Principles Of Medications
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- Words: 2,548
- Pages: 93
Medications PREPARED BY : MS. AILEEN S. ADRALES,RN
Pretest
1. 2. 3. 4.
A client tells the nurse, “This pill is a different color than the one that I usually take at home.” Which is the best response by the nurse? “Go ahead and take your medicine.” “I will recheck your medication orders.” “Maybe the doctor ordered a different medication.” “I’ll leave the pill here while I check with the doctor.”
Question 2
1. 2. 3. 4.
If the following medications are listed on a client’s medication administration record (MAR), which one should the nurse question? Lasix 40 mg, po, STAT Ampicillin 500 mg, q6 hr, IVPB Humulin L (Lente) insulin 36 u, sc, q am, ac Codeine q 4-6 hr, po. Prn for pain
Question 3
1.
2. 3. 4.
The primary care provider prescribed 5 mL of a medication to be given deep IM for a 40-year old female who is 5’7” tall and weighs 135 pounds. Which of the following is the most appropriate method of administration? A tuberculin syringe, #25-#27 gauge, ¼ -5/8 inch needle. Two 3-mL syringes, #20-#23 gauge, 1 ½ inch needle. Two 2-mL syringes, #25 gauge, 5/8inch needle. Two 2-mL syringes, #20-#23 gauge, 1inch needle.
Question 4
1. 2. 3. 4.
An elderly client with renal insufficiency is to receive a cardiac medication. The nurse is most likely to administer which of the following? A decreased dosage. The standard dosage. An increased dosage. A divided dosage.
Question 5
1. 2. 3. 4.
Proper administration of an otic medication to a two-year-old client includes which of the following? Pull the ear straight back. Pull the ear down and back. Pull the ear up and back. Pull the ear straight upward.
Administration of Medications • Medication: substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of disease • Drug: same as medication – but also refers to illicitly obtained substance
Administration of Medications • Prescription: The written direction for the preparation and administration of a drug • Generic name: name given before drug becomes officially approved • Official name: name which drug is listed in official publications
•Supportive •Substitutive •Chemotherapeutic •Restorative
Administration of Medications • Chemical name: name that describes the constituents of the drug • Trade name: name given to drug by manufacturer (brand name)
• Pharmacology: study of the effect of drugs on living organisms • Pharmacy: Art of preparing, compounding, and dispensing drugs
Legal Aspects of Administering Medications • Nursing practice acts • Responsibility for actions • Question any order that appears unreasonable • Refuse to give the medication until the order is clarified
Controlled Substances • • • •
Kept under lock Special inventory forms Documentation requirements Counts of controlled substances • Procedures for discarding
Effects of Drugs 1. Therapeutic effect = desired effect • Reason drug is prescribed 2. Side effect = secondary effect • Unintended, usually predictable • May be harmless or harmful 3. Drug toxicity • Result from overdose, ingestion of external use drug • Buildup of drug in blood
Effects of Drugs 4. Drug allergy • Immunologic reaction to drug • Mild to severe reactions (anaphylaxis) 5. Drug tolerance • Need increasing doses to maintain therapeutic effect 6. Drug interaction • One drug affecting effect of another
Effects of Drugs 7. Potentiating effect • Effect of one or both drugs is increased 8. Inhibiting effect • Effect of one or both drugs is decreased 9. Synergistic effect • When two drugs increase the action of one or another drug
Drug Misuse • Improper use of medications • Drug abuse • Drug dependence • Physiologic dependence • Psychologic dependence • Drug habituation • Illicit drugs
Actions of Drug on Body • Pharmacodynamics • Process by which drug changes body • Pharmacokinetics • Study of absorption, distribution, biotransformation, and excretion of drugs
Factors Affecting Medication Action 1. 2. 3. 4. 5. 6. 7. 8.
Developmental Gender Cultural, ethnic, and genetic Diet Environment Psychologic Illness and disease Time of administration
Routes of Medication Administration 1. 2. 3. 4.
Oral Sublingual Buccal Parenteral oSubcutaneous oIntramuscular oIntradermal oIntravenous
Routes of Medication Administration 5. Topical ― Rectal ― Vaginal ― Transdermal ― Inhalation
Copyright 2008 by Pearson Education, Inc.
