What is the concentration, in mg/mL, of the following medication?
The concentration is the amount of drug in a given volume. From the drug label, we can see that the Zithromax comes as 100 mg/ 5 mL. The question asks for the concentration in mg/mL.
100 mg / 5 mL = 20 mg/mL concentration
Which one of the 6 rights of medication administration is missing?
Right Patient
Right Route
Right Dose
Right Time
Right to Refuse (Right Documentation)
Right ________
What is the Right Medication?
The nurse recognizes this class of medications, which Blocks H₂ receptors suppressing gastric acid secretion by the suffix -tidine.
What are H2 antagonists?
Example: Famotidine, Cimetidine
This class of medications includes ibuprofen and aspirin.
What are Non-steroidal anti-inflammatories (NSAIDs)?
The nurse recognizes the above symbol to mean __________ and knows that special training, equipment, and handling will be required for medications or excreta from the patient.
What is radioactive?
Migraine medications are classified in two types, __________ or ___________.
What are abortive or preventative?
pH 7.29, pO2 88, CO2 56, HCO3- 24
What is respiratory acidosis?
CO2 elevated, pH decreased
All patients on anticoagulants should also be on this type of precaution.
What are bleeding precautions?
How many teaspoons are in 30 mL?
Knowing that 5 mL = 1 tsp. you could do the following:
30 mL/ 5 mL = 6 tsp.
or
x = tsp. 1 tsp x 30 mL = 6 tsp.
5 mL 1
What's wrong with the following orders?
1. Administer 5u regular insulin ac & hs. T.O. Dr. Feelgood/ B. Johnson, RN
1. Administer 4.0mg MSO4 IM q 4 hr. prn pain 8-10 on a 0-10 pain scale. T.O./ Dr. Feelgood/ B. Johnson, RN
Order #1:
What is "u"? Units should be written out so as not to be confused with cc, etc.
Order #2:
a. NO TRAILING ZEROES! This could easily be mistaken for 40 mg
b. MSO4 should be written out as Morphine Sulfate, as it could easily be mistaken for MgSO4, Magnesium Sulfate. The abbreviations ac & hs are acceptable, as they stand for before meals and at bedtime.
**Technically, both orders should be signed within 24 hours also, because they are telephone orders taken by the nurse, not originally written by the provider.
The nurse recognizes this class of medications, that reduces gastric acid by stopping the enzyme that
produces, from the suffix -prazole.
What are PPIs, or Proton Pump Inhibitors?
Examples: Omeprazole, Lansoprazole
If an overdose of an opiate is suspected, the nurse knows that this is the antidote. It may be given IV, IM, or Intranasally.
What is naloxone (Narcan)?
Of the following insulins, which one has no peak and lasts for 24 hours?
a. Regular
b. Humalog
c. NPH
d. Lantus
What is Lantus?
Remember: Lantus is Long-Acting.
The classic triad of Parkinson's disease consists of tremors, rigidity, and ______________.
What is bradykinesia?
When a patient is on this type of medication, it cannot be stopped abruptly; the nurse must watch out for adrenal insufficiency, and the nurse must carefully watch the patient's blood sugar, as it may become elevated even with short-term usage.
What are corticosteroids?
Before giving the Lovenox (enoxaparin), the nurse must check the CBC, specifically the ________ count.
What is the platelet count?
If PLT count is < 150,000 the nurse should hold the lovenox and notify the physician.
How much does the patient who weighs 330 lbs weigh in kg?
Know: 1 kg = 2.2 lbs.
330 lbs. / 2.2 = 150 kg
or
x = kg 1 kg x 330 lbs. = 150 kg
2.2 lbs. 1
Before each medication is administered, the nurse will check the 6 R's, perform the 3 checks, and check two patient identifiers. Name two accepted patient identifiers.
What are name and date of birth (DOB)?
What is sucralfate (carafate)?
The hallmark sign of an aspirin overdose is _______.
What is tinnitus (ringing in the ears)?
Oral anti-diabetic medications work in a variety of ways.
1. The ________ class, of which metformin belongs to, works by increasing sensitivity to insulin the person is already producing.
2. Could a Type 1 diabetic be treated with this class of medications?
1. Biguanide class
2. NO! T1DM requires exogenous insulin because the Beta cells of the pancreas are destroyed and no longer produce insulin.
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Metformin: Biguanide; increases sensitivity to insulin the person is already producing.
Sulfonylurea: Glipizide; increases insulin production and increases insulin sensitivity.
Glucagon: Hormone; increases glucose levels in an emergency. May be administered IM, if oral or IV routes are unavailable.
