Chapter 28: Medications

A nurse administers a does of an oral medication for hypertension to a patient who immediately vomits after swallowing the pill. What would be the appropriate initial action of the nurse in this situation?

A nurse is administering an oral medication to a patient via a gastric tube. The nurse observes the medication enter the tube, and the tube becomes clogged. What would be the appropriate initial action of the nurse in this situation?

A nurse who is administering medications to patients in an acute care setting studies the pharmacokinetics of the drugs being administered. Which statements accurately describe these mechanisms of action?

A nurse is reconstituting powdered medication in a vial. Which action is a recommended step in this process?

A medication order reads "K-Dur, 20 mEq po bid" When and how does the nurse correctly give this drug?

A nurse is preparing medications for patients in the ICU. The nurse is aware that there are patient variables that may affect the absorption of these medications. Which statements accurately describe these variables?

A physician orders a pain medication for a postoperative patient that is a PRN order. When would the nurse administer this medication?

A nurse is administering a pain medication to a patient. In addition to checking his identification bracelet, the nurse correctly verifies his identity by

The nurse is administering a medication to a patient via a nasogastric tube. Which are accurate guidelines related to this procedure?

A medication order reads "Hydromorphone, 2 mg IV every 3 to 4 hours PRN pain" The prefilled cartridge is available with a label reading "Hydromorphone 2mg/ 1 mL" The cartridge contains 1.2 mL of hydromorphone. Which nursing action is correct?

A patient requires 40 units of NPH insulin and 10 units of regular insulin daily subcutaneously. What is the correct sequence when mixing insulins?

Ms. Hall has an order for hydromorphone (Dilaudid), 2 mg intravenously, q 4 hours PRN pain. the nurse notes that according to Ms. Hall's chart, she is allergic to Dilaudid. The order for medication was signed by Dr. Long. What would be the correct procedure for the nurse to follow in this situation?

A nurse is administering heparin subcutaneously to a patient. What is the correct technique for this procedure?

A nurse discovers that she made a medication error. What should be the nurse's first response?

A nurse is teaching an adolescent patient how to use a meter-dosed inhaler to control his asthma. What are appropriate guidelines for this procedure?

The correct order for using a meter-dosed inhaler is: 1 - [blank_start]remove the mouthpiece cover[blank_end] 2 - [blank_start]shake the inhaler well[blank_end] 3 - [blank_start]breath normally through the spacer[blank_end] 4 - [blank_start]depress the canister[blank_end] 5 - [blank_start]release one puff into the spacer[blank_end] 6 - [blank_start]inhale slowly and deeply[blank_end] 7 - [blank_start]hold breath for 5-10 sec[blank_end] 8 - [blank_start]exhale slowly through pursed lips[blank_end] 9 - [blank_start]wait 1-5 min b4 next puff[blank_end] 10 - [blank_start]gargle/rinse w/tap water[blank_end]

Nurses are legally responsible for understanding the pharmacotherapeutics of all drugs they administer.

Most drugs are inactivated by the [blank_start]liver[blank_end] and transformed to inactive substances for [blank_start]excretion[blank_end].

The [blank_start]kidneys[blank_end] excrete most drugs. The [blank_start]lungs[blank_end] are the primary route for the excretion of gaseous substances (anesthetics). Many drugs are excreted through bile in the gastrointestinal tract. The [blank_start]mammary[blank_end], [blank_start]salivary[blank_end] and [blank_start]sweat[blank_end] glands are also routes of drug excretion.

A student nurse is permitted to accept a verbal order from a physician.

Nurses are not legally responsible for the drugs they administer.

Best practice is to question the patient about ever having received the medication and ask whether the patient is aware of any reaction to the medication.

It is common practice to check controlled substances daily at specified intervals.

If for any reason a controlled substance prepared for administration has to be discarded, a [blank_start]second[blank_end] [blank_start]nurse[blank_end] should act as a witness.