Parts of a Medication Order 1. Full name of the client 2. Date and time the order written 3. Name of drug to be administered 4. Dosage 5. Frequency of administration 6. Route of administration 7. Signature of person writing the order
Prescription
Types of Medication Orders 1. Stat order • Demerol 100mg IM stat 2. Single Order • Seconal 100mg hs before surgery 3. Standing order • Demerol 100 mg IM q4h x 5 days 4. PRN order Amphojel 15 mL prn
MAR
Administering Medications 1. 2. 3. 4. 5. 6.
Identify the client Inform the client Administer the drug Provide adjunctive interventions as indicated Record the drug administered Evaluate the client’s response to the drug
Ten “Rights” of Accurate Medication Administration 1. Right medication 2. Right dose 3. Right time 4. Right route 5. Right client
6. Right client education 7. Right documentation 8. Right to refuse 9. Right assessment 10.Right evaluation
The six rights OF Medication Pass D Drug R Route P Patient A Amount T Time S Scribe/ Documentation
Helps prevent medication errors
1. Right patient: – identify the patient you are going to give the medicine
Look at the patient’s ID band too!!!
2. Right Drug
• Is this the appropriate drug for the condition of the patient? • Is this the correct drug?
Right Dosage:
Is this the right dose based on the patients size and age?
Right Route: Does the patient’s condition need the quick acting route – or can I use the longer acting route? • Is the medication made to be given by that route? – Not all IV meds can be given IM and vise versa
Right Time:
Is the timing between the dosages correct? • Is it every 3 minutes? • Or every 5 minutes? • Can I give this medication only once
Right Scribe/Documentation • Documentation of what you have done D – Drug A – Amount R – Route T – Time
Medication exam:
•
Correct medication • Correct concentration • Expiration date • Seals intact • Color • No precipitate (floaters)
Medications Administration Packaging:
1. Prefilled Syringe 2. Ampule 3. Vial 4. Tubex
Prefilled syringe two pieces that screw together and medication is quickly administered • • Most emergency • meds are in prefilled syringes •
Tubex: • A type of prefilled Syringe
• Need an adapter for administration
Non prefilled syringes • Pick the right size
for the job • Need to know how much medication you will be drawing up – – – –
1cc or tuberculin 3cc 5cc 10cc
Non Prefilled
• Luer lock needle screws onto the tip most •syringes Slip Lock needle slips onto the tip push then twist
LUER LOCK LOCK
SLIP
Ampule – breakable glass container that can be used only once
Vial Self-sealing rubber stopper in the top •
• Single dose vial • Multidose vial
Parenteral Medications • Common nursing procedure • Absorbed more quickly than oral • Careful and accurate administration • Aseptic technique
Copyright 2008 by Pearson Education, Inc.
Syringes
Types of Syringes
Syringe Tips
Luer-Lok syringe (note threaded tip)
non-Luer-Lok syringe (note the smooth graduated tip)
Prefilled Syringes
The cartridge slides into syringe barrel, turns, and locks at needle end. The plunger then screws into cartridge end
Needles
• Stainless steel • Most disposable • Parts • Hub • Cannula or shaft • Bevel
Needles
• Characteristics • Slant or length of bevel • Length of the shaft • Gauge
Elder Considerations • • • •
Altered memory Decreased visual acuity Decrease in renal function Less complete and slower absorption from the gastrointestinal tract
Elder Considerations • Increased proportion of fat to lean body mass • Decreased liver function • Decreased organ sensitivity • Altered quality of organ responsiveness • Decrease in manual dexterity
Administering Oral Medications Skill 35-1 Compare the medication label to the MAR
A cutting device can be used to divide tablets
Pouring a liquid medication from a bottle
Copyright 2008 by Pearson Education, Inc.
The bottom of the meniscus is the measuring guide
Things to Consider
What are the life span considerations for administering oral medications?
What are the home care considerations for administering oral medications?
