Topic 1
What are the six rights of medication safety?
Right drug, right dose, right time, right route, right documentation, right patient.
What are the steps that a drug must take when moving through the body? (aka pharmacokinetics)
Absorption, distribution, metabolism and excretion
A nurse administers medication and sees the time on her watch as 7:45pm. What is the correct time she should document in her notes?
19:45
The point at which increasing a drug's dosage no longer increases the desired therapeutic response.
How many tablespoons are in a teaspoon?
1 tbsp = 3 tsp
List and describe five of the various routes of medication administration.
Sublingual, buccal, oral, transdermal, topical, instillations, inhalation, nasogastric, suppositories, parenteral
What is pharmacogenetics and/or what factors need to be considered?
The study of how a person responds to medication based on their body’s DNA or genome. Factors to consider: age, weight, liver & kidney function, and gender.
Compare wristband to the patient's medical record, utilize photo id to compare if available and utilize family members as resource
When do you draw trough drug levels?
Trough levels are drawn just before the next dose, regardless of the route of administration.
List as many conversions as you can think of.
1 cup=8 ounces
1 ounce=2 tbsp
1 ounce = 30 mL
1 teaspoon = 5 mL
1 gram = 1000 mg
1 kg = 1000 grams
1 kg = 2.2 pounds
1 liter = 1000 mL
1 mg = 1000 mcg
1 mL = 1 cc
What is the difference between pharmacokinetics and pharmacodynamics?
Pharmacokinetics is the movement of the drug in the body and pharmacodynamics is the effects of drugs on the body.
What is the difference between the peak drug levels and trough drug levels?
The trough drug levels is the lowest plasma concentration of a drug and measures the rate at which the drug is eliminated.
What is Just Culture?
-Fair and not punitive
-Encourages reporting of errors
-Goal is to repair system
Rate of dissolution, surface area, rate of blood flow, lipid solubility, and pH partitioning
Hydromorphone 2mg IV Q2-4hrs PRN is prescription. The supply is 4mg/mL syringes.
How many mL will you be giving in one dose?
0.5 mL per dose
What are the various components of a drug label?
Active ingredients, Inactive ingredients, Purpose, Uses, Warnings, Directions for proper usage
What are the diagnostic lab and/or values related to liver and kidney function?
Liver: AST (aspartate transaminase), ALT (alanine aminotransferase) and ALP (alkaline phosphatase)
Kidneys: CR (creatinine) and BUN (blood urea nitrogen)
List 3 out of 6 rights that nurses have when administering medications.
-Right to a complete and clear order-contact providing healthcare provider
-Right to have the correct drug, route (form) and dose dispensed
-Right to have access to information
-Right to have policies to guide safe medication administration
-Right to administer medications safely and to identify system problems
-Right to stop, think, and be vigilant when administering medications. (Quiet space)
What is a black box warning?
Strongest form of warning issued by the FDA.
Needs to be on drugs that may cause serious adverse effects.
Your patient weighs 25 lbs. How many mg will you give your patient if they require 2 mg/kg of medication?
Change lbs to kg… 25 ÷ 2.2 = 11.36 kg
=22.72 mg
What are common medication math errors?
--Label reading (total number of mL in the bottle, total of mL or mg per dose, total number of mL or mg per day, changes in mg based on mL of diluent)
--Conversion errors (converting the wrong direction, and using an incorrect conversion factor)
How do your genetics/cultural background affect how a drug will impact the body?
Topic 2.5*
Biological variations, tolerance, drug responsiveness, placebo effect and drug interactions
Explain the steps for reporting medication errors.
-Is the client safe?
-Notify immediate supervisor
-Check for adverse drug reporting
-Identify your responsibility for external reporting
-U.S. Pharmacopeia Medication Errors Reporting Program
What is the Tuskegee Experiment and what did the researchers not obtain?
The U.S. Public Health Service (USPHS) Syphilis Study at Tuskegee was conducted between 1932 and 1972 to observe the natural history of untreated syphilis. As part of the study, researchers did not collect informed consent from participants and they did not offer treatment, even after it was widely available.
Your patient weighs 50 kg. They are on a heparin drip and their PTT was subtherapeutic. The protocol says to give them a bolus of 40 units/kg of heparin. How many units of heparin will you give your patient?
50 kg x 40 units
= 2000 units