Indiana QMA: Lesson 36-50 Graded A

Indiana QMA: Lesson 36-50 Graded A most frequently used route of administration oral because of simplicity and convenience scored tablets may be split or crushed (unless contraindicated) when meds are consumed BEFOR ...

Indiana QMA: Lesson 36-50 Graded A most frequently used route of administration oral because of simplicity and convenience scored tablets may be split or crushed (unless contraindicated) when meds are consumed BEFORE a meal meds are absorbed more quickly BUT may irritate the stomach when meds are consumed AFTER a meal meds may be less irritating to the GI tract BUT will be absorbed more slowly oral meds are contraindicated in which situations? the resident is unconscious, uncooperative, or unable to swallow due to a medical condition when are the THREE checks performed 1. read the label when removing from med cart 2. verify with the MAR when selecting the medication 3. read label/verify with MAR once more before administering which are absorbed more readily - liquid or tablets/capsules? liquid meds are absorbed more quickly what can be used to measure liquid meds other than a med cup? an oral syringe the correct way to measure liquid meds hold med cup at eye level or place med cup on a level surface powdered meds that have been reconstituted (mixed with a liquid) should be administered ... immediately after mixing what should the QMA do if crushing a med or altering a capsule is contraindicated? the QMA must notify the nurse; the nurse should contact the physician to obtain the med in an alternate form meds which are NOT to be crushed sublingual, enteric-coated, time-released, multi-layer sublingual meds dissolved under tongue, readily absorbed don't swallow or drink fluid until dissolved do not crush enteric-coated meds drug is covered by a material that allows or dissolution in the intestines rather than the stomach; do not crush timed-release meds released over an extended period of time reduces stomach irritation, do not crush multi-layer meds outside layer dissolves rapidly, remaining layers dissolve slower do not crush can time-released capsules be altered? capsules can be opened and administered in food so long as the beads are not crushed or chewed how many categories of scheduled drugs are there? five categories drug diversion - the transfer of a drug from the person for whom it was prescribed to another individual - is a crime under Indiana law - can result in loss of license/certification as well as incarceration when should scheduled medications be counted beginning and end of each shift; or when keys change hands who can count scheduled meds? 2 nurses or 1 nurse and 1 QMA not 2 QMAs if there is a discrepancy in scheduled count, what should the QMA do? notify the nurse immediately (after double checking count) transdermal patches A dosage form that is applied to the skin and releases the drug over a period of time -sites need to be rotated -new patches must be labeled with the date/time/site/initials -should be monitored frequently -dispose according to facility policy canthus either corner where the upper and lower eyelids meet saline a mixture of sodium/salt and water eye medications -SOME are stored in refrigerator (must be room temp to administer) -once opened, should be used in 1 month -if two or more types of drops are ordered, wait 5 minutes in between asepsis Absence of pathogens/clean eye drops/ointments should be placed place in the pouch formed by gently pulling down on the lower lid what temperature should ear drops be prior to administration room temperature - for comfort and decreased chance of side effects How do you straighten the ear canal in an adult? Pulling the ear lobe up and backward nares nostrils nasal septum a wall of cartilage that divides the nose into two cavities what should you ask the resident to do prior to administering nasal drops or sprays? gently blow nose into tissue when is the best time to administer a vaginal suppository/cream? bedtime position for vaginal suppository/cream dorsal recumbent rectal suppositories may be used for treating what conditions? constipation, N/V, pain, fever, hemorrhoids absorption of medications from rectal suppositories is ... unpredictable and may produce higher levels of the med in the bloodstream position for rectal suppository Sim's objective observations things that can be seen, heard, smelled, and touched subjective observations things reported by someone else - resident, family, etc. routine reporting done at the end of the shift immediate reporting must occur at the time a significant observation is made if it wasn't documented ... IT WASN'T DONE!