1. What are the rights to medication administration? The 7 Rights to Medication Administration • Right medication. • Right dose.• Right route. • Right time. • Right client. • Right documentation. • Right education. 2. List the steps for administering medications via gastrointestinal tubes. Assess vital signs, lab work and tube placement. Gather equipment and check rights to medication administration. Crush medications and dissolve in water. Check residual. . Assess for therapeutic and side effects of the medications. What is the difference between a mild allergic reaction and anaphylactic shock? Allergies reaction is an exaggerated reaction by the body’s immune system to any substance Anaphylactic is a life threatening allergic reaction that can causes shock (hypo perfusion) and airway swelling TD Neuroleptics malignant syndrome Sedation Orthostatic hypotension Seizure Family teaching: Advise client that antipsychotic medication does not cause addition Take medication as prescribed and take it on a regular schedule Therapy effect of antipsychotic drug will be noticeable in a few days significant improvement may take 2 to 4 weeks. Make sure that all medications are stored appropriately. List 2 reasons the elderly may be adversely affected by medications. and . Where do you give a subcutaneous injection of Insulin? Subcutaneous injection is given at sites with lot of fat such as (abdomen.3. When a client is on antipsychotic medications what will the nurse monitor? What are the possible complications of antipsychotic medications? What client and family teaching should be done? Monitored ESP and worsening of psychotic disorder Complications of antipsychotic medications Acute dystonia Parkinsonism Akathesia Late EPS.????? 6. thighs) 5. and possibly several months for full effects 4. always assess the need for PRN medications prior to administering. literal upper arms. What is the process for nurses administering a PRN order? For PRN medications. upper hips. What pertinent data should be reviewed before administering medications? Prior to medication administration always check pertinent . Document administration and client’s response to medication. Dispose of any unused medications according to facility/agency policy. Document any side effects that the client may experience when taking the medication(s). Use resources to check on the purpose and actions of pharmacological agents Provide accurate client education about their medication regimen and on any actions and therapeutic effects of medication and pharmacological interactions. Review medication order to determine appropriateness of medication for client (understand why client is taking medication). Implement medication rights. Notify the primary care provider of any actual adverse effects of the clients medications. Withhold any medication dose if the client experiences an adverse effect to the medication. Keep the medication administration record (MAR) up to date and reconcile and maintain regularly.check expiration dates and compatibility with other medications. What should the nurse teach the client regarding taking SSRI medications? Take medications as prescribed Take medication in the morning to minimize sleep disturbances Advise clients to take medications with food to minimize GI disturbance 13. List adverse effects of antidepressants. A child weighs 15 kg. pain rating and allergies. lab results.5 mg in 5ml.25 mg per kilogram. 9. blurred vision. You need to give a 10 kg child Benadryl every 6 hours. thereby increasing the amount of norepinephrine. dry mouth. How many mL do you give to this child per dose? 11. Seizures Weight loss/lack of appetite Headache. restlessness and insomnia. Example :phenelzine(nardil) Isocarboxazid(marplan) Tranylcypromine(parnate) . nausea. The safe dose range for this medication is 5mg/kg/day in divided doses. The dose for DIPHENHYDRAMINE is 1. What are MAO Inhibitors? (Monoamine oxidase inhibitors) Are medication that block MAO-A in the brain. How many mg will you give to this child? The medication provided is 12. What medications are often given when a client is withdrawing from alcohol? Long-acting benzodiazepines and diazepam 12. GI distress.Data such as vital signs. You anticipate the dose to be__________20 Mg 10. photophobia. increase heart rate. tachycardia. urinary hesitancy or retention Orthostatic hypotension Sedations Excessive sweating 14. dopamine and serotonin available for transmission of impulses. constipation. Selegiline (emsam) – transdermal MAOI 15. What do you do prior to giving this medication? Prior to giving medication Check pulse rate and rhythm before administration of digoxin and record. What signs and symptoms are you going to assess for to make sure this client are not experiencing adverse effects of this medication? 