Nasogastric/Gastrostomy Tube Medication Administration
• Check with pharmacist for a liquid form • Check to see if medication can be crushed • Crush a tablet into a fine powder and dissolve in at least 30 mL of warm water • Open capsules and mix the contents with water only with the pharmacists advice
Nasogastric/Gastrostomy Tube Medication Administration
• Do not administer whole or undissolved medications • Assess tube placement • Aspirate stomach contents and measure the residual volume
Nasogastric/Gastrostomy Tube Medication Administration
• Remove the plunger from the syringe • Connect syringe to a pinched or kinked tube • Put 15 - 30 mL (5 - 10 mL for children) of water into the syringe barrel to flush the tube • Pour liquid or dissolved medication into the syringe barrel and allow to flow by gravity into the enteral tube
Nasogastric/Gastrostomy Tube Medication Administration
• Administer each medication separately and flush in between • After administration of all medications, flush again • If the tube is connected to suction, disconnect the suction and keep the tube clamped to enhance absorption
Preparing Medications From Ampules
Breaking the neck of an ampule
Withdrawing a medication from an ampule
Preparing Medications From Vials –
Withdrawing a medication from a vial that is held with the base down
Withdrawing a medication from an inverted vial
Mixing Medications Using One Syringe – Skill 35-4 Mixing two types of insulin
Intradermal Injections
Administering Intradermal Injections- Skill 35-5
Subcutaneous Injections
Administering a Subcutaneous Injection - Skill 35-6
Injections (Intramuscular) Video
Back to Directory
Intramuscular Injections • • • • •
Ventrogluteal Vastus lateralis Dorsogluteal Deltoid Rectus femoris
Ventrogluteal Site
Vastus Lateralis Site
infant adult Copyright 2008 by Pearson Education, Inc.
Dorsogluteal Site
Copyright 2008 by Pearson Education, Inc.
Deltoid Site
Rectus Femoris Site
Administering IV Medications Using IV Push – Skill 35-9
Administering Ophthalmic Instillations – Skill 35-10
Copyright 2008 by Pearson Education, Inc.
Administering Otic Instillations – Skill 35-11
Copyright 2008 by Pearson Education, Inc.
Nasal Medications
Administering Vaginal Instillations – Skill 35-12
Copyright 2008 by Pearson Education, Inc.
Inserting Rectal Suppository
Copyright 2008 by Pearson Education, Inc.
Proper Use of a Metered Dose Inhaler (MDI) Video
Click here to view a video on using a metered dose inhaler. Back to Directory
Respiratory Inhalation
Copyright 2008 by Pearson Education, Inc.
Post Test
1. 2.
3. 4.
A client tells the nurse, “This pill is a different color than the one that I usually take at home.” Which is the best response by the nurse? “Go ahead and take your medicine.” “I will recheck your medication orders.” “Maybe the doctor ordered a different medication.” “I’ll leave the pill here while I check with the doctor.”
Rationales 1 1. 2.
3. 4.
Do not administer the medication if there is any doubt. Correct. If there is any doubt, the medication administration process should be interrupted until the question is clarified. Do not administer the medication if there is any doubt. Never leave medication unattended.
Copyright 2008 by Pearson Education, Inc.
Question 2
1. 2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
If the following medications are listed on a client’s medication administration record (MAR), which one should the nurse question? Lasix 40 mg, po, STAT Ampicillin 500 mg, q6 hr, IVPB Humulin L (Lente) insulin 36 u, sc, q am, ac Codeine q 4-6 hr, po. Prn for pain
Rationales 2 1. 2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
Order is okay. Order is okay. Order is okay. Correct. The dosage is missing from this order.
Question 3 The primary care provider prescribed 5 mL of a medication to be given deep IM for a 40year old female who is 5’7” tall and weighs 135 pounds. Which of the following is the most appropriate method of administration? 1.
A tuberculin syringe, #25-#27 gauge, ¼ -5/8 inch needle. 2. Two 3-mL syringes, #20-#23 gauge, 1 ½ inch needle. 3. Two 2-mL syringes, #25 gauge, 5/8-inch needle. 4. Two 2-mL syringes, #20-#23 gauge, 1-inch Copyright 2008 by Pearsonneedle. Education, Inc.
Rationales 3
Copyright 2008 by Pearson Education, Inc.
1. This syringe would be too small to give two 2.5 mL doses. 2. Correct. 5 mL is too much to inject into one site and needs to be divided into two 2.5 mL doses. Therefore a 3mL syringe can be used. 3. This syringe would be too small to give two 2.5 mL doses.
