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A comprehensive review of key concepts and procedures related to medication administration, covering topics such as medication rights, safe dosage ranges, tube medication administration, im and subcutaneous injections, insulin types and administration, antidiabetic agents, and injection techniques. It includes detailed instructions, examples, and practical tips for nursing students preparing for the mape101 exam.
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Course Title and Number: MAPE101 Exam Exam Title: MAPE101 Exam Exam Date: Exam 2024- 2025 Instructor: [Insert Instructorās Name] Student Name: [Insert Studentās Name] Student ID: [Insert Student ID]
180 minutes
Read All Instructions Carefully and Answer All the Questions Correctly Good Luck: - 11 expectations as stated in syllabus: 1. Checks physician's orders Identifies and researches unfamiliar drugs Reviews client chart and verbalizes allergies, lab data, any contraindications Uses hand hygiene Demonstrates medication rights (right client, right time, right route, right medica- tion, right dose, right documentation, right reason for giving medication) Checks for expiration date Performs needed calculations Prepares medication as indicated Selects correct supplies for administration Provides pertinent data for medication administration, verbalizes where to find information Uses nursing judgement and critical thinking at all times Oral Meds: things to consider: safe dosage range, expiration date, lab values of patient Tube Medications: Can the med be crushed? start with 30 mL flush Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
Removing medication from a vial: Gather appropriate syringe and needle/blunt cannula Remove metal/plastic cap Scrub stopper top with alcohol and allow to dry Draw air into syringe equal to amount of medication to be withdrawn Place vial on flat surface Pierce center of stopper top with needle Inject air into space above solution, not into solution itself Invert vial Keep tip of needle/blunt cannula below level of fluid Hold vial with one hand while withdrawing medication with the other Keep syringe vertical and at eye level Draw up appropriate amount of medication Tap barrel of syringe to remove air bubbles and move needle tip above solution to reinject air bubbles into vial Return needle tip to solution and ensure ordered dose is withdrawn Change needle if necessary If multidose vial, label with date/time opened and date to be discarded Reconstituting medications: Medication in vial as a powder Diluent must be added to form a solution Follow instructions on vial label regarding amount/type of diluent Draw up appropriate amount of diluent Inject into vial containing powder Agitate gently May take a few minutes to fully dissolve Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
Rapid acting insulins: Insulin aspart (NovoLog) Insulin lispro (Humalog) Insulin glulisine (Apidra) Administer 15 minutes before/immediately after a meal Used in combination with longer acting insulin/insulin infusion pump Onset within 15 minutes Peak 1-2 hours Duration 3-4 hours regular insulin: Novolin R/Humulin R Administer 15- 30 minutes before a meal Onset 30-60 minutes Peak 2-4 hours Duration 5-7 hours long acting insulins: Insulin degludec (Tresiba) Insulin detemir (Levemir) Insulin glargine (Lantus) Degludec: onset within 2 hours; peak 12 hours; duration up to 42 hours Detemir: onset 3-4 hours; peak 3-14 hours; duration 6-24 hours Glargine: onset 3- hours; no peak; duration 24 hours Usually administered at bedtime NPH Insulin: Neutral protamine Hagedorn insulin Intermediate acting Also called isophane insulin Humulin N Novolin N Onset 2-4 hours Peak 4-10 hours Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
Patient/Family Teaching for All Antidiabetic Agents: CBG monitoring Diet/exercise Foot checks S/s of hyper/hypoglycemia Carry a form of sugar Medical ID Adverse affects of IM injections: pain tissue irritation hematoma bone/nerve injury abscess necrosis last three only going to happen if we did something wrong with our injection IM injection needle size: 1" used most often 22- gauge <130 pounds: 5/8" 130-152 pounds: 1" 153-200 pound women/153-260 pound men: 1-1.5" Women >200 pounds/men>260 pounds: 1.5" Less redness/swelling with longer needles IM injection sites: Deltoid Ventrogluteal Anterolateral thigh Dorsogluteal not recommended - may hit ciatic nerve Pediatric IM injection sites: Neonates: 5/8" anterolateral thigh Infants: 1" anterolateral thigh ventrogluteal >7 months Toddlers: 1-1.25" anterolateral thigh/ventrogluteal 5/8- 1" deltoid Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
