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3040 Test 2
Medication/Documentation/Skin Integrity
| Question | Answer |
|---|---|
| Intradermal (ID) injection (Max mL, Sites, types of testing, needle size, Degree, how to administer) | MAX 0.1mL Sites- forearms, scapula, anterior chest Testing- Tb skin test and allergy testing Needle size- #25-#27 gauge; 1/4 to 5/8 inch 5-15 degrees Spread flat with fingers |
| Subcutaneous (SubQ) injection (Max mL, Sites, types of testing, needle size, Degree, how to administer) | MAX 1mL Sites- abdomen, below scapula, outer aspect of upper arms, anterior aspect of thighs Testing- vaccines, insulin, and heparin Needle size- #25 gauge, 5/8-inch for 45 degrees (ADULT); 3/8-inch for 90 degrees (CHILD) Pinch an inch = 90 degrees |
| Intramuscular (IM) injection (Max mL, Sites, types of testing, needle size, Degree, how to administer) | MAX 1mL (Deltoid); 3mL Sites- ventrogluteal, Vastus lateralis, dorsogluteal, rectus femoris, deltoid Needle size- #23 to #25, 1 inch for deltoid; #20 for more viscous solutions; 2 inches for obese clients; 1 inch for emaciated clients Z-track; Aspirate |
| Who regulates the production, prescription, distribution, and administration of drugs? | Federal drug legislation |
| Generic name (of drug) | given before a drug officially becomes an approved medication; generally used throughout the drug's lifetime |
| Trade name (of drug) | name of drug given by the drug manufacturer; also known as the brand name |
| Who defines limits on the nurse's responsibilities regarding medications? | Nursing practice acts |
| Therapeutic effect | the primary effect effect intended of a drug; reason the drug is prescribed, also known as desired effect |
| Side effect | the secondary effect of a drug that is unintended; usually predictable and may be either harmless or potentially harmful |
| Adverse effect | more severe side effects that may justify the discontinuation of a drug |
| Drug toxicity | the quality of a drug that exerts a deleterious effect on an organism or tissue ex: overdosage, ingestion of drug intended for external use, or cumulative effect |
| Cumulative effect | buildup of the drug in the blood because of impaired metabolism or excretion |
| Drug allergy | an immunologic reaction to a drug |
| Anaphylactic reaction | a severe allergic reaction that usually occurs immediately after the administration of a drug |
| Drug tolerance | a condition in which successive increases in the dosage of a drug are required to maintain a given therapeutic effect |
| Idiosyncratic effect | a different, unexpected, or individual effect from the normal one usually expected from a medication; the occurrence of unpredictable and unexplainable symptoms |
| Drug interactions | the beneficial or harmful interaction of one drug with another drug |
| Potentiating effect | the increased effect of one or more drugs |
| Inhibiting effect | the decreased effect of one or more drugs |
| Additive effect | when two of the same types of drugs increase the actions of each other |
| Synergistic effect | when two different drugs increase the action of one or another drug |
| Onset of action | the time after administration when the body initially responds to the drug |
| Peak plasma level | the highest plasma level achieved by a single dose when the elimination rate of a drug equals the absorption rate |
| Drug half-life | the time required for the elimination process to reduce the concentration of the drug to one-half what it was at initial administration |
| Plateau | a maintained concentration of a drug in the plasma during a series of scheduled doses |
| Medication orders include: | Client’s full name; date and time the order is written; name of the medication; dosage, frequency, and route of administration; and signature of the ordering PCP or nurse |
| Stat order | The medication is to be given immediately and only once |
| Single order | Medication to be given once; also known as one-time order |
| Standing order | An order that may be carried out indefinitely until another order is written to cancel it, or that may be carried out for a specified number of days |
| PRN order | “as needed order”; permits the nurse to give a medication when, in the nurse’s judgment, the client requires it |
| Three important areas for medication reconciliation to occur are? | on admission; during shift reports, transfers, and with new medication administration records; and at discharge |
| Preferred IM site for infant 1 year and younger? | Vastus Lateralis |
| Preferred IM site for clients older than 7 months? | Ventrogluteal |
| percutaneous | through the skin |
| intentional body wounds | trauma occurs during therapy |
| unintentional body wounds | wounds are accidental; i.e. automobile collision |
| pressure ulcers | injury to the skin and/or underlying tissue, usually over a body prominence, as a result of force alone or in combination with movement |
| friction | a force acting parallel to the skin surface |
| shearing force | a combination of friction and pressure |
| skin maceration | tissue softened by prolonged wetting or soaking i.e. moisture from incontinence |
