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GENERAL CONTENT:
1. Define the terms
Nomenclaturethe devising or choosing names for things.
generic nameidentifies a drugs main ingredient; name assigned by manufacturer when
first developed.
official nameusually generic name; name given used in official publications
trade nameAKA brand name; specific drug name given by a certain manufacturer.
pharmacokineticsliterally means drug motion answers the question: How does the
drug concentration changes as it moves through the different part of the body? and
indicates the movement of drugs throughout the body via:
1. Absorptionroute administration determines the rate of absorption.
2. DistributionThe movement of drugs throughout the body.
3. MetabolismThe chemical changes the occur; drug moves from one form to a
new form. LIVER is the chief metabolizer.
4. ExcretionThe process of removing the drug from the body. KIDNEYS excrete
most drugs.
Book DefWhat your body does to the drug
pharmacodynamicsliterally means, drug power answers the question: How does the
drug exert its effect(s) on your body? Deals with drug potency; drug receptor
interactions. Indicative of a drugs impact, effect (efficacy) on the body.
Book DefWhat the drug does to your body.
adverse effectsUnwanted harmful effects of a drug on the body.
allergic effectImmune system response when body interprets drug as foreign and
antibodies formed to fight.
drug toleranceOccurs as body becomes accustomed to a drug.
toxic effectDrug effects that cause risk for permanent damage and/or death.
idiosyncratic effectUnusual/peculiar effect of a drug on the body.
therapeutic rangethe concentration of drug in the blood serum that produces the desired
effect without causing harm.
peak levelHighest concentration of drug when absorption complete.
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2. Define and explain the significance of EC, LA (long lasting), CR/CRT (controlled
release), SA (sustained action), SR (sustained-release), and XL (extended release) oral
medications.
Oral meds that are indicated as extended-release. They should not be crushed or chewed
unless specifically indicated. Doing so destroys extended-release effect and may result in
toxic peaks or low troughs.
3. List the 2 main types of oral medication preparations.
a. Liquid
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b. Solid
4. List the 4 main types of liquid medication preparations (SEE Number 1).
5. Discuss the difference between multidose bottles and single dose containers of liquid
medications.
a. MultidoseMay be used for multiple doses
b. Single doseSingle use only.
6. List common techniques that can be used to help disguise or mast oral medications with
bad taste.
a. Crush and add to small bit of food; be sure all eaten before leaving.
b. Suck on ice
c. Use syringe to give meds at back of tongue.
d. Oral hygiene ASAP post admin.
e. Allow with copious amount of water.
7. Discuss the main difference between sublingual and buccal
medications.
a. Sublingualunder tongue
b. Buccalcheek
8. Review the skill actions with rationales on administering oral medications.
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Inside barrel
Plunger that enters barrel
Tip of barrel
Needle; save the exterior of needle hub
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6. Compare and contrast an ampule and a vial medication method (p. 775-776).
Ampulecontains a single dose of medication. Must be broken open; filter needle used.
Excess must be wasted.
Vialscontain a rubber/self-sealing stopper. Multi doses may be taken from one vial. Air
should be injected into vial before drawing, as helps with medication retrieval.
7. Explain the difference between prefilled cartridge and prefilled syringe (p. 776).
a. Prefilled cartridgeis inserted into a reusable holder or injection device; most
are overfilled. Excess must be wasted prior to administration. Come with excess
air.
b. Prefilled syringeusually have their needle attached; Also comes with excess air;
in some cases should not be expelled (e.g. Enoxaparin [Lovenox]).
8. Using a table, list the sites, landmarks, and need gauges/lengths/angles for ID, SQ,
and IM. SEE LAB NOTES!
9. Explain how the nurse can reduce discomfort during administration of SQ and IM
injections (p. 779).
a. Select needle with smallest gauge that right for the site/solution/length.
b. Be sure needle free of solution that could irritate when inserting.
c. Use Z-track method.
d. Inject into relaxed muscles.
e. DO NOT inject into hard muscles or tender areas.
f. Dart-like motion
g. DO NOT exceed recommended solution amounts for injection site.
h. Apply gentle pressure afterward.
i. Allow patients to talk about fears.
j. Rotate sites for patients who require frequent injections.