Question 4
1. 2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
An elderly client with renal insufficiency is to receive a cardiac medication. The nurse is most likely to administer which of the following? A decreased dosage. The standard dosage. An increased dosage. A divided dosage.
Rationales 4 1.
2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
Correct. Due to renal insufficiency, the dose of the medication would need to be decreased in order to avoid accumulation of the medication and the risk of toxicity. Incorrect. Incorrect. Incorrect.
Question 5
1. 2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
Proper administration of an otic medication to a two-year-old client includes which of the following? Pull the ear straight back. Pull the ear down and back. Pull the ear up and back. Pull the ear straight upward.
Rationales 5 1. 2.
3. 4.
Copyright 2008 by Pearson Education, Inc.
Incorrect. Correct. In clients less than 3 years of age, the ear must be pulled down and back. This method is only used in individuals over 3 years of age. Incorrect.
Rationales 1 1. 2.
3. 4.
Copyright 2008 by Pearson Education, Inc.
Do not administer the medication if there is any doubt. Correct. If there is any doubt, the medication administration process should be interrupted until the question is clarified. Do not administer the medication if there is any doubt. Never leave medication unattended.
Rationales 2 1. 2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
Order is okay. Order is okay. Order is okay. Correct. The dosage is missing from this order.
Rationales 3
Copyright 2008 by Pearson Education, Inc.
1. This syringe would be too small to give two 2.5 mL doses. 2. Correct. 5 mL is too much to inject into one site and needs to be divided into two 2.5 mL doses. Therefore a 3mL syringe can be used. 3. This syringe would be too small to give two 2.5 mL doses.
Rationales 4 1.
2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
Correct. Due to renal insufficiency, the dose of the medication would need to be decreased in order to avoid accumulation of the medication and the risk of toxicity. Incorrect. Incorrect. Incorrect.
Rationales 5 1. 2.
3. 4.
Copyright 2008 by Pearson Education, Inc.
Incorrect. Correct. In clients less than 3 years of age, the ear must be pulled down and back. This method is only used in individuals over 3 years of age. Incorrect.
Pretest
1. 2. 3. 4.
A client tells the nurse, “This pill is a different color than the one that I usually take at home.” Which is the best response by the nurse? “Go ahead and take your medicine.” “I will recheck your medication orders.” “Maybe the doctor ordered a different medication.” “I’ll leave the pill here while I check with the doctor.”
Question 2
1. 2. 3. 4.
If the following medications are listed on a client’s medication administration record (MAR), which one should the nurse question? Lasix 40 mg, po, STAT Ampicillin 500 mg, q6 hr, IVPB Humulin L (Lente) insulin 36 u, sc, q am, ac Codeine q 4-6 hr, po. Prn for pain
Question 3
1.
2. 3. 4.
The primary care provider prescribed 5 mL of a medication to be given deep IM for a 40-year old female who is 5’7” tall and weighs 135 pounds. Which of the following is the most appropriate method of administration? A tuberculin syringe, #25-#27 gauge, ¼ -5/8 inch needle. Two 3-mL syringes, #20-#23 gauge, 1 ½ inch needle. Two 2-mL syringes, #25 gauge, 5/8inch needle. Two 2-mL syringes, #20-#23 gauge, 1inch needle.
Question 4
1. 2. 3. 4.
An elderly client with renal insufficiency is to receive a cardiac medication. The nurse is most likely to administer which of the following? A decreased dosage. The standard dosage. An increased dosage. A divided dosage.
Question 5
1. 2. 3. 4.
Proper administration of an otic medication to a two-year-old client includes which of the following? Pull the ear straight back. Pull the ear down and back. Pull the ear up and back. Pull the ear straight upward.
