HFHS General Orientation Exam
6 Rights of Drug Administration - ANSRight Patient, Time, Route, Drug, Dose, and
Documentation
High Alert Medications - ANSPotassium chloride, Heparin, Insulin, Warfarin, Calcium,
Chemotherapeutic drugs, Opioids, and Lidocaine
All Chemotherapy, PCA, and Heparin drips require.... - ANSVerification by two RNs which is
documented in the eMAR
When can't verbal orders be given? - ANSAntineoplastic Agents
When should verbal orders be used? - ANSTrue emergencies or when the issuing provider
is unavailable (e.g., during sterile procedures)
Range Order: Doc orders Morphine 2-8 mg q 4 hrs PRN pain... @ 1400 Pt states their pain
is a 7/10 and 2 mg of Morphine is given. When you reassess the patient's pain score an hour
later (1500) the patient states that there had been no relief. Therefore, you administer an
additional 3 mg of Morphine. How much morphine can be given from 1600-1800? - ANS3
mg of Morphine
? g = 1 kg - ANS1000 g
? mg = 1 g - ANS1000 mg
? mcg = 1 mg - ANS1000 mcg
? mL = 1 L - ANS1000 mL
? lbs = 1 kg - ANS2.2 lbs
? tbs = 15 mL - ANS1 tbs
? oz = 30 mL - ANS1 oz
What is the most common allergy that's an anti-infective - ANSPCN
What drugs constitute the Penicillins? - ANSAmoxacillin, Ampicillin, Augmentin, Nafcillin
Sodium, Piperacillin sodium, PCN G, PCN VK, Trimox, Unasyn
When might Penicillins be used? - ANSSkin and urinary tract infections, bronchitis,
pneumonia, tonsilitis, ear infections
, Serious Adverse Reactions to Penicillins - ANSAnaphylaxis, Neutropenia, Leukopenia,
Thrombocytopenia, Hepatotoxicity
NSG Considerations when giving Penicillins - ANSGive with full glass of water on an empty
stomach and do not give with acidic fruit juice because is decomposes PCN
What kind of infections might you assess for when administering anti-infective agents? -
ANSSuperinfections such as thrush, yeast infections, C. diff (diarrhea/abdominal cramps),
stomatitis, and glossitis
True or False: Dehydration can lead to anti-infectives reaching toxic levels - ANSTRUE
Patient education for Penicillins - ANSNotify docs of bloody diarrhea and abdominal
cramping and that PCNs can decrease the effectivness of birth control pills.
Name some Tetracyclines - ANSDoxycycline (Vibramycin), Minocycline, and tetracycline
Serious Adverse Reactions of Tetracyclines - ANSNeutropenia, Thrombocytopenia,
Hepatotoxicity, Superinfection, Hemolytic Anemia, Anaphylaxis
Nursing Considerations for Tetracyclines - ANSEffectiveness is reduced with ant-acids, iron
salts, and foods high in calcium, Give 1 hr before meals and 2 hrs after meals, and give with
full glass of water because it can irritate the esophagus
Patient education for Tetracyclines - ANSPhotosensitivity, teeth discoloration,, & don't take
after it expires because can cause syndrome that damages the kidneys.
