Enteral
List 3 ways a med can be administered enterally.
Oral
Rectal
via J tube
Via G tube
NG tube
You are giving an IM injection? What is an appropriate site for this injection?
Ventral gluteal
Vastis lateralis
Deltoid
List 5 types of topical medications.
Cream/ ointment
eye drops
ear drops
inhaler
Patch
mouth wash/ rinse (not swallowed)
How do you confirm your person/ patient?
ID band, confirm full name and DOB (2 identifiers)
Why might your patient be receiving acetaminophen?
Pain management and reducing fever.
What should you ask your patient before giving an oral medication (or any medication)?
do you have any allergies
You are giving dalteparin to your patient, how would you administer it?
SC injection
- lower abdomen
- upper outer arm
- anterior thigh
How do you put on a nicotine patch?
GLOVEs on
Place on patients preferred site on upper body (upper arm, upper chest, shoulder, back)
Site should be clean, dry, hairless, avoid sites that are irritated
Date patch
How would you break an ampule?
HINT: Where does the dot go?
- Dot is pointed away
- Use an unopened alcohol swap
- Break away from you
Why would your patient be receiving ringer's lactate instead of normal saline?
Ringer's Lactate also contains potassium, calcium and lactate in addition to sodium and chloride (where as NS only has sodium and chloride).
What position should you direct your patient into if your administering a rectal suppository?
Have patients lay on left side with upper leg flexed upwards
You are giving an SC injection. What supplies do you need to administer this med?
Gloves
Antiseptic swab
The medication
Laptop/ scanner to document and scan patient/ med
Sharps bin (to dispose needle after use)
Potentially a cotton swab or gauze if bleeding occurs after administration
You're in head and neck for the day. Your patient has a tongue flap and requires chlorhexine mouth wash twice daily. What piece of equipement should you have on hand.
May say syringe to spray wash in, or saline to rinse (which are true).
I'm looking for suction. Important to have ready to use.
What are the 8 rights of medication administraion?
Right...
- person
- medication
- Dose
- Frequency
- time
- route
- site
- reason
You're giving a dalteparin injections for you third time today, you're basically a pro. Carter ask how does dalteparin work, do you know?
Dalteparin is an anticoagulant.
It increases the activity of antithrombin III, a plasma protein that inhibits thrombin, factor Xa, and several other clotting factors.
You have an order to administer liquid acetaminophen, 650g PO q6h prn for pain.
The stock acetaminophen concentration is 160mg/5mL
What volume should you give to complete the order?
20.3125mL
List 5 items that should be included in a systematic assessment of an IV infusion.
check drip rate
check for patency and that its intact
check IV site (Fluid leaking, tenderness, redness, swelling, pain)
Dressing
Palpate skin for tenderness or swelling
Signs of infiltration or phlebitis (inspect dressing)
What steps should a nurse take to ensure safe and effective administration of creams/ ointments?
Asess area prior to application
Clean and dry area before application
Gloves, change as needed.
List 5 things you should know about a medication before administering it to your patient.
- What the med is used for
- MOA
- Adverse effects
- Route
- why the patient is taking the med
Your giving furosemide (LASIX). What adverse effects should you be watching for and what assessments would you use to monitor this?
Low BP (leading to dizziness, confusion, weakness, weight changes, headaches etc). Would do vitals before med pass. Monitor with regular vitals.
Decreased electrolyte levels (K+, Na+, Cl-). Monitored with blood work/ labs.
Walk through the steps of administering a tablet via G tube.
- Retrieved med, verify it can be crushed.
- Crush med and place in pill cup (silent knight pill crusher)
- verify 8 rights of med administration
- Hand hygiene + gloves
- Used patient designated G tube syringe
- Flush tube with 50mL of tap water (Draw up water, Connect syringe to tube, Unclamp, Flush, Clamp, Detach syringe)
- Mix crushed med with water (syringe tip attached), draw up
- Administer med via G tube
- Flush with 50mL of tap water
List 4 nursing actions for an infiltration or phlebitis
phlebitis scale to grade the severity, 0-4
stop the infusion and discontinue the IV
Elevate the affected extremity, and wrap it in a warm, moist compress for 20 minutes
Switch IV location
Document
If purulent drainage is present, collect swab and send for testing
You have a patient with asthma and you are helping them administer their Ventolin. They bring the inhaler to their mouth and administer the medication as they breath in. How can you use health teaching to promote proper administration of this medication?
Use an AEROCHAMBER
Breath out, push down inhaler and breath in.
List 5 ways you can minimize medication errors.
Follow 8 rights of medication administration
Use independent double checks for high-alert meds (checking with another nurse)
Avoid distractions
clarify any unclear orders
Refer to MAR
ensure proper documentation
Attend in-service programs on the medications you commonly administer.
Follow established employer policies and procedures when using technology to administer medications.
You are administering Atorvastatin which is a type of statin. How does this drug work?
Decreased cholesterol levels and LDLs, increased HDLs.
Done via the inhibition of HMG-CoA reductase enzyme, resulting in a reduction of cholesterol synthesis