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Chapter 11
Paramedic: Medication Administration
278
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10/06/2012

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Term
Form of off-line or indirect medical control where you perform certain predefined procedures before contacting the physician.
Definition
Standing Orders 469
Term
Some EMS system medical directors may not allow paramedics to perform certain procedures (administering certain narcotics) before making contact with him or her.
Definition
Online (Direct) Medical Control 469
Term
How many times should you read the drug label before administering any drug?
Definition
3 Times 470
Term
The practice of preventing contamination of the patient by using aseptic technique.
Definition
Medical Asepsis 471
Term
A method of cleansing used to prevent contamination of a site when you are performing an invasive procedure, such as starting an IV line.
Definition
Aseptic Technique 471
Term
What refers to the destruction of all living organisms and is achieved by using heat, gas, or chemicals.
Definition
Sterile 471
Term
What is the site called on a patient's hand that has been cleaned with iodine and alcohol before staring an IV line?
Definition
Medically Clean 471
Term
_____ may be accomplished through the use of sterilization of equipment, antiseptics, or disinfectants.
Definition
Medical Asepsis 471
Term
Used to cleanse an are before performing an invasive procedure such as IV therapy or medication administration.
Definition
Antiseptics 472
Term
What are the 3 most common antiseptics you will use in the field?
Definition
Isopropyl Alcohol (Rubbing Alcohol), Iodine, and 2% Chlorhexdine Gluconate (ChloraPrep) 472
Term
What is capable of destroying pathogens, but are not toxic to living tissues?
Definition
Antiseptics 472
Term
Toxic to living tissue and should never be used on a patient.
Definition
Disinfectants 472
Term
What cleaning product should be used on nonliving objects such as the inside of the ambulance, laryngoscope blades, and other nondisposable equipment.
Definition
Disinfectants 472
Term
The first rule is to treat any body fluid as being potentially infectious.
Definition
Standard Precautions 472
Term
What is the most effective way to prevent the spread of disease according to the CDC?
Definition
Hand Washing 472
Term
What is any contaminated item that can cause injury?
Definition
Sharps 472
Term
What can only exist in a special balanced environment?
Definition
Human Cell 472
Term
What is the cell membrane?
Definition
Phospholipid Bilayer 472
Term
The ability to selectively allow certain compounds into the cell based on the cell's current needs.
Definition
Selective Permeability 473
Term
Constitutes 60% of teh weight of an adult.
Definition
Total Body Water (TBW) 473
Term
What serves as a transport medium for nutrients, hormones, and waste materials?
Definition
Water 473
Term
____ is composed mostly of water, provides the environment where the chemical reactions necessary for life take place.
Definition
Human Body 473
Term
Normally accounts for 45% of body weight.
Definition
Intracellular Fluid 473
Term
Accounts for 15% of body weight.
Definition
Extracellular Fluid 473
Term
What are the two types of fluid that extracellular fluid is divided into?
Definition
Interstitial Fluid ad Intravascular Fluid 473
Term
Accounts for about 10.5% of body weight.
Definition
Interstitial Fluid 473
Term
What are special fluid collections of interstitial fluid?
Definition
CSF and Intraocular Fluid 473
Term
Normally accounts for 4.5% of body weight.
Definition
Intravascular Fluid (Plasma) 473
Term
What is the water that is bathing the cells?
Definition
Interstitial Fluid 473
Term
What is the water within the blood vessels, carries red blood cells, white blood cells, and vital nutrients?
Definition
Intravascular Fluid 473
Term
The fluids in the body are composed of dissolved elements and water, a combination known as?
Definition
Solution 473
Term
The fluid that does the dissolving, or the solution that contains the dissolved components.
Definition
Solvent 473
Term
The dissolved particles contained in the solvent.
Definition
Solute 473
Term
What is the universal solvent in the body?
Definition
Water 473
Term
Two or more atoms that bond together form what?
Definition
Molecule 473
Term
Contain carbon atoms.
Definition
Organic Molecules 473
Term
Charged atoms or compounds that result from the loss or gain of an electron. These are ions that the body uses to perform cerain critical metabolic functions.
Definition
Electrolytes 473
Term
Charged atoms or compounds that results from the loss or gain of an electron.
Definition
Ions 473
Term
Pertaining to the breakdown of ingested foodstuffs into smaller and smaller molecules and atoms that are used as energy sources for cellular function.
Definition
Metabolic 473
Term
Electrolytes with a positive charge.
Definition
Cations 473
Term
Electrolytes with a negative charge.
Definition
Anions 473
Term
The unit of measurement for electrolytes and it represents the chemical combining power of the ion and is based on the number of available ionic charges in an electrolyte solution.