Administration of Medications • Medication: substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of disease • Drug: same as medication – but also refers to illicitly obtained substance
Administration of Medications • Prescription: The written direction for the preparation and administration of a drug • Generic name: name given before drug becomes officially approved • Official name: name which drug is listed in official publications
•Supportive •Substitutive •Chemotherapeutic •Restorative
Administration of Medications • Chemical name: name that describes the constituents of the drug • Trade name: name given to drug by manufacturer (brand name)
• Pharmacology: study of the effect of drugs on living organisms • Pharmacy: Art of preparing, compounding, and dispensing drugs
Legal Aspects of Administering Medications • Nursing practice acts • Responsibility for actions • Question any order that appears unreasonable • Refuse to give the medication until the order is clarified
Controlled Substances • • • •
Kept under lock Special inventory forms Documentation requirements Counts of controlled substances • Procedures for discarding
Effects of Drugs 1. Therapeutic effect = desired effect • Reason drug is prescribed 2. Side effect = secondary effect • Unintended, usually predictable • May be harmless or harmful 3. Drug toxicity • Result from overdose, ingestion of external use drug • Buildup of drug in blood
Effects of Drugs 4. Drug allergy • Immunologic reaction to drug • Mild to severe reactions (anaphylaxis) 5. Drug tolerance • Need increasing doses to maintain therapeutic effect 6. Drug interaction • One drug affecting effect of another
Effects of Drugs 7. Potentiating effect • Effect of one or both drugs is increased 8. Inhibiting effect • Effect of one or both drugs is decreased 9. Synergistic effect • When two drugs increase the action of one or another drug
Drug Misuse • Improper use of medications • Drug abuse • Drug dependence • Physiologic dependence • Psychologic dependence • Drug habituation • Illicit drugs
Actions of Drug on Body • Pharmacodynamics • Process by which drug changes body • Pharmacokinetics • Study of absorption, distribution, biotransformation, and excretion of drugs
Factors Affecting Medication Action 1. 2. 3. 4. 5. 6. 7. 8.
Developmental Gender Cultural, ethnic, and genetic Diet Environment Psychologic Illness and disease Time of administration
Routes of Medication Administration 1. 2. 3. 4.
Oral Sublingual Buccal Parenteral oSubcutaneous oIntramuscular oIntradermal oIntravenous
Routes of Medication Administration 5. Topical ― Rectal ― Vaginal ― Transdermal ― Inhalation
Copyright 2008 by Pearson Education, Inc.
Parts of a Medication Order 1. Full name of the client 2. Date and time the order written 3. Name of drug to be administered 4. Dosage 5. Frequency of administration 6. Route of administration 7. Signature of person writing the order
Prescription
Types of Medication Orders 1. Stat order • Demerol 100mg IM stat 2. Single Order • Seconal 100mg hs before surgery 3. Standing order • Demerol 100 mg IM q4h x 5 days 4. PRN order Amphojel 15 mL prn
MAR
Administering Medications 1. 2. 3. 4. 5. 6.
Identify the client Inform the client Administer the drug Provide adjunctive interventions as indicated Record the drug administered Evaluate the client’s response to the drug
Ten “Rights” of Accurate Medication Administration 1. Right medication 2. Right dose 3. Right time 4. Right route 5. Right client
6. Right client education 7. Right documentation 8. Right to refuse 9. Right assessment 10.Right evaluation
The six rights OF Medication Pass D Drug R Route P Patient A Amount T Time S Scribe/ Documentation
Helps prevent medication errors
1. Right patient: – identify the patient you are going to give the medicine
Look at the patient’s ID band too!!!
2. Right Drug
• Is this the appropriate drug for the condition of the patient? • Is this the correct drug?
Right Dosage:
Is this the right dose based on the patients size and age?
Right Route: Does the patient’s condition need the quick acting route – or can I use the longer acting route? • Is the medication made to be given by that route? – Not all IV meds can be given IM and vise versa
Right Time:
Is the timing between the dosages correct? • Is it every 3 minutes? • Or every 5 minutes? • Can I give this medication only once
Right Scribe/Documentation • Documentation of what you have done D – Drug A – Amount R – Route T – Time
Medication exam:
•
Correct medication • Correct concentration • Expiration date • Seals intact • Color • No precipitate (floaters)
Medications Administration Packaging:
1. Prefilled Syringe 2. Ampule 3. Vial 4. Tubex
Prefilled syringe two pieces that screw together and medication is quickly administered • • Most emergency • meds are in prefilled syringes •
Tubex: • A type of prefilled Syringe
• Need an adapter for administration
Non prefilled syringes • Pick the right size
for the job • Need to know how much medication you will be drawing up – – – –
1cc or tuberculin 3cc 5cc 10cc
Non Prefilled
• Luer lock needle screws onto the tip most •syringes Slip Lock needle slips onto the tip push then twist
LUER LOCK LOCK
SLIP
Ampule – breakable glass container that can be used only once
Vial Self-sealing rubber stopper in the top •
• Single dose vial • Multidose vial
Parenteral Medications • Common nursing procedure • Absorbed more quickly than oral • Careful and accurate administration • Aseptic technique
Copyright 2008 by Pearson Education, Inc.
