Test 4 Review
Chapter 35: Medication Administration
Drug Classification
o Prescription and OTC
o Generic name or Trade/Brand name
Legal
o Nurses must have physician orders
o Controlled substances = CASPER system tracking in KY
o US legislation – keeps drugs on or off the market
o State laws – restrictions on certain OTC drugs
Drug Effects
o Side effects – (secondary effect) Expected and treated; may be harmless or
potentially harmful
o Adverse reactions – (adverse effects) aren’t expected, deadly; may justify the
discontinuation of the drug
o Drug toxicity – (harmful effects of a drug on an organism or tissue) too
much/overdose; ingention of a drug intended for external use or buildup of the
drug in the blood because of impaired metabolism or excretion; elderly/kids at
risk, kidney/liver
o Allergy = anaphylactic reaction (occurs immediately after the drug is
administered), doesn’t mean you had side effects of a drug
o Drug interactions – occurs when the administration of one drug before, at the
same time as, or after another drug alters the effect of one or both drugs;
contraindications, drug compatibility
Actions
o Half-life – amount of time for half the med to get out of the body
o Onset – the time it takes for the med to start work
o Peak plasma level – highest level of med. PO (30-60) IV (med is done)
o Trough – Right before dose (lowest amount)
Pharmacokinetics
o Absorption – the process by which a drug passed into the bloodstream; first step
in the movement of the drug through the body
o Distribution – the transportation of a drug from its site of absorption to its site of
action
o Biotransformation (metabolism) – process by which a drug is converted to a less
active form, mostly takes place in the liver- products called metabolites
o Excretion – process by which metabolites and drugs are eliminated from the
body
Factors affecting med action
, o Developmental – pregnancy, kids (immune body systems), older adults
(decreased renal function *start low go slow* - safety tops on pill bottles)
o Sex – Males = more protein & metabolize faster; females = more adipose tissue
o Genetic – genetic testing
o Diet – effects absorption (Coumidin – Vit K)
o Psychological – think it won’t work, won’t take certain meds, generic vs brand
names
o Disease- Cancer, circulatory issues, gut, renal, liver
o Time of administration – some drugs have to be taken with food or without food,
or am/pm
Oral
o SAFEST ROUTE/MOST CONVIENENT – does not break skin barrier
o Tablets – can be scored/crushed as long as not enteric coated
o Capsules, liquid
o Sublingual (under tongue - NITROGLYCERIN)
o Buccal (Cheek)
o Enteral – tube feed, crushed or liquid
If a person is on suction, stop suction before giving meds – wait 30 mins
to start suction again
o How to measure and administer liquid medication?
Thoroughly mis the medication before pouring. Discard any medication
that has changed color or turned cloudy.
Remove cap and place upside down on the countertop (avoids
contamination)
Place medicine cup on a flat surface at eye level and fill it to the desired
level, using the bottom of the meniscus to align with the container scale
(ensures accurate measurement)
Wipe the lip of bottle off with paper towel before capping bottle
Transdermal
o Applied to skin, local and maybe systemic effects
o Lotion, creams, ointments, patches
o Soap/water, gloves, pat dry and apply
o Wrap in glove and put in sharps container
o Rotate sites
Parenteral
o Injected VIA
Intradermal – under the epidermis (into the dermis)
Subcutaneous – into the subcutaneous tissue, just below the skin
Intramuscular – into a muscle
Intravenous – into a vein
ANY TIME YOU SUSPECT AN ALLERGIC REACTION – GIVE BENADRYL
o Do not need to stop and ask – emergency protocol
Topical
, o Skin/body cavity
o Eye – Lower and outer. Ointment is applied in to out
o Ear – 3+ up & back, -3 down & back
o Vagina – Need to go up by cervix
o Rectum – lube always, make sure not melted or too cold
o Nose – blow before, slow inhale
Medication Orders types
o STAT – ASAP
o Single Order – one time only (Diflucan)
o Standing order – there if needed in an emergency (Benadryl)
o PRN – as needed
o If written by the nurse (phone or verbal order) ALWAYS read back & verify
accuracy of the order
Valid Drug orders
o Full name of pt.
o Date/time written
o Name of drug
o Dosage
o Frequency
o Route
o Signature
Administering Safely
o Assessment – based on drug type and drug action - BP, HR, AAO
o Suitable route – right size syringe/needle
o Med History – taken it before, allergies, any illegal drugs, herbal drugs
o Allergies
o Drug specifics – time of day? w/ or w/o meals?
o Self-administration issues – Vision, dexterity
Administering Medications (Box on page 769)
o Nurses who administer medications are responsible for their own actions.
Question any order that is illegible or that you consider incorrect. Call the
person who prescribed the medication for clarification.
o Be knowledgeable about the medications you administer. You need to know why
the client is receiving the medication. Look up necessary information if you are
not familiar with the medication.
o Federal law governs the use of narcotics and barbiturate. Keep those medications
in a locked place.
o Use only medications that are in a clearly labeled container.
o Do not use liquid medications that are cloudy or have changed color.
o Administer only medications personally prepared.
o Before administering a medication, identify the client correctly using the
appropriate means of identification, such as checking the identification bracelet.