| skin excoriation | area of loss of the superficial layers of the skin; also known as denuded area i.e. from feces, gastric tube drainage, and urea in urine |
| The Braden Scale for Predicting Pressure Sore Risk | sensory perception, moisture, activity, mobility, nutrition, and friction and shear 23 total points; below 18 points is considered at risk |
| Norton's Pressure Area Risk Assessment Form Scale | general physical condition, mental state, activity, mobility, and incontinence, and medications 24 total points; Scores of 15 and 16 are at risk |
| primary intention healing | occurs where the tissue surfaces have been approximated (closed) and there is minimal or no tissue loss; it is characterized by the formation of minimal granulation tissue and scarring i.e. closed surgical incision |
| secondary intention healing | a wond that is extensive and involves considerable tissue loss, and in which the edges cannot or should not be approximated i.e. pressure ulcer |
| tertiary intention | wounds that are left open for 3 to 5 days to allow edema or infection to resolve or exudate to drain and are then closed with sutures, staples, or adhesive skin closures |
| inflammatory phase | initiated immediately after injury and lasts 3 to 6 days. |
| hemostasis | the cessation of bleeding |
| phagocytosis | macrophages engulf microorganisms and cellular debris |
| proliferative phase | extends from day 3 or 4 to about day 21 post injury fibroblasts begin to form collagen; epithelial cells proliferate over connective tissue or dried plasma cells and dead cells form |
| maturation phase | begins on about day 21 and can extend 1 or 2 years after the injury collagen fibers reorganize themselves , the wound is remodeled and contracted, and the scar becomes stronger |
| exudate | fluid and cells that has escaped from blood vessels during the inflammatory process and is deposited in tissue or on tissue surfaces |
| serous | consists of serum (the clear portion of blood) i.e. blister from a burn |
| purulent | presence of pus, which consists of leukocytes, liquefied dead tissue debris, and dead and living bacteria vary in color such as blue, green, or yellow |
| sanguineous | consists of large amounts of red blood cells, indicating damage to capillaries |
| serosanguineous | consisting of clear and blood-tinged drainage; commonly seen in surgical incisions |
| purosanguineous | consisting of blood and pus; often seen in a new wound that is infected |
| suppuration | process of pus formation |
| hemorrhage | massive bleeding |
| hematoma | a localized collection of blood underneath the skin that may appear as reddish blue swelling (bruise) |
| infection | microorganisms colonizing the wound multiply excessively or invade tissues; may cause fever and elevated WBC count |
| dehiscence | the partial or total rupturing of a sutured wound; i.e. an abdominal wound in which the layers below the skin also separate |
| evisceration | protrusion of the internal viscera through an incision |
| RYB color code | protect (cover) red, cleanse yellow, and debride black |
| rebound phenomenon | occurs at the time the maximum therapeutic effect of the hot or cold application is achieved and the opposite effect begins |
| range of motions | the maximum movement that is possible for that joint |
| proprioception | describes awareness of posture, movement, and changes in equilibrium and the knowledge of position, weight, and resistance of objects in relation to the body |
| cerebral cortex | initiates voluntary motor activity; directs arm to pick up coffee; coordinates moves not muscles |
| cerebellum | coordinates the motor activities of movement; blends and coordinates the muscles involved in voluntary movement |
| basal ganglia | maintains posture |
| degrees of head movement | 45 degrees MAX |
| degrees of shoulder movement | 50 degrees (adduction, hyperextension) 180 degrees (abduction, extension, flexion) 360 degrees (circumduction) |
| degrees of elbow | 150 degrees (flexion, extension) 90 degrees (rotation for supination, rotation for pronation) |
| degrees of wrist | 90 degrees (flexion, extension, hyperextension) 0-20 degrees (radial flexion) abduction 30-50 degrees (ulnar flexion) adduction |
| degrees of hand and fingers | 90 degrees (flexion, extension) 30 degrees (hyperextension) 20 degrees (abduction, adduction) |
| degrees of thumb | 90 degrees (flexion, extension) 30 degrees (adduction, abduction) |
| degrees of hip | 90-120 degrees (flexion, extension) 30-50 degrees (hyperextension, abduction) 20-30 degrees (adduction) 360 degrees (circumduction) |
| degrees of knee | 120 degrees (flexion, extension) |
| degrees of ankle | 20 degrees (extension) 45-50 degrees (flexion) 5 degrees (eversion, inversion) |
| degrees of toes | 35-60 degrees (flexion, extension) |
| degrees of trunk | 70-90 degrees (flexion) 20-30 degrees (hyperextension) 35 degrees (lateral flexion) 30-45 degrees (rotation) |
| Parts of body with pivot joint | neck |
| Parts of body with ball-and-socket joint | shoulder, hip |
| Parts of body with hinge joint | elbow, knee, ankle, toes |
| Parts of body with condyloid joint | wrist |
| Parts of body with saddle joint | thumb |
| Parts of body with gliding joint | trunk |
Created by:
landonmc
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