Syringes
Types of Syringes
Syringe Tips
Luer-Lok syringe (note threaded tip)
non-Luer-Lok syringe (note the smooth graduated tip)
Prefilled Syringes
The cartridge slides into syringe barrel, turns, and locks at needle end. The plunger then screws into cartridge end
Needles
• Stainless steel • Most disposable • Parts • Hub • Cannula or shaft • Bevel
Needles
• Characteristics • Slant or length of bevel • Length of the shaft • Gauge
Elder Considerations • • • •
Altered memory Decreased visual acuity Decrease in renal function Less complete and slower absorption from the gastrointestinal tract
Elder Considerations • Increased proportion of fat to lean body mass • Decreased liver function • Decreased organ sensitivity • Altered quality of organ responsiveness • Decrease in manual dexterity
Administering Oral Medications Skill 35-1 Compare the medication label to the MAR
A cutting device can be used to divide tablets
Pouring a liquid medication from a bottle
Copyright 2008 by Pearson Education, Inc.
The bottom of the meniscus is the measuring guide
Things to Consider
What are the life span considerations for administering oral medications?
What are the home care considerations for administering oral medications?
Nasogastric/Gastrostomy Tube Medication Administration
• Check with pharmacist for a liquid form • Check to see if medication can be crushed • Crush a tablet into a fine powder and dissolve in at least 30 mL of warm water • Open capsules and mix the contents with water only with the pharmacists advice
Nasogastric/Gastrostomy Tube Medication Administration
• Do not administer whole or undissolved medications • Assess tube placement • Aspirate stomach contents and measure the residual volume
Nasogastric/Gastrostomy Tube Medication Administration
• Remove the plunger from the syringe • Connect syringe to a pinched or kinked tube • Put 15 - 30 mL (5 - 10 mL for children) of water into the syringe barrel to flush the tube • Pour liquid or dissolved medication into the syringe barrel and allow to flow by gravity into the enteral tube
Nasogastric/Gastrostomy Tube Medication Administration
• Administer each medication separately and flush in between • After administration of all medications, flush again • If the tube is connected to suction, disconnect the suction and keep the tube clamped to enhance absorption
Preparing Medications From Ampules
Breaking the neck of an ampule
Withdrawing a medication from an ampule
Preparing Medications From Vials –
Withdrawing a medication from a vial that is held with the base down
Withdrawing a medication from an inverted vial
Mixing Medications Using One Syringe – Skill 35-4 Mixing two types of insulin
Intradermal Injections
Administering Intradermal Injections- Skill 35-5
Subcutaneous Injections
Administering a Subcutaneous Injection - Skill 35-6
Injections (Intramuscular) Video
Back to Directory
Intramuscular Injections • • • • •
Ventrogluteal Vastus lateralis Dorsogluteal Deltoid Rectus femoris
Ventrogluteal Site
Vastus Lateralis Site
infant adult Copyright 2008 by Pearson Education, Inc.
Dorsogluteal Site
Copyright 2008 by Pearson Education, Inc.
Deltoid Site
Rectus Femoris Site
Administering IV Medications Using IV Push – Skill 35-9
Administering Ophthalmic Instillations – Skill 35-10
Copyright 2008 by Pearson Education, Inc.
Administering Otic Instillations – Skill 35-11
Copyright 2008 by Pearson Education, Inc.
Nasal Medications
Administering Vaginal Instillations – Skill 35-12
Copyright 2008 by Pearson Education, Inc.
Inserting Rectal Suppository
Copyright 2008 by Pearson Education, Inc.
Proper Use of a Metered Dose Inhaler (MDI) Video
Click here to view a video on using a metered dose inhaler. Back to Directory
Respiratory Inhalation
Copyright 2008 by Pearson Education, Inc.