When to seek emergent medical attention with tetracyclines? - ANSConfusion, vision
changes, severe HA, allergic reaction, liver changes, bruising/bleeding, severe fatigue
When should pts notify their doctor with Tetracyclines - ANSN/V, increased sensitivity to light,
swollen tongue (... i think this should be in the emergent section), yeast infection
Name Aminoglycosides - ANSAmikacin, Gentamycin (Garamycin), Streptomycin,
Tobramycin
Indications of Aminoglycosides - ANScirrhosis, gonorrhea, pneumonia, septicemia, and UTIs
NSG Considerations for Aminoglycosides - ANSNephrotoxicity (esp if poor renal fxn) but is
limited if given for less than 5 days. Ototoxicity (s&s tinnitits, hearing impairment, and
vestibular symptoms such as dizziness, nystagmus, vertigo, and ataxia)
Serious Adverse Reactions of Aminoglycosides - ANSNephrotoxic, Ototoxic,
Agranulocytosis, Thrombocytopenia, Neurotoxicity
Patient Education for Aminoglycosides - ANSDo not take if sulfite sensitivity, kidney disease,
hearing loss or loss of balance due to ear problems, Parkingsons disease or an
neuromuscular disorder such as myasthenia gravis
6 Rights of Drug Administration - ANSRight Patient, Time, Route, Drug, Dose, and
Documentation
High Alert Medications - ANSPotassium chloride, Heparin, Insulin, Warfarin, Calcium,
Chemotherapeutic drugs, Opioids, and Lidocaine
All Chemotherapy, PCA, and Heparin drips require.... - ANSVerification by two RNs which is
documented in the eMAR
When can't verbal orders be given? - ANSAntineoplastic Agents
When should verbal orders be used? - ANSTrue emergencies or when the issuing provider
is unavailable (e.g., during sterile procedures)
Range Order: Doc orders Morphine 2-8 mg q 4 hrs PRN pain... @ 1400 Pt states their pain
is a 7/10 and 2 mg of Morphine is given. When you reassess the patient's pain score an hour
later (1500) the patient states that there had been no relief. Therefore, you administer an
additional 3 mg of Morphine. How much morphine can be given from 1600-1800? - ANS3
mg of Morphine
? g = 1 kg - ANS1000 g
? mg = 1 g - ANS1000 mg
? mcg = 1 mg - ANS1000 mcg
? mL = 1 L - ANS1000 mL
? lbs = 1 kg - ANS2.2 lbs
? tbs = 15 mL - ANS1 tbs
? oz = 30 mL - ANS1 oz
What is the most common allergy that's an anti-infective - ANSPCN
What drugs constitute the Penicillins? - ANSAmoxacillin, Ampicillin, Augmentin, Nafcillin
Sodium, Piperacillin sodium, PCN G, PCN VK, Trimox, Unasyn
When might Penicillins be used? - ANSSkin and urinary tract infections, bronchitis,
pneumonia, tonsilitis, ear infections
, Serious Adverse Reactions to Penicillins - ANSAnaphylaxis, Neutropenia, Leukopenia,
Thrombocytopenia, Hepatotoxicity
NSG Considerations when giving Penicillins - ANSGive with full glass of water on an empty
stomach and do not give with acidic fruit juice because is decomposes PCN
What kind of infections might you assess for when administering anti-infective agents? -
ANSSuperinfections such as thrush, yeast infections, C. diff (diarrhea/abdominal cramps),
stomatitis, and glossitis
True or False: Dehydration can lead to anti-infectives reaching toxic levels - ANSTRUE
Patient education for Penicillins - ANSNotify docs of bloody diarrhea and abdominal
cramping and that PCNs can decrease the effectivness of birth control pills.
Name some Tetracyclines - ANSDoxycycline (Vibramycin), Minocycline, and tetracycline
Serious Adverse Reactions of Tetracyclines - ANSNeutropenia, Thrombocytopenia,
Hepatotoxicity, Superinfection, Hemolytic Anemia, Anaphylaxis
Nursing Considerations for Tetracyclines - ANSEffectiveness is reduced with ant-acids, iron
salts, and foods high in calcium, Give 1 hr before meals and 2 hrs after meals, and give with
full glass of water because it can irritate the esophagus
Patient education for Tetracyclines - ANSPhotosensitivity, teeth discoloration,, & don't take
after it expires because can cause syndrome that damages the kidneys.
When to seek emergent medical attention with tetracyclines? - ANSConfusion, vision
changes, severe HA, allergic reaction, liver changes, bruising/bleeding, severe fatigue
When should pts notify their doctor with Tetracyclines - ANSN/V, increased sensitivity to light,
swollen tongue (... i think this should be in the emergent section), yeast infection
Name Aminoglycosides - ANSAmikacin, Gentamycin (Garamycin), Streptomycin,
Tobramycin
Indications of Aminoglycosides - ANScirrhosis, gonorrhea, pneumonia, septicemia, and UTIs
NSG Considerations for Aminoglycosides - ANSNephrotoxicity (esp if poor renal fxn) but is
limited if given for less than 5 days. Ototoxicity (s&s tinnitits, hearing impairment, and
vestibular symptoms such as dizziness, nystagmus, vertigo, and ataxia)
Serious Adverse Reactions of Aminoglycosides - ANSNephrotoxic, Ototoxic,
Agranulocytosis, Thrombocytopenia, Neurotoxicity
Patient Education for Aminoglycosides - ANSDo not take if sulfite sensitivity, kidney disease,
hearing loss or loss of balance due to ear problems, Parkingsons disease or an
neuromuscular disorder such as myasthenia gravis
