1. What are the rights to medication administration? The 7 Rights to Medication Administration Right medication. Right dose.

e. 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 bodys immune system to any substance Anaphylactic is a life threatening allergic reaction that can causes shock (hypo perfusion) and airway swelling

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, 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, and possibly several months for full effects

4. Where do you give a subcutaneous injection of Insulin? Subcutaneous injection is given at sites with lot of fat such as (abdomen, upper hips, literal upper arms, thighs) 5. List 2 reasons the elderly may be adversely affected by medications.????? 6. What is the process for nurses administering a PRN order? For PRN medications, always assess the need for PRN medications prior to administering. Make sure that all medications are stored appropriately, and

check expiration dates and compatibility with other medications. Implement medication rights. Review medication order to determine appropriateness of medication for client (understand why client is taking medication). Keep the medication administration record (MAR) up to date and reconcile and maintain regularly. 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. Document administration and clients response to medication. 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. Document any side effects that the client may experience when taking the medication(s). Dispose of any unused medications according to facility/agency policy. What pertinent data should be reviewed before administering medications? Prior to medication administration always check pertinent

Data such as vital signs, lab results, pain rating and allergies. 9. You need to give a 10 kg child Benadryl every 6 hours. The safe dose range for this medication is 5mg/kg/day in divided doses. You anticipate the dose to be__________20 Mg 10. The dose for DIPHENHYDRAMINE is 1.25 mg per kilogram. A child weighs 15 kg. How many mg will you give to this child? The medication provided is 12.5 mg in 5ml. How many mL do you give to this child per dose? 11. What medications are often given when a client is withdrawing from alcohol? Long-acting benzodiazepines and diazepam 12. 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. Seizures Weight loss/lack of appetite Headache, dry mouth, GI distress, constipation, increase heart rate, nausea, restlessness and insomnia, blurred vision, photophobia, tachycardia, urinary hesitancy or retention Orthostatic hypotension Sedations Excessive sweating 14. What are MAO Inhibitors? (Monoamine oxidase inhibitors) Are medication that block MAO-A in the brain, thereby increasing the amount of norepinephrine, dopamine and serotonin available for transmission of impulses. Example :phenelzine(nardil) Isocarboxazid(marplan) Tranylcypromine(parnate)

Selegiline (emsam) transdermal MAOI 15. Your client is in heart failure and receiving Digoxin. What do you do prior to giving this medication? Prior to giving medication Check pulse rate and rhythm before administration of digoxin and record. Notify the provider if heart rate is less than 60 /mm in an adult, less than 70/mm in children and less than 90 in infant Monitor serum levels of K+ to maintain a level between 3.5 to 5.0 and digoxin level What are the signs of Digoxin toxicity that you will watch for? Watches for Sign of digoxin toxicity are: hypokalemia, nausea/vomiting and general weakness What electrolytes are important to monitor while this client is on this medication? Potassium 16. You are providing a medication that is known to be hepatotoxic. What signs and symptoms are you going to assess for to make sure this client are not experiencing adverse effects of this medication? 17. 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, respiratory depression, organic brain disease or during lactation Use with caution with client history of substance abuse, liver dysfunction and renal failure 18. Your client has been prescribed a corticosteroid for SLE. She is concerned as she has heard horrible things about these medications. What side effects do you explain to her so that she is prepared 19. You are providing care to a client with type 1 diabetes. You administer his AC breakfast dose of regular insulin at 8:15. 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, abnormal behavior or both, such as the inability to complete routine tasks Visual disturbances, such as double vision and blurred vision Seizures, though uncommon

Loss of consciousness, though uncommon Heart palpitations Shakiness Anxiety Sweating Hunger Tingling sensation around the mouth 20. 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. The physician at the bedside has ordered Narcan to be given. What is the expected client response? Respiratory depression will be reverse upon given the Narcan 21. 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.g., due to digoxin toxicity), since hyperkalemia can cause cardiac arrhythmia and death. They are effective at reducing serum potassium levels,[3] although there is concern about possible side effects when it is mixed with sorbitol. Kayexalate is available as a powder or liquid and is taken by mouth or as a rectal enema. 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. Side Effects Side effects of Kayexalate include constipation, diarrhea, upset stomach, nausea and vomiting Kayexalate can cause serious side effects including unusual swelling, increased thirst and rectal or lower stomach pain Warnin:Monitor yourself for signs of a low potassium level which can include irritability, confusion, severe muscle weakness and irregular heartbeat Kayexalate can also decreased levels of magnesium and calcium in the blood. Risks