Children 3-10: 1-1.25" anterolateral thigh/ventrogluteal 5/8-1" deltoid Adolescents: 1-1.5" anterolateral thigh/ventrogluteal 5/8-1" deltoid IM injection Techique: Scrub the hub Inject air into vial equal to dose Air bubbles Use Z-track technique/stretch skin taut Do not place thumb on plunger until ready to administer medication Dart! 90-degree angle To aspirate or not to aspirate? Safe needle disposal IM injection aftercare: Pressure Bandaid Movement Ice Tylenol Adverse reactions - tell pt worsening redness, severe swelling that doesn't get better What is the proper technique for administering enoxaparin?: 2 inches from the umbilicus, don't express the bubble. Never adjust the dose. What is the most appropriate administration site for an infant receiving a vaccine? An adult?: vastus lateralus (outside thigh), deltoid for adults Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
Antidote to Warfarin: Vitamin K Takes 24 hours for any change in clotting time to be seen Vit K makes liver make more clotting factors Warfarin administration: 10-15 mg PO initially 2- mg/day based on PT/INR Lower doses for geriatric patients Takes 3-5 days to develop anticoagulant effects might start warfarin before discharge because they do not interact with heparin, because W won't start working INR = 1.1 or less, on warfarin = 2-3 to be therapeutic International normalized ratio how fast your blood clots - higher = longer, lower = less time, thickness of blood Foods with Vitamin K - Warfarin education: Keep it consistant - just don't change Leafy greens Brussels sprouts Broccoli/cauliflower Cabbage Liver Fish Meat Eggs Anticoagulant medication contraindications: Recent trauma Recent surgery Spinal puncture GI ulcers IUD placement Tuberculosis Indwelling catheters Renal/hepatic disease Anticoagulant adverse effects: Bleeding Rebound thrombo-embolic events with rapid discontinuation of anticoagulants GI disturbances if you stop really fast you may have too much clotting - Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
Thrombolytic contraindications: Recent surgery Active internal bleeding CVA within the last 2 months Aneurysm Obstetrical delivery Organ biopsy Recent major trauma Recent CPR Uncontrolled hypertension Liver disease low molecular weight heparin contraindications (enoxaparin/lovenox): Al- lergy to pork products Heparin therapy drug-drug interactions with medications that affect clot formation: In- creased risk of bleeding with all of the following... NSAIDs Aspirin SSRIs/SNRIs Concurrent use with any other medication that affects clot formation contraindications for medications affecting clot formation: Known bleeding disorder/active bleed History of stroke/TIA Pregnancy/lactation ADVERSE EFFECTS OF MEDICATIONS THAT AFFECT CLOT FORMATION- : Bleeding/bruising Headache Dizziness Weakness GI distress Rash NURSING CONSIDERATIONS FOR MEDICATIONS AFFECTING BLOOD CO- AGULATION: Mark chart of Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
Digoxin nursing implications: Monitor apical pulse for 60 seconds prior to administration Hold digoxin if HR <60 for adults, <70 for children, < for infants Bowel sounds CNS checks Therapeutic digoxin levels between 0.5 - 2 ng/ml Emergency equipment on standby: potassium salts/lidocaine/phenytoin/at- ropine/cardiac monitor NURSING IMPLICATIONS FOR ALL HEART FAILURE MEDICATIONS: Close cardiac assessment Pulse/BP Daily weights Intake/output Capillary refill Baseline ECG Lab tests: CBC/electrolytes/renal/hepatic function tests 3lbs in a day 5lbs in a week PATIENT/FAMILY EDUCATION FOR HEART FAILURE MEDICATIONS: Take at same time each day Do not double dose Daily weights Contraception Home BP/pulse monitoring if they miss a dose, do not double dose daily weights - after they go to the bathroom first thing in the morning, before breakfast and getting dressed keep a journal and write it down for weight and BP and pulse monitoring sites for subcutaneous injections: Outer aspect of upper arm Abdomen Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
Anterior thigh Upper back Upper ventro/dorsogluteal area needle size for subcutaneous injections: 25 - 30 gauge 3/8" - 1" 3/8" and 5/8" needle most common BEFORE ADMINISTERING ANY MEDICATION: Hand hygiene Provide privacy Two identifiers Nine rights Three checks Don gloves BEFORE ANY ADMINISTERING ANY INJECTION: Assess patient for appro- priate needle size Scrub the hub Scrub the skin and let dry Inject air into vial equal to dose subcutaneous injection administration: Pinch skin around injection site, if necessary Hold syringe in dominant hand (uncap needle with nondominant hand) Dart! 45-90 degree angle Release pinched skin, if necessary Slowly inject medication Withdraw needle at same angle Discard needle in sharps bin without recapping subcutaneous injection aftercare: Do not massage site Gentle pressure with gauze if needed Bandaid Document Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
