Nursing Implications by Oral Route of Administration Correct Answer - -avoid grapefruit juice
-in general, administer on an empty stomach (1 hr before meals, 2 hr after meals)
-use liquid form to facilitate swallowing whenever possible
Nursing Implications by Drop Instillation Route of Administration Correct Answer
- -side-lying
-place client supine with head positioned to allow medication to enter appropriate nasal passage
-instruct client to breathe through mouth, stay in supine position, and blowing nose
for 5 min after drop insertion
-dropped into center of conjunctival sac
-close eye to improve distribution of medication
needle sizes: subcutaneous Correct Answer - 3/8 to 5/8, 25 to 27 gauge
(abdomen, upper hips/love handles, lateral upper arms)
needle sizes: Intramuscular Correct Answer - 22 to 25 gauge, 1 to 1.5 inches
((ventrogluteal, deltoid, vastus lateralis (pediatrics))
needle sizes: Intravenous Correct Answer - surgical: 18 gauge
trauma: 16 gauge
actions to verify trough level Correct Answer - blod specimen obtained immediately prior to the next dose of medication 6 patient rights Correct Answer - patient, medication, dose, time, route, documentation
(product, price, time, place for right person)
preventing med errors: assessment Correct Answer - ensure knowledge of medication. use appropriate resources: drug handbooks, physicians desk reference, professional journals
preventing med erros: implementation Correct Answer - avoid distractions during medication preparation (poor lighting, noise, interruptions)
Safe IV Administration Correct Answer - -potassium chloride can cause serious adverse reactions; should be delivered with an electronic infusion pump for dose control
-scissors or electric shaver for hair removal
maintaining patency of IV access Correct Answer - - do not stop continuous infusion or or allow blood to back up into the catheter, clots can form
-flush intermittent IV catheters with appropriate solution after every med admin or every 8 to 12 hours
infiltration Correct Answer - stop infusion and remove catheter
extravasation (infiltration of vesicant/tissue-damaging medication) Correct Answer
- stop infusion and notify provider
hematoma Correct Answer - ecchymosis at site -apply pressure after IV catheter removal
phebitis/thrombophebitis Correct Answer - edema, throbbing, burning, pain at the site
- assess for palpable, hard mass above insertion site is a clinical manifestation of thrombophlebitis
FDA risk to fetus medication categories:
(A is best, X is worst) Correct Answer - Category A: There is no evidence of risk to fetus during pregnancy based on adequate and well-controlled studies.
Category B: There is no evidence of risk to animal fetuses based on studies, but there are no adequate and well-controlled studies in pregnant women.
Category C: Adverse effects have been demonstrated on animal fetuses. There are no adequate and well-controlled studies in pregnant women, but use of the medication during pregnancy may be warranted based on the potential benefits.
D: adverse effects demonstrated on data from investigational or marketing experience
X: adverse effects demonstrated on animal and human fetuses
Glucocorticoids Correct Answer - background
- produced in adrenal cortex
-cortisol produce to regulate glucose in responce to stress
Exemplar
Prednisone
AE: increase dose causes Cushing's syndrome
Cushing's syndrome: fluid retention, HTN, weight gain, fat redistribution and truncal obesity, moon face, buffalo hump, susceptibility to infection, hyperglycemia, osteoporosis, menstrual irregularities, thin fragile skin, hirsutism