactions. Occurs when a patient is exposed to the allergens for the first time.

Occurs when a patient is exposed to the allergens for the first time. First exposure to an allergen will sensitize the immune system. When the patient is exposed to the same allergens for the second time, an anaphylactic reaction may occur. Pharyngeal edema, constriction of bronchiolar muscles, and severe wheezing are the signs of an anaphylactic reaction. It is a life-threatening condition and is a type of allergic reaction.

The primary health care provider prescribed sulfamethoxazole (Bactrim) to a patient with a urinary tract infection. The nurse finds that the patient is allergic to sulfa drugs and obtains an order for another medication. What is the nurse's responsibility in this situation to prevent such medication error in future? Reporting it to the patient Considering it as a common error Writing it in the patient's medical record Reporting it to the hospital administration

Reporting it to the hospital administration When the medication, to which the patient is allergic, is modified before reaching the patient, it is called a near miss. When such an error occurs in a health care setting, it should be reported to the hospital administration. Even though it did not harm the patient, it should be reported so as to prevent such errors in the future. Reporting it to the patient is not appropriate, because it may create a negative impression about the hospital. The nurse should not consider it a common error, because it could have harmed the patient. Writing it in the patient's medical record is not an appropriate intervention.

The nurse who is responsible for dispensing medications understands that every patient requires a different dosage for a given drug. Various factors affect the absorption of drugs. Which factors influence absorption? Total body weight Body temperature Route of administration Lipid solubility of the drug Blood flow to the site of administration

Route of administration Lipid solubility of the drug Blood flow to the site of administration Factors that influence absorption are the route of administration, ability of the medication to dissolve, blood flow to the site of administration, body surface area (BSA), and lipid solubility of medication. The absorption of drugs depends on the route of administration; oral route has the least absorption, and the intravenous route has the highest absorption. The human body absorbs medications in a liquid state more readily than tablets and capsules. Higher blood flow to the site of administration favors faster absorption of drugs. Because the cell membrane has a lipid layer, highly lipid-soluble medications cross cell membranes easily and are absorbed quickly. Absorption of drugs depends on body surface area, not on body weight. Body temperature does not affect the absorption of drugs.