10. Using a chart, list, compare, and contrast the types of intravenous methods, IVF, IV
bolus/push, IV intermittent/IVPB (p. 785).
a. IVFinfusion solution; drug added to liquid infusion. Administered over set
amount of time.
b. IVP/Bolusmedication administration in single injection of concentrated
solution direct into IV line. Administer slowly over 1 minute.
c. Intermittent IVPMedication added to small amount of solution (gen 50-100
mL) and set with infusion pump.
11. Discuss the advantages and disadvantages of using the parenteral routes of medication
administration.
Parenteral admin is most invasive increasing the likelihood of infection or accident; once
a solution injected cannot be withdrawn. Conversely it has the fastest absorption rate.
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12. Discuss the criteria used in the selection of a site for parenteral administration (p. 774775).
a. Pt body size
b. Pt body build/size
c. Medication type
d. Route of administration
e. Viscosity of solution
f. Quantity to be administered
g. Age (Amarachis Addition)
13. Describe the Z track method of injection and discuss the rationale for its use (p. 784).
Recommended for all IM injections because it ensures the medication does not leak back
along the needle track and into the subcutaneous tissue. Also suggested for older pts who
have a decreased muscle mass.
14. Discuss factors that influence and alter the rate of an intravenous infusion.
Continuous Infusion
Intermittent Infusion
Bolus Push
15. Review the skill actions with rationales removing medication from an ampule.
16. Review the skill actions with rationales removing medication from a vial.
17. Review the skill actions with rationales on administering intradermal injection.
18. Review the skill actions with rationales on administering subcutaneous injection.
19. Review the skill actions with rationales on administering intramuscular injection.
20. Review the skill actions with rationales on administering medication by IV Bolus/Push.
21. Review the skill actions with rationales on administering IVPB medication.
22. Review the skill actions with rationales on administering medication by saline loc.
1. Using a table, differentiate between the various forms of eye medications; drops and
ointments (p. 787).
Dropsliquid; used for local effects (e.g. dilation, infection control).
Ointmentthick, jelly-like substance; used for local infection or irritation. Must be
dropped in the inner canthus (apply from inner canthus to outer canthus). May cause
temporary blurred vision.
2. Explain the importance of instilling eye medications in the conjunctive sac.
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Must be placed into the conjunctive sac because most applications cannot be placed into
the eyeball directly. Sac helps distribute safely.
3. Using a table, differentiate between the various forms skin-transdermal medications.
Transdermallayered patch placed on skin to ensure timed drug releaase.
3. Utilize critical thinking skills to plan and evaluate nursing care for patients receiving
medications.
MEDICATION DOCUMENTATION-ERRORS-EDUCATION:
a.
b.
c.
d.
Be vigilant
Communicate if something unclear
Perform 3 medication checks
Observe/Practice patient 5 medication rights
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5 Main
1.
2.
3.
4.
5.
Right Patient
Right Drug
Right Dosage
Right Time
Right Route
Others:
Right reason
Documentation
Assessment
Education
Response
Refuse
9. Explain how the NPSGs patient identification method is essential to safe medication
administration.
10. List ways to maintain a safe medication administration environment (p.767).
a.
b.
c.
d.
Capsule
Elixir
Enteric coated
Powder
Solution
Suspension
Tablet
Lotion
Lozenge
Transdermal patch
Ointment
Syrup
Suppository
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8. Explain the importance of serum levels in drug dosing and administration (p.759-760).
o Developmental considerations
o Weight
o Gender
o Cultural/genetics
o Psychologic considers
o Pathology
o Environment
o Timing of administration
9. List and discuss the importance of the use of drug legislation in the United States (p.760).
They help regulate and control drug safety for the safety and security of the public.
o SPECIAL POPULATION: OLDER ADULTS:
1. List the recommend IM sites for the older adult.
o Ventralgluteal
o Deltoid
2. List the recommended needle length for the older adult (IM only listed).
o Vastus lateralis5/8-1
o Deltoid5/8-11/2
o Ventrogluetal-11/2
3. Recognize the special considerations of the older adult population during medication
administration (p. 758).
o Toxic effectdue to lower hepatic functioning
o Drug-to-drug interactions
o Idiosyncratic response to drugs.