run out of time IV pumps clean bottles draw stuff up IV calculations heparin Mark all cups and syringes with: what med/amount/date or expiration. Peg tube feeding (look up process): 30mL check for patency crush pills independently 10 mL between meds to rinse 30mL after to flush for feeding tube medication make sure you can the pill.: for feeding tube medication make sure you can crush the pill. Will want to see prioritization: Will be at your own table will be using arms, stomachs, etc at your table. Will be a table of mass supplies you will need to go to to assemble all of your supplies for your patient. All supplies will be new Don't listen to other people and think that you are wrong with your med calculations. Multiple people may have the same patient's name but different MAR. Will have 2 patients one will be a kid patient: Watch Safe dose for weight based (especially on your kid patient ) Must educate pt. with each medication: Must educate pt. with each medication Must know needle size, and angle for each injection route: ex. if patient is very thin, may need to use 45* for subcut injection Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
Watch for route especially for vaccinations.: Such as MMR vacs this one is sub-q not IM. Other vaccinations are oral or intradermal. There is an index in the back of the drug guide Student needs to show priority with medication administration.: For exam- ple, if the vitals of the patient show high pain level you may need to go give PNR or scheduled pain medication then go back for the rest of the scheduled medications. Don't forget to follow up with your patient regarding how they tolerated medications.: ex. check BP, ask for pain level 1 hour after administration Areas of priority that you may encounter: ABC Pain acute over chronic Antibiotic Blood sugar Don't give to immunocompromised/: MMR - live Flu vac nasal - live (eggs) yellow fever - live chickenpox (varicella,) smallpox - live Medications containing pork (enoxaparin) to: Pork/ Enoxaparin Muslim Some Jewish Folks anyone allergic to pork lol Egg may be in (if pt has egg allergy do not give):: All flu MMR Rabies yellow fever Heparin labs to look at (normal lab values in back of the book):: ptt aptt Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
Selection, dosage and duration - shorten RxAssessing risk and addressing harm of opioid use What are some contraindications for aspirin?: scheduled surgery within 1 week, pregnancy/lactation, children <18yo, children/teens with influenza or chicken- pox How could you help a client with swallowing issues take a PO med?: pud- ding or applesauce What size needle will you use for IM?: IM = 22- gauge & 1inch for most 22-25 gauge<130 pounds: 5/8" 130-152 pounds: 1" 153-200 pound women/153-260 pound men: 1-1.5" Women >200 pounds/men>260 pounds: 1.5" What size needle will you use for Subcutaneous?: SubCut= 25-30 & -1 inch, but usually 5/8 25-30 gauge How do you mix medications in a single syringe?: Ensure compatibilityIf drugs become cloudy/form precipitate in syringe, discard and prepare separatelyDo not mix more than 2 medicationsDraw medications from multi-dose vials before single dose vialsDraw medications from vials before ampules How do you draw up medications from a vial?: scrub the hub, inject air, multi-dose before single dose What is the most important assessment to have documented correctly for a client prescribed heparin?: Weight is most important Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤
What are some nursing implications for digoxin? Adverse effects of digox- in?: before administering measure apical pulse - hold for <60, <70 for children, <90 for infants. Maximum safe serum level. Adverse effects: HeadacheWeakness/drowsiness, Yellow halo in vision, Arrythmias, Digoxin toxicity What are some diet guidelines for clients taking spironolactone?: avoid foods high in potassium What teaching should you provide for someone receiving diuretics?: main- tain adequate fluid intake, clear path to the bathroom, hi/low potassium diet depend- ing on what diuretic they are on, daily weights, s/s/adverse effects of electrolyte imbalance, importance of compliance What are some nursing implications for glucocorticoids?: Administer daily between 8- amSpace multiple doses evenlyUse lowest dose possible for shortest time possibleTaper dosesIncrease doses if patient is under stressUse alternate day maintenance therapyAvoid live virus vaccinesProtect patients from exposure to infection/invasive procedures When do you administer rapid acting insulin? Regular insulin? Long-act- ing insulin? Intermediate insulin?: Rapid = 15 minutes before or immediately after regular= 15/30 minutes before a meal Long acting = once a day intermediate =Intermediate-acting insulin covers insulin needs for about half the day or overnight. Need Writing š¤Help? We've Got You Covered! ā 100% NO A I or Plagiarism Guaranteedš¤