Kayexalate contains sodium which can worsen certain conditions such heart failure, high blood pressure and fluid retention. Your physician will discuss the risks and benefits of taking this medication. 22. Explain the complications of giving a laxative and what you monitor the client for once you administer these meds. Complications of laxative are: GI irritation rectal burning sensation leading to proclitic, Laxative with magnesium can also lead to accumulation of toxic levels of magnesium. Laxatives with sodium salt such as sodium phosphate, 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. 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. These medicines are sometimes called blood thinners, although they do not actually thin the blood. They also will not dissolve clots that already have formed, but they may prevent the clots from becoming larger and causing more serious problems. They are often used as treatment for certain blood vessel, heart, and lung conditions. Advise client to report any sign or bleeding and to observe and report any sign of bleeding such as increase heart rate, decrease blood pressure, bruising, petechiae, hematomas, black terry stools Clients should avoid aspirin Monitor activated partial thromboplastic time, keep value at 1.5 to 2 times the base line (60 to 80 seconds) 24. What are the effects of Thrombolytic? Effects of Thrombolytic

Thrombolysis, also known as thrombolytic therapy, is a treatment to dissolve dangerous clots in blood vessels, improve blood flow, and prevent damage to tissues and organs. 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. 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 is often used as an emergency treatment to dissolve blood clots that form in arteries feeding the heart and brain, the main cause of heart attacks and ischemic strokes, and in the arteries of the lungs (acute pulmonary embolism). Thrombolysis is also used to treat blood clots in: Veins that cause deep vein thrombosis (DVT) or clots in the legs, pelvic area, and upper extremities. If left untreated, pieces of the clot can break off and travel to an artery in the lungs, resulting in an acute pulmonary embolism. Bypass grafts. Dialysis catheters. If a blood clot is determined to be life-threatening, thrombolysis may be an option if initiated as soon as possible -- ideally within one to two hours -- after the onset of symptoms of a heart attack, stroke, or pulmonary embolism (once a diagnosis has been made). Types of Thrombolysis The most commonly used clot-busting drugs -- also known as thrombolytic agents -- include: Eminase (anistreplase) Retavase (reteplase) Streptase (streptokinase, kabikinase) t-PA (class of drugs that includes Activase) TNKase (tenecteplase) Abbokinase, Kinlytic (rokinase) Depending on the circumstances, a doctor may choose to inject clot-busting drugs into the access site through a catheter. More often, however, doctors insert a longer catheter into the blood vessel and guide it near the blood clot to deliver medications directly to the clot.

During both types of thrombolysis, doctors use radiologic imaging to see if the blood clot is dissolving. If the clot is relatively small, the process may take several hours. But treatment for a severe blockage may be necessary for several days. Doctors also may opt for another type of thrombolysis called mechanical thrombectomy. During this procedure, a long catheter tipped with a tiny suction cup, rotating device, high-speed fluid jet, or ultrasound device is used to physically break up the clot. 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, it's not recommended for everyone. Thrombolysis may not be recommended for patients who use blood-thinning medication, herbs, or dietary supplements or for people with certain conditions associated with an increased risk of bleeding. 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. 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. 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. Each works by affecting a different part of your kidneys, and each may have different uses, side effects and precautions. Which diuretic is best for you depend on your health and the condition being treated. Examples of thiazide diuretics include: Chlorothiazide Hydrochlorothiazide (Microzide) Indapamide

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. 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. Thiazide diuretics increase the elimination of sodium and chloride in approximately equivalent amounts. 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, but do have some side effects. The most common side effect of diuretics is increased urination. This occurs most frequently in people taking loop diuretics. For most people, this side effect improves within a few weeks of taking a diuretic. People who take diuretics may also have too much potassium in their blood (hyperkalemia) if they take a potassium-sparing diuretic, or too little potassium in their blood (hypokalemia) if they take a thiazide diuretic. 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. When administering a bile-acid sequestrant, 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