Definition
Milliequivalent (mEq) 473
Term
An ion that contains one charge.
Definition
Monovalent 473
Term
An ion that contains two charges.
Definition
Bivalent 473
Term
____ is the principal extracellular cation needed to regulate the distribution of water throughout the body in the intravascular and interstitial fluid compartments.
Definition
Sodium 473
Term
How much of the body's potassium is found inside the cells of the body?
Definition
About 98% 474
Term
What is the principal intracellular cation?
Definition
Potassium 474
Term
What plays a major role in neuromuscular function and in the conversion of glucose into glycogen?
Definition
Potassium 474
Term
The mechanism by which the cell brings in 2 potassium ions and releases 3 sodium ions.
Definition
Sodium-Potassium Pump 474
Term
What helps the sodium-potassium pump?
Definition
Insulin and Epinephrine 474
Term
Leads to decreased skeletal muscle funtion, GI disturbances, and alterations in cardiac function.
Definition
Hypokalemia 474
Term
Can lead to hyperstimulation of neural cell transmission, resulting in cardiac arrest.
Definition
Hyperkalemia 474
Term
What is the principal cation needed for bone growth?
Definition
Calcium 474
Term
It plays an important part in the functioning of heart muscle, nerves, and cell membranes and is necessary for proper blood clotting.
Definition
Calcium 474
Term
What can lead to overstimulation of nerve cells?
Definition
Hypocalcemia 474
Term
Skeletal muscle cramps, abdominal cramps, carpopedal spasms, hypotension, and vasoconstriction are signs and symptoms of what?
Definition
Hypocalcemia 474
Term
Hand or foot spasms; usually the result hyperventilation or hypocalcemia.
Definition
Carpopedal Spasms 474
Term
What can lead to decreased stimulation of nerve cells?
Definition
Hypercalcemia 474
Term
Skeletal muscle weakness, lethargy, ataxia, vasodilation, and hot, flushed skin are signs and symptoms of what?
Definition
Hypercalcemia 474
Term
A staggered walk or gait.
Definition
Ataxia 474
Term
____ has important role as a coenzyme in the metabolism of proteins and carbohydrates.
Definition
Magnesium 474
Term
Acts in a manner similar to calcium in controlling neromuscular irritability.
Definition
Magnesium 474
Term
What is the primary buffer used in all circulating body fluids?
Definition
Bicarbonate 474
Term
What are a determining factor between metabolic acidosis and alkalosis?
Definition
Bicarbonate Levels 474
Term
What regulates the pH of the stomach?
Definition
Chloride 474
Term
What regulates the extracellular fluid levels?
Definition
Chloride 474
Term
What is an important component in adenosine triphosphate (ATP), the body's powerful energy source?
Definition
Phosphorus 474
Term
What are solutes the have no electrical charge?
Definition
Nonelectrolytes 474
Term
What are 2 nonelectrolytes?
Definition
Glucose and Urea 474
Term
What is the normal concentration of glucose in the blood?
Definition
70-110 mg per 100 mL 474
Term
What is created when concentrations of charges or compounds are greater on one side of the cell membrane than on the other side?
Definition
Gradient 474
Term
The natural tendency for materials is to flow from an area of higher concetration to one of lower concentration, establishes a _______.
Definition
Concentration Gradient 474
Term
When compounds or charges concentrated on one side of a cell membrane move across it to an area of lower concentration.
Definition
Diffusion 474
Term
What is another type of diffusion that is commonly used by the kidneys to clean blood?
Definition
Filtration 475
Term
A hormone produced by the pituitary gland that signals the kidneys to prevent excretion of water.
Definition
Antidiuretic Hormone (ADH) 475
Term
A method used to move compounds to create or maintain an imbalance of charges and must use energy in the form of ATP.
Definition
Active Transport 475
Term
The rapid movement of electrolytes across a cell membrane that changes the cell's overall charge.
Definition
Depolarization 475
Term
This rapid shifting of electrolytes and cellular charges is the main catalyst for muscle contraction and neural transmissions.
Definition
Depolarization 475
Term
What kind of movement is the sodium-potassium pump?
Definition
Active Transport 475
Term
The movement of water across a membrane and occurs when there are different concentrations on each side of a membrane, and equal numbers of molecules on either side are displaced to the other side.
Definition
Osmosis 475
Term
Water moves from the solution of lower solute concentration to the solution of higher solute concentration.
Definition
Osmosis 475
Term
The osmotic pressure of a solution, based on the relationship between sodium and water inside and outside the cell, that takes advantage of their chemical and osmotic properties to move water to areas of higher sodium concentration.