4. Discuss how age can have an impact on the effects of medication pharmacodynamics.
Decreased nurmber of protein-binding sights.
5. Explain how the normal physiological aging changes can impact medication
administration (p. 758).
a. Difficulty swallowing
b. Decreased lipid content in skin
c. Decreased lean body mass
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d. Dry mouth
e. Decreased oral secretions
6. List helpful strategies for administering oral medication to the older adult population.
a. Allow extra admin time; reflexes slow
b. May have trouble swallowingcrush meds or use liquid form
c. Reevaluated dosage; wt and age criteria
d. Assist with making schedule for med reminders
e. Monitor pt for adverse reactions
f. Teach pt drug names rather than color identification
7. Discuss criteria considered when selecting IV sites in the older adult population.
Ultrasound of peripheral and IV placement may be needed as landmarks in aged may be
difficult to find.
4. List the recommended IM sites for infants, toddlers, and children (IM Only Listed).
DeltoidChildren (3-18 yrs) Some toddlers may have sufficient muscle mass for
deltoid injection (Kyle 381).
Vastus LateralisInfants, toddlers and children
5. List the recommended needle length and gauge for the pediatric population.
o Vastus Lateralis5/8-1
o Deltoid5/8-11/2
o Ventrogluetal-11/2
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6. Recognize the special considerations for the pediatric population during medication
administration.
a. Development
b. Dose determination (BSA)
c. Administration types/guidelines for each
7. Discuss how age can have an impact on the effects of medication pharmacodynamics and
pharmacokinetics (Kyle p. 374).
A childs age/body may affect pharmocodymanicsdrug may not act as intended.
A childs wt and BSA/body composition affect a drugs pharmacokietics. Affects 4 parts of
drug movement (i.e. enzyme production, skin permeability, distribution)
8. Discuss how developmental age impacts medication administration and common nursing
interventions to address the issues and concerns.
Age Group
Infant
Toddler
Issue
Development of
Trust
Development of
Autonomy
Preschool
Development
Initiative
School-Age
Development
Industry
Teens
Development of
Identity
Nursing Intervention
Involve parents
therapeutic hugging
Follow routine rituals when giving
meds
Allow simple choice
Allow equipment handling
Offer choice
Involve parents
Allow equipment handling
Explain medications purpose
Allowing to help set-up
Give more choices
Reward System
Approach like and adult
Maintain privacy
9. Explain the importance of the use of praise when administering medications to the
pediatric population.
Fosters cooperation and courage?
10. List helpful strategies for administering oral medications to the pediatric population.
Use a dropper with infants & young kids for liquids
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11. List helpful strategies for administering topical medications to the pediatric population.
Rectalnot the preferred med admin route because invasive, drugs absorption may be
erratic and unpredictable. Used if child is NPO.
12. List helpful strategies for administering ophthalmic medications to the pediatric
population (Kyle 379).
13. List helpful strategies for administering optic medications to the pediatric population
(Kyle 380).
Explain in easily understandable terms
Room temp drops
Ages less than 3 years pull; pinna down and back
Ages older than 3 pull pinna up and back
14. List helpful strategies for administering parenteral medications to the pediatric
population.
Needle size
Site selection
Muscle mass
Medication viscosity
15. List safeguards to reduce medication errors in the pediatric population (Kyle 326).
Confirming childs weight accurate
Weigh kids in kg
Double check med calculation
If dose seems to large or small, verify
Confirming child identity
Double-checking dosage prior to administration
Always report med errors
Use med order/administration systems
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16. Explain how to provide atraumatic care to the pediatric population when it comes to
medication administration (Kyle 383).
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