FUNDAMENTALS OF NURSING EVOLVE CHAPTER 34 MEDICATION
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A nurse administering medications has many responsibilities. Among those responsibilities is the knowledge of pharmacokinetics. Which statement best describes pharmacokinetics?
A. The study of how medications enter the body, reach their site of ac -
a. Pharmacokinetics is the study of how medications enter the body, travel to the site of action, metabolize, and exit the body.
b. Distribution refers to the method by which medication, after absorption, is moved within the body.
c. Absorption is the passage of medication molecules into the blood from the site of administration.
d. The degree to which medications bind to serum protein is protein binding. -
A nurse provides a medication to a client. Who has the ultimate responsibility for the medication that is being administered?
A. The client taking the medication
B. The physician, advanced practice nurse, or physician’s assistant prescribi - b. The nurse does not have sole responsibility for medication administration. However, the nurse administering the medication is accountable for knowing which medications are prescribed for the client, therapeutic and nontherapeutic effects, nursing implications, and the level of client's knowledge. The prescriber and the pharmacist also help ensure the right medication gets to the right client.
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The following orders were written by a prescriber (physician, advanced practice nurse, physician ’s assistant). Which order is written correctly?
A. Aspirin 2 tablets prn
B. Zolpidem (Ambien) 5 mg PO hs prn
C. Haloperidol (Haldol) ½ - b. Zolpidem is the only medication order written with the essential components of a drug order—name of medication, dose, route of administration, and frequency
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To better control the client’s blood glucose level, the physician orders a high regular insulin dosage of 20 units of U-500 insulin. The nurse only has a U-100 syringe. How many units will be given?
A. 4
B. 5
C. 10
D. 20 - a. U-500 insulin is 5 times as strong as U-100 insulin. Therefore the amount of U -500 insulin should be divided by 5; 20 units divided by 5 equals 4 units.
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The nurse is administering an intramuscular (IM) injection. The Z-track method is recommended for IM injections because:
A. It allows for repeated injections into the same site.
B. It is easier for the nurse to inject.
C. It minimizes -
c. It minimizes local skin irritation, providing more comfort for the client.
a. Repeated injections in the same muscle can cause severe discomfort and poor absorption.
b. The Z-track method of injection requires practice by the nurse to master a smooth injection process due to an increased number of steps in technique.
d. Aspiration is still required with the Z-track method -
What is the best nursing practice for administrating a controlled substance if part of the medications has to be discarded?
A. The nurse discards the unused portion and documents on the control inventory form.
B. The nurse documents on the m - c. The nurse would sign both records and have a second nurse witness the discarding of the controlled substance and also sign the control inventory form. Agency policy would dictate how the substance would be discarded to avoid environmental concerns.
- When administering medications, it is essential for the nurse to have an understanding of basic arithmetic to calculate doses. The physician has ordered 250 mg of a medication that is available in 1-g amount. The vial reads 2 ml = 1.0 g. What dose would
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b. 0.5 ml = 250 mg of this medication.
Dose ordered
----------------- × Amount on hand = Amount administered
Dose on hand
250 mg 500
--------- × 2 ml = ----- or ½ ml, in decimals 0.5 ml
1000 mg (1g) 1000 -
While the nurse is administering medication, the client says, “This pill looks different then what I usually take.†What is the nurse’s best practice?
A. The client has a history of confusion, so ignore the statement.
B. Leave the medi - c. This is a safety issue and should not be ignored. Leaving the medication at the bedside is an unsafe practice and does not demonstrate the nurse's responsibility. If checking the medication order does not clarify the situation, then check with the pharmacist regarding shapes and colors, etc. Different manufacturers will design "their brand" differently than the "other brand." Checking the client's statement can avoid a potential medication error, and the client appreciates the efforts of the nurse
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The client is a 40-year-old man who weighs 160 pounds and is 5 feet 9 inches tall. The order is for 5 ml of a medication to be given deep IM. What size syringe and needle gauge and length should the nurse use for best practice?
A. 5-ml syringe, 20 - d. A medication dose of 5 ml administered IM is unlikely to absorb properly. Therefore dividing the dose is correct. Dividing the doses equally allows 2.5 ml to be given in two different sites, so the nurse will need two 3 ml syringes. A deep IM injection must pass through subcutaneous tissue and penetrate deep muscle; therefore the needle must be long enough (1½ inch) and the gauge heavy enough (20 to 23 is the best choice).
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Although this site has been a traditional site for IM injections in the past, it is no longer recommended. If used, the risk exists of striking the underlying sciatic nerve or major blood vessel. What is the name of this site?
A. Dorsogluteal
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a. The dorsogluteal is the old not-so-safe traditional site.
b. The ventrogluteal muscle is situated deep and away from major nerves and blood vessels.
c. The vastus lateralis muscle is thick and well developed.
d. The plexor is the middle finger of the dominant hand used during percussion or a percussion hammer to strike the pleximeter and is not related to IM sites