Definition
Tonicity 475-476
Term
The balance of all body systems of the body.
Definition
Homeostatsis 476
Term
How much fluid does a healthy person lose daily through urine output, the lungs (exhalation), and through the skin?
Definition
2-2.5 L 476
Term
What is the cardinal sign of overhydration?
Definition
Edema 476
Term
What is defined as inadequate total systemic fluid volume?
Definition
Dehydration 476
Term
Decreased level of consciousness, postural hypotension, tachypnea, dry mucous membrane, decreased urine output, tachycardia, poor skin turgor, and flused, dry skin are signs and symptoms of what?
Definition
Dehydration 476
Term
Diarrhea, vomiting, GI drainage, infections, metabolic disorders such as diabetic ketoacidosis, hemorrhage, environmental emergencies, high caffine diet, and insufficient fluid intake can cause what?
Definition
Dehydration 476
Term
When the body's total systemic fluid volume increases.
Definition
Overhydration 476
Term
Fluid is lost from the vascular compartment, the body reacts by shifting interstitial fluid into the vascular area; fluid also shifts from the intracellular to the extracellular compartments.
Definition
Dehydration 476
Term
Fluid fills the vascular compartments, filters into the interstitial compartments, and is forced from the engorged interstitial compartment into the intracellular compartment.
Definition
Overhydration 476
Term
Shortness of breath, puffy eyelids, edema, polyuria, moist crackles (rales), and acute weight gain are signs and symptoms of what?
Definition
Overhydration 476
Term
Unmonitored IVs (in pediatrics), kidney failure, water intoxication in endurance sports, and prolonged hypoventilation can cause what?
Definition
Overhydration 476
Term
What are the 2 IV categories?
Definition
Crystalloid or Colloid 477
Term
Dissolved crystals (salts or sugars) in water.
Definition
Crystalloid Solutions 477
Term
What is the 3-to-1 replacement rule?
Definition
3 mL of isotonic crystalloid solution is needed to replace 1 mL of a patients blood. 477
Term
What is the body's internal blood-clotting mechanism?
Definition
Hemostasis 477
Term
Contain molecules (usually proteins) that are too large to pass out of the capillary membranes and, therefore, remain in the vascular compartment.
Definition
Colloid Solutions 477
Term
What are the 3 categories related to tonicity?
Definition
Isotonic, Hypotonic, and Hypertonic 478
Term
What kind of IV soluiton is 0.9% sodium chloride (normal saline) and LR?
Definition
Isotonic 478
Term
What kind of IV solution is 5% dextrose in water (D5W)?
Definition
Hypotonic 478
Term
What kind of IV solution is 9.0% saline, blood products, and albumin?
Definition
Hypertonic 478
Term
What are the effects of osmotic pressure on a cell?
Definition
Tonicity 478
Term
____ is the concentration of sodium in a solution and the movement of water in relation to the sodium levels inside and outside the cells.
Definition
Tonicity 478
Term
Has the same concentration of sodium as does the cell.
Definition
Isotonic 478
Term
Has a greater concentration of sodium then does the cell.
Definition
Hypertonic 478
Term
Has a lower concentration of sodium than does the cell.
Definition
Hypotonic 478
Term
The ability to influence the movement of water across a semipermeable membrane.
Definition
Osmolarity 478
Term
What is 0.9% sodium chloride?
Definition
Normal Saline 478
Term
What type of patient's are at greater risk for fluid overloading?
Definition
Hypertension and CHF 478
Term
What can increase preload and in turn increase the workload of the heart, causing fluid to back in the lungs?
Definition
Fluid Overload 478
Term
____ is contraindicated for nitro, nitroprusside, norepinephrine, propranolol, and methylprednisone infusions.
Definition
Lactated Ringers (LR) Solution 478
Term
What is usually administered when you are preparing medication infusions such as dopamine (Intropin) or amiodarone (Cordorone).
Definition
D5W 478
Term
The shifting of fluid into the tissues, creating edema.
Definition
Third Spacing 479
Term
The amount of charged particles found in a particular area.
Definition
Ionic Concentration 479
Term
What is the best fluid to replace blood?
Definition
Whole Blood 479
Term
What does intravenous mean?
Definition
Within a vein 479
Term
What is the most important point to remember about IV therapy?
Definition
Keep IV equipment sterile 479
Term
Cannulation of a vein with an IV catheter to access the patient's vascular system.
Definition
Intravenous IV Fluid 479
Term
The insertion of a catheter, such as into a vein to allow for fluid flow.
Definition
Cannulation 479
Term
Cannulating veins of the periphery, that is, those that can be seen and/or palpated.
Definition
Peripheral Vein Cannulation 