17. organic brain disease or during lactation Use with caution with client history of substance abuse. Your client is in heart failure and receiving Digoxin. such as double vision and blurred vision Seizures.5 to 5. She is concerned as she has heard horrible things about these medications. such as the inability to complete routine tasks Visual disturbances. Your client has been prescribed a corticosteroid for SLE. though uncommon .0 and digoxin level What are the signs of Digoxin toxicity that you will watch for? Watches for Sign of digoxin toxicity are: hypokalemia. liver dysfunction and renal failure 18. Notify the provider if heart rate is less than 60 /mm in an adult. You administer his AC breakfast dose of regular insulin at 8:15. You are providing a medication that is known to be hepatotoxic. abnormal behavior or both. respiratory depression. What time do you note that you should return to check on this client for S/S of hypoglycemia? What are the S/S of Hypoglycemia? S/S of Hypoglycemia Confusion. You are providing care to a client with type 1 diabetes. What precautions would you consider prior to giving a Benzodiazepine to a client? Benzodiazepine is a pregnancy risk D Contracted indicated in client: sleep apnea. What side effects do you explain to her so that she is prepared 19. less than 70/mm in children and less than 90 in infant Monitor serum levels of K+ to maintain a level between 3. nausea/vomiting and general weakness What electrolytes are important to monitor while this client is on this medication? Potassium 16. . What is Kayexalate used to treat? How does it work? Any medication that you should not give while using Kayexalate to treat a client? How do you know this medication is having the desired effect? Kayexalate (sodium polystyrene sulfonate) are used to remove dangerously high levels of potassium in the blood (e. What is the expected client response? Respiratory depression will be reverse upon given the Narcan 21. Kayexalate is available as a powder or liquid and is taken by mouth or as a rectal enema. confusion.[3] although there is concern about possible side effects when it is mixed with sorbitol. The physician at the bedside has ordered Narcan to be given. Your client who just returned from the PACU is experiencing respiratory depression from her Morphine dose that she received just prior to leaving the OR. diarrhea. increased thirst and rectal or lower stomach pain Warnin:Monitor yourself for signs of a low potassium level which can include irritability. Don't mix the powder form of kayexalate with orange juice to disguise the taste of this medication because orange juice has high potassium content.g. Risks . since hyperkalemia can cause cardiac arrhythmia and death. They are effective at reducing serum potassium levels. due to digoxin toxicity).Loss of consciousness. though uncommon Heart palpitations Shakiness Anxiety Sweating Hunger Tingling sensation around the mouth 20. upset stomach. severe muscle weakness and irregular heartbeat Kayexalate can also decreased levels of magnesium and calcium in the blood. Side Effects Side effects of Kayexalate include constipation. nausea and vomiting Kayexalate can cause serious side effects including unusual swelling. They also will not dissolve clots that already have formed. What are the effects of Thrombolytic? Effects of Thrombolytic . although they do not actually thin the blood. place a client at risk for absorption and fluid retention Osmotic diuretics can cause dehydration Monitor client: Monitor I&O Sign of dehydration (dry mouth and poor skin turgor) Encourage client to increase fluid intake to 2 to 3 L/day from food and beverage sources 23. These medicines are sometimes called blood thinners. and lung conditions.5 to 2 times the base line (60 to 80 seconds) 24. petechiae. Why would you need to give a client an anticoagulant? What do you explain to them about the medication? What do you monitor? Description Anticoagulants decrease the clotting ability of the blood and therefore help to prevent harmful clots from forming in the blood vessels. Laxative with magnesium can also lead to accumulation of toxic levels of magnesium. but they may prevent the clots from becoming larger and causing more serious problems. Your physician will discuss the risks and benefits of taking this medication.Kayexalate contains sodium which can worsen certain conditions such heart failure. black terry stools Clients should avoid aspirin Monitor activated partial thromboplastic time. hematomas. bruising. keep value at 1. Explain the complications of giving a laxative and what you monitor the client for once you administer these meds. Laxatives with sodium salt such as sodium phosphate. 