Post Test
1. 2.
3. 4.
A client tells the nurse, “This pill is a different color than the one that I usually take at home.” Which is the best response by the nurse? “Go ahead and take your medicine.” “I will recheck your medication orders.” “Maybe the doctor ordered a different medication.” “I’ll leave the pill here while I check with the doctor.”
Rationales 1 1. 2.
3. 4.
Do not administer the medication if there is any doubt. Correct. If there is any doubt, the medication administration process should be interrupted until the question is clarified. Do not administer the medication if there is any doubt. Never leave medication unattended.
Copyright 2008 by Pearson Education, Inc.
Question 2
1. 2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
If the following medications are listed on a client’s medication administration record (MAR), which one should the nurse question? Lasix 40 mg, po, STAT Ampicillin 500 mg, q6 hr, IVPB Humulin L (Lente) insulin 36 u, sc, q am, ac Codeine q 4-6 hr, po. Prn for pain
Rationales 2 1. 2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
Order is okay. Order is okay. Order is okay. Correct. The dosage is missing from this order.
Question 3 The primary care provider prescribed 5 mL of a medication to be given deep IM for a 40year old female who is 5’7” tall and weighs 135 pounds. Which of the following is the most appropriate method of administration? 1.
A tuberculin syringe, #25-#27 gauge, ¼ -5/8 inch needle. 2. Two 3-mL syringes, #20-#23 gauge, 1 ½ inch needle. 3. Two 2-mL syringes, #25 gauge, 5/8-inch needle. 4. Two 2-mL syringes, #20-#23 gauge, 1-inch Copyright 2008 by Pearsonneedle. Education, Inc.
Rationales 3
Copyright 2008 by Pearson Education, Inc.
1. This syringe would be too small to give two 2.5 mL doses. 2. Correct. 5 mL is too much to inject into one site and needs to be divided into two 2.5 mL doses. Therefore a 3mL syringe can be used. 3. This syringe would be too small to give two 2.5 mL doses.
Question 4
1. 2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
An elderly client with renal insufficiency is to receive a cardiac medication. The nurse is most likely to administer which of the following? A decreased dosage. The standard dosage. An increased dosage. A divided dosage.
Rationales 4 1.
2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
Correct. Due to renal insufficiency, the dose of the medication would need to be decreased in order to avoid accumulation of the medication and the risk of toxicity. Incorrect. Incorrect. Incorrect.
Question 5
1. 2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
Proper administration of an otic medication to a two-year-old client includes which of the following? Pull the ear straight back. Pull the ear down and back. Pull the ear up and back. Pull the ear straight upward.
Rationales 5 1. 2.
3. 4.
Copyright 2008 by Pearson Education, Inc.
Incorrect. Correct. In clients less than 3 years of age, the ear must be pulled down and back. This method is only used in individuals over 3 years of age. Incorrect.
Rationales 1 1. 2.
3. 4.
Copyright 2008 by Pearson Education, Inc.
Do not administer the medication if there is any doubt. Correct. If there is any doubt, the medication administration process should be interrupted until the question is clarified. Do not administer the medication if there is any doubt. Never leave medication unattended.
Rationales 2 1. 2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
Order is okay. Order is okay. Order is okay. Correct. The dosage is missing from this order.
Rationales 3
Copyright 2008 by Pearson Education, Inc.
1. This syringe would be too small to give two 2.5 mL doses. 2. Correct. 5 mL is too much to inject into one site and needs to be divided into two 2.5 mL doses. Therefore a 3mL syringe can be used. 3. This syringe would be too small to give two 2.5 mL doses.
Rationales 4 1.
2. 3. 4.
Copyright 2008 by Pearson Education, Inc.
Correct. Due to renal insufficiency, the dose of the medication would need to be decreased in order to avoid accumulation of the medication and the risk of toxicity. Incorrect. Incorrect. Incorrect.
Rationales 5 1. 2.
3. 4.
Copyright 2008 by Pearson Education, Inc.
Incorrect. Correct. In clients less than 3 years of age, the ear must be pulled down and back. This method is only used in individuals over 3 years of age. Incorrect.
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