Chapter 35: Medication Administration
Drug Classification
o Prescription and OTC
o Generic name or Trade/Brand name
Legal
o Nurses must have physician orders
o Controlled substances = CASPER system tracking in KY
o US legislation – keeps drugs on or off the market
o State laws – restrictions on certain OTC drugs
Drug Effects
o Side effects – (secondary effect) Expected and treated; may be harmless or
potentially harmful
o Adverse reactions – (adverse effects) aren’t expected, deadly; may justify the
discontinuation of the drug
o Drug toxicity – (harmful effects of a drug on an organism or tissue) too
much/overdose; ingention of a drug intended for external use or buildup of the
drug in the blood because of impaired metabolism or excretion; elderly/kids at
risk, kidney/liver
o Allergy = anaphylactic reaction (occurs immediately after the drug is
administered), doesn’t mean you had side effects of a drug
o Drug interactions – occurs when the administration of one drug before, at the
same time as, or after another drug alters the effect of one or both drugs;
contraindications, drug compatibility
Actions
o Half-life – amount of time for half the med to get out of the body
o Onset – the time it takes for the med to start work
o Peak plasma level – highest level of med. PO (30-60) IV (med is done)
o Trough – Right before dose (lowest amount)
Pharmacokinetics
o Absorption – the process by which a drug passed into the bloodstream; first step
in the movement of the drug through the body
o Distribution – the transportation of a drug from its site of absorption to its site of
action
o Biotransformation (metabolism) – process by which a drug is converted to a less
active form, mostly takes place in the liver- products called metabolites
o Excretion – process by which metabolites and drugs are eliminated from the
body
Factors affecting med action
, o Developmental – pregnancy, kids (immune body systems), older adults
(decreased renal function *start low go slow* - safety tops on pill bottles)
o Sex – Males = more protein & metabolize faster; females = more adipose tissue
o Genetic – genetic testing
o Diet – effects absorption (Coumidin – Vit K)
o Psychological – think it won’t work, won’t take certain meds, generic vs brand
names
o Disease- Cancer, circulatory issues, gut, renal, liver
o Time of administration – some drugs have to be taken with food or without food,
or am/pm
Oral
o SAFEST ROUTE/MOST CONVIENENT – does not break skin barrier
o Tablets – can be scored/crushed as long as not enteric coated
o Capsules, liquid
o Sublingual (under tongue - NITROGLYCERIN)
o Buccal (Cheek)
o Enteral – tube feed, crushed or liquid
If a person is on suction, stop suction before giving meds – wait 30 mins
to start suction again
o How to measure and administer liquid medication?
Thoroughly mis the medication before pouring. Discard any medication
that has changed color or turned cloudy.
Remove cap and place upside down on the countertop (avoids
contamination)
Place medicine cup on a flat surface at eye level and fill it to the desired
level, using the bottom of the meniscus to align with the container scale
(ensures accurate measurement)
Wipe the lip of bottle off with paper towel before capping bottle
Transdermal
o Applied to skin, local and maybe systemic effects
o Lotion, creams, ointments, patches
o Soap/water, gloves, pat dry and apply
o Wrap in glove and put in sharps container
o Rotate sites
Parenteral
o Injected VIA
Intradermal – under the epidermis (into the dermis)
Subcutaneous – into the subcutaneous tissue, just below the skin
Intramuscular – into a muscle
Intravenous – into a vein
ANY TIME YOU SUSPECT AN ALLERGIC REACTION – GIVE BENADRYL
o Do not need to stop and ask – emergency protocol
Topical
, o Skin/body cavity
o Eye – Lower and outer. Ointment is applied in to out
o Ear – 3+ up & back, -3 down & back
o Vagina – Need to go up by cervix
o Rectum – lube always, make sure not melted or too cold
o Nose – blow before, slow inhale
Medication Orders types
o STAT – ASAP
o Single Order – one time only (Diflucan)
o Standing order – there if needed in an emergency (Benadryl)
o PRN – as needed
o If written by the nurse (phone or verbal order) ALWAYS read back & verify
accuracy of the order
Valid Drug orders
o Full name of pt.
o Date/time written
o Name of drug
o Dosage
o Frequency
o Route
o Signature
Administering Safely
o Assessment – based on drug type and drug action - BP, HR, AAO
o Suitable route – right size syringe/needle
o Med History – taken it before, allergies, any illegal drugs, herbal drugs
o Allergies
o Drug specifics – time of day? w/ or w/o meals?
o Self-administration issues – Vision, dexterity
Administering Medications (Box on page 769)
o Nurses who administer medications are responsible for their own actions.
Question any order that is illegible or that you consider incorrect. Call the
person who prescribed the medication for clarification.
o Be knowledgeable about the medications you administer. You need to know why
the client is receiving the medication. Look up necessary information if you are
not familiar with the medication.
o Federal law governs the use of narcotics and barbiturate. Keep those medications
in a locked place.
o Use only medications that are in a clearly labeled container.
o Do not use liquid medications that are cloudy or have changed color.
o Administer only medications personally prepared.
o Before administering a medication, identify the client correctly using the
appropriate means of identification, such as checking the identification bracelet.