22. high blood pressure and fluid retention. Complications of laxative are: GI irritation rectal burning sensation leading to proclitic. decrease blood pressure. They are often used as treatment for certain blood vessel. Advise client to report any sign or bleeding and to observe and report any sign of bleeding such as increase heart rate. heart. doctors insert a longer catheter into the blood vessel and guide it near the blood clot to deliver medications directly to the clot. improve blood flow. pelvic area. Dialysis catheters. pieces of the clot can break off and travel to an artery in the lungs. More often. Bypass grafts.Thrombolysis. is a treatment to dissolve dangerous clots in blood vessels.ideally within one to two hours -. Types of Thrombolysis The most commonly used clot-busting drugs -.after the onset of symptoms of a heart attack. . and prevent damage to tissues and organs. If a blood clot is determined to be life-threatening. resulting in an acute pulmonary embolism.also known as thrombolytic agents -. stroke. the main cause of heart attacks and ischemic strokes. If left untreated. Thrombolysis may involve the injection of clot-busting drugs through an intravenous (IV) line or through a long catheter that delivers drugs directly to the site of the blockage. Thrombolysis is also used to treat blood clots in: Veins that cause deep vein thrombosis (DVT) or clots in the legs. and in the arteries of the lungs (acute pulmonary embolism). a doctor may choose to inject clot-busting drugs into the access site through a catheter. Kinlytic (rokinase) Depending on the circumstances. or pulmonary embolism (once a diagnosis has been made). It also may involve the use of a long catheter with a mechanical device attached to the tip that either removes the clot or physically breaks it up. thrombolysis may be an option if initiated as soon as possible -. kabikinase) t-PA (class of drugs that includes Activase) TNKase (tenecteplase) Abbokinase.include: Eminase (anistreplase) Retavase (reteplase) Streptase (streptokinase. also known as thrombolytic therapy. Thrombolysis is often used as an emergency treatment to dissolve blood clots that form in arteries feeding the heart and brain. however. and upper extremities. herbs. Why do you administer an antitussive? What kind of clients would you question giving this medication to and why? Antitussive is administered to help suppress cough 26. If the clot is relatively small. Which diuretic is best for you depend on your health and the condition being treated. or dietary supplements or for people with certain conditions associated with an increased risk of bleeding. Each works by affecting a different part of your kidneys. the process may take several hours. side effects and precautions. Examples of thiazide diuretics include: Chlorothiazide Hydrochlorothiazide (Microzide) Indapamide . or ultrasound device is used to physically break up the clot. a long catheter tipped with a tiny suction cup. These conditions include: Severe high blood pressure Active bleeding or severe blood loss Hemorrhagic stroke from bleeding in the brain Severe kidney disease Recent surgery 25. During this procedure. doctors use radiologic imaging to see if the blood clot is dissolving. Doctors also may opt for another type of thrombolysis called mechanical thrombectomy.During both types of thrombolysis. high-speed fluid jet. Risks of Thrombolysis Although thrombolysis can safely and effectively improve blood flow and relieve or eliminate symptoms in many patients without the need for more invasive surgery. and each may have different uses. But treatment for a severe blockage may be necessary for several days. What is the difference between a loop diuretic and a Thiazide diuretic? What are the side effects? There are three types of diuretics: thiazide. loop and potassium-sparing. Thrombolysis may not be recommended for patients who use blood-thinning medication. it's not recommended for everyone. rotating device. but do have some side effects. For most people. this side effect improves within a few weeks of taking a diuretic. This occurs most frequently in people taking loop diuretics. The high efficacy of loop diuretics is due to the unique site of action involving the loop of Henle (a portion of the renal tubule) in the kidneys. or too little potassium in their blood (hypokalemia) if they take a thiazide diuretic. They do this by inhibiting the reabsorption of sodium and chloride in the distal convoluted tubules in the kidneys Side effects and cautions Diuretics are generally safe.Metolazone (Zaroxolyn) Examples of loop diuretics include: Bumetanide Ethacrynic acid (Edecrin) Furosemide (Lasix) Torsemide (Demadex) Examples of potassium-sparing diuretics include: Amiloride Eplerenone (Inspra) Spironolactone (Aldactone) Triamterene (Dyrenium Loop diuretic is the most potent diuretics as they increase the elimination of sodium and chloride by primarily preventing reabsorption of sodium and chloride. People who take diuretics may also have too much potassium in their blood (hyperkalemia) if they take a potassium-sparing diuretic. Thiazide diuretics increase the elimination of sodium and chloride in approximately equivalent amounts. The most common side effect of diuretics is increased urination. Other side effects of diuretics may include: . Low sodium in your blood (hyponatremia) Dizziness Headaches Increased thirst Muscle cramps Increased blood sugar Increased cholesterol Rash Joint disorders (gout) Impotence Menstrual irregularities Breast enlargement in men (gynecomastia) 27. what diet interventions do you explain to the client? Client should be advise to increase the intake of high fiber food and oral fluid if not restricted . When administering a bile-acid sequestrant.