Medication/Oxygenation

The nurse auscultates a client with soft, high-pitched popping breath sounds on inspiration. The nurse documents the breath sounds heard as:

*Crackles*

The nurse is preparing to administer prescribed intravenous antibiotics to a client. While assessing the medication lock, the nurse notes that there is resistance when administering the saline flush solution. What would be the best action by the nurse?

*Insert a new IV medication lock and remove the old one.* The nurse is to flush the medication IV lock every 8 to 12 hours, or depending on the facility policy. When flushing the IV lock, the nurse verifies the patency of the lock by aspirating blood return and the lock should flush without resistance. If the nurse is unable to flush without resistance, if there is leaking from the site during flushing, or if patency cannot be verified, the nurse should remove the IV lock and insert a new IV lock. If the nurse has resistance with flushing with saline, flushing with heparin would not be an appropriate option. The nurse should not administer the antibiotic if the IV lock is resistant during flushing. Calling the physician to change the order is not appropriate.

Three checks of medication administration

1. When you reach for the med pack, 2. when you obtain it and compare it to the CMAR, 3. at the bedside before administration

Which type of drug preparation is a medication in a clear liquid containing water, alcohol, sweeteners, and flavor?

An elixir is a medication in a clear liquid containing water, alcohol, sweeteners, and flavor. A suspension contains finely divided, undissolved particles in a liquid medium. A solution is a drug dissolved in another substance. A syrup is medication combined in a water and sugar solution.

The nurse is caring for a client who has a compromised cardiopulmonary system and needs to assess the client's tissue oxygenation. The nurse would use which appropriate method to assess this client's oxygenation?

Arterial blood gases include the levels of oxygen, carbon dioxide, bicarbonate, and pH. Blood gases determine the adequacy of alveolar gas exchange and the ability of the lungs and kidneys to maintain the acid-base balance of body fluids.

What is MedWatch?

FDA maintained which encourages health care professionals to report adverse effects that occur from the use of and approved drug or other medical products

The nurse is preparing to administer meperidine as an intramuscular injection in an adult client's deltoid site. Which needle should the nurse select for this injection?

IM injections using the deltoid site require a 20- to 25-gauge needle that is between 1 and 1½ inches (2.5 and 4 cm) in length.

The nurse is reviewing the chart of a client receiving oxygen therapy. The nurse would question which supplemental oxygen prescription if written by the health care practitioner?

The correct amount delivered FiO2 for a nonrebreather mask is 12 L/min; 8-11 L/min for partial rebreather mask; 4-10 L/min for Venturi mask; and 1-6 L/min for nasal cannula. However, per nasal cannula it may be no more than 2-3 L/min to for a client with chronic lung disease.

Respiratory rates for different ages

The infant's normal respiratory rate is 30 to 55 breaths per minute. The normal range for a child age 1 to 5 years is 20 to 40 breaths per minute. For a child 6 to 12 years of age the normal respiratory rate is 18 to 26 breaths per minute. The normal respiratory rate for an adult 65 years and older is 16 to 24 breaths per minute.

What is meant by the unit dose supply method?

The nurse should understand that a unit dose supply method is a method in which self-contained packets hold one tablet or capsule for an individual client. An individual supply is a container with enough of the prescribed medication for several days or weeks and is common in long-term care facilities such as nursing homes. 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 (p.r.n.) medications, controlled medications, and emergency medications.

Describing different breathe sounds

Vesicular breath sounds are normal and described as low-pitched, soft sounds over the lungs' peripheral fields. Crackles are soft, high-pitched, discontinuous popping sounds heard on inspiration. Medium-pitched blowing sounds heard over the major bronchi describe bronchovesicular breath sounds. Bronchial breath sounds are loud, high-pitched sounds heard over the trachea and larynx.

A nurse needs to combine two different prescribed drugs in a syringe and then administer them to a client with influenza. Which precaution should the nurse take when combining drugs?

When combining more than one drug in a single syringe, the nurse should take exact amounts from each drug container because, once the drugs are in the barrel of the syringe, there is no way to expel one without expelling the other. Mixing the two drugs before administering, or shaking the drug containers before withdrawing, is not suitable because it can cause chemical reactions and precipitates. Expelling both the drugs separately in a vial before use could also lead to a chemical reaction, which often causes a precipitate to form.

In which of the following medication supply systems are large quantities of medications kept on the nursing unit making them immediately available to the nurse?

With the stock supply system, large quantities of medications are kept on the nursing unit. The medications are readily available to the nurse, but this eliminates the double-check system by the pharmacy.

Half-life

amount of time it takes for 50% of blood concentration of a drug to be eliminated from the body

Adverse effects of morphine

constipation nausea vomiting

A nurse is assessing the breath sounds of a newborn. Which sound is an expected finding for this developmental level?

crackles

teratogenic

drugs that are known to have potential to cause developmental defects in the embryo or fetus Ex. Alcohol, Cocaine, phenytoin

Pharmacodynamics

process by which drugs alter cell physiology and affect the body.

Right of medication administration

right patient right dose right reason right time right medication right route

Pharmacokinetics

the effect of the body on the drug Absorption Distribution Metabolism Elimination

Through level

the point when the drug is at its lowest concentration, indicating the rate of elimination