If the patient receives several drugs, offer them [blank_start]separately[blank_end] so that if one is refused or dropped, positive identification can be made and the drug can be recorded or replaced.

Drugs given orally are intended for absorption in the [blank_start]stomach[blank_end] and [blank_start]small[blank_end] [blank_start]intestine[blank_end].

[blank_start]Enteric[blank_end]-[blank_start]coated[blank_end] tablets are released in the [blank_start]small[blank_end] [blank_start]intestine[blank_end] and used when the active ingredient of the drug is irritating to the [blank_start]stomach[blank_end] mucosa.

For patients who find it difficult to take liquids from a cup, use an [blank_start]oral[blank_end] [blank_start]syringe[blank_end] and place the medicine between the [blank_start]gum[blank_end] and [blank_start]cheek[blank_end] and give the liquid to the patient slowly.

Shake [blank_start]emulsions[blank_end] and [blank_start]suspensions[blank_end] well and administer them promptly to ensure accurate dosage.

For drugs that discolor the teeth, mix it well with [blank_start]liquid[blank_end], have the patient use a [blank_start]straw[blank_end] and encourage them to drink [blank_start]water[blank_end] after administration.

Use a [blank_start]dropper[blank_end] to give infants or very young children liquid medications while holding them in a [blank_start]sitting[blank_end] or semi-sitting position; placing the medication between the gum and cheeks to prevent [blank_start]aspiration[blank_end].

Sublingual and buccal meds can be swallowed.

Drugs that deteriorate in solution are usually dispensed as [blank_start]powders[blank_end] and are reconstituted [blank_start]immediately[blank_end] before injection. Drugs that remain stable in solution are usually dispensed in ampules, bottles, pre-filled cartridges or vials in an [blank_start]aqueous[blank_end] or [blank_start]oily[blank_end] solution or suspension.

If not all medicine from an ampule is used, you can save it for later use.

Use a [blank_start]filter[blank_end] [blank_start]needle[blank_end] to remove the medication from an ampule.

Multidose vials are usually good for only [blank_start]24[blank_end] [blank_start]hours[blank_end].

Prefilled syringes come with excess air. In some cases, this air should [blank_start]not be[blank_end] expelled.

Some drugs have limited compatibility (when mixing meds in one syringe) and should be administered w/in [blank_start]15[blank_end] [blank_start]minutes[blank_end] of preparation. Incompatible drugs may become [blank_start]cloudy[blank_end] or form a precipitate in the syringe.

When preparing meds from an ampule and a vial, prepare the med in the [blank_start]vial[blank_end] first, and then the med in the [blank_start]ampule[blank_end].

[blank_start]Lantus[blank_end] and [blank_start]Levemir[blank_end] cannot be mixed w/other insulin.

Before administering any insulin be aware of the [blank_start]onset[blank_end] [blank_start]time[blank_end], [blank_start]peak[blank_end], and [blank_start]duration[blank_end] of effects and ensure that proper food is available.

Injections should be given an [blank_start]inch[blank_end] away from the previous injection site.

[blank_start]Intravenous[blank_end] route is the most dangerous route because the drug is placed directly into the bloodstream.

Check the patient receiving meds by a continuous IV infusion for possible adverse side effects at least every [blank_start]hour[blank_end].

Intravenous Bolus or Push is administered very slowly over at least [blank_start]1[blank_end] minute.

Transdermal patches that contain [blank_start]estrogen[blank_end] should not be applied to breast tissue due to the associated risks of breast cancer.

Patient should not blow nose before instilling drops.

Ask the patient to [blank_start]void[blank_end] before inserting a vaginal medication.

Rectal suppositories can be administered to patients at risk for cardiac arrhythmias.

For better medication delivery, use a [blank_start]spacer[blank_end] whenever administering meds via an MDI.

DPIs are [blank_start]breath[blank_end] activated.

Teaching about meds is an ongoing process and should begin as soon as the patient is admitted to the health care facility.