Semaglutide: GLP-1 receptor agonist; Binds to the GLP-1 receptor affecting appetite and also stimulating insulin release and preventing glucagon release. This medication can be used for weight reduction and for lowering blood glucose values.
The number one prescribed medication for Parkinson's is __________ which works to augment the dopamine supply in the patient to reduce the symptomology of the Parkinson's triad.
What is Sinemet (Carbidopa/Levodopa)?
Short acting beta agonists, or SABAs, are used for the active management of an acute problem. The most well-known SABA for acute asthma attacks is ______________.
**Fun fact: You should always give this medication before a steroid to make sure the airways are open to receive the other medication.
What is albuterol?
The most common side effect of iron sulfate (FeSO4) is constipation. To increase absorption, the nurse could administer this medication with ___________.
What is orange juice?
Orange juice aids in the absorption of iron sulfate.
Pro-tip: Administer oral liquid preparations of iron through a straw to avoid staining of the teeth.
The patient has a dose of tenofovir 450 mg by mouth due at 0900. On hand, the nurse has tenofovir 150 mg capsules. How many capsules will the nurse administer?
___________ capsules
450 / 150 = 3 capsules
or
x = capsules
1 capsule x 450mg = 3 capsules
150 mg dose
What are the accepted angles of insertion for a subcutaneous injection?
What are 45o and 90o?
Use your nursing judgement and base it on the patient's body habitus.
This GI disorder is often treated with PPIs and an antibiotic. If left untreated, it can cause gastritis and lead to peptic ulcer disease (PUD)?
What is H. Pylori?
Often seizure medications are given as adjuvants to pain control. The nurse knows that seizure medications should not be administered with this type of juice, as it can inhibit the effectiveness of the medication.
What is grapefruit juice?
Hypothyroidism can be caused by several disease processes, and can manifest with symptoms of headache, insomnia, irritability, tachycardia, & tachypnea. The first line treatment for hypothyroidism is ______________, which the patient should expect to be on as a life-long treatment.
What is Synthroid (Levothyroxine)?
Patients who take seizure medications must be compliant with the taking of their medications, and they must avoid __________ as it interferes with the metabolism of the drugs.
What is alcohol (Etoh)?
The MOST important drug to administer during an anaphylactic reaction is _____________.
What is epinephrine?
Alphabet soup......
When discussing antiretroviral medications for HIV/AIDS, the nurse recognizes the following abbreviations to mean.......
1. PrEP ______________
2. PEP _______________
3. HAART _____________
4. ART _______________
What is:
PrEP: Pre-Exposure Prophylaxis
PEP: Post-Exposure Prophylaxis (begin within 72 hours)
ART- AntiRetroviral Therapy
HAART- Highly Active AntiRetroviral Therapy
The patient needs 2000 mL of Normal Saline to be infused over 16 hours.
1. What will the rate be in mL/ hour?
2. What will the rate be in gtts/ minute using a standard 10 gtt/mL gtt set?
1. mL per hour
2000 mL / 16 hours = 125 mL/ hour
* Volume over Time
2. gtts per minute
Total mL x gtt factor = gtt/min
total minutes
2000 mL x 10 gtt/mL = 20000 gtt = 20.8 or 21
960 minutes 960 min
Answer: 21 gtts/min
How many mL can the nurse safely inject into the deltoid muscle?
What is 1 mL?
If a patient is taking a laxative, it is either bulk-forming, affects the surfactant, or osmotic in nature. Laxatives that are bulk forming in nature do this: ____________________. Those that affect the surfactant soften the fecal mass, and osmotic laxatives stimulate peristalsis.
What is adds bulk to the stool and also softens it?
Some medications make the pain medication work better when given at the same time. An example of this is promethazine (Phenergan) and meperidine (Demerol). Promethazine _________ the effectiveness of meperidine, making it work stronger and better. *Be careful, drowsiness is a side effect of both medications, so careful reassessment is critical to prevent hypoventilation.
What is potentiates?
Potentiate defined:
To increase the power, effect, or likelihood of (something, especially a drug or physiological reaction).
When mixing two types of insulin in the same syringe......
1. Which two types can be mixed?
2. Which does the nurse draw up first?
1. Regular and NPH
2. The nurse draws up the Regular first.
Alzheimer's is an irreversible type of dementia. Patients take ___________ which prevents the breakdown of the neurotransmitter acetylcholine which
improves communication amongst healthy nerve cells in the brain.
What is Aricept?
Your patient just used their Flovent inhaler. You know that Flovent is a steroid. What nursing intervention will you ensure is completed following the use of this inhaler?
What is that the patient will rinse out his/her mouth following usage of the inhaler?
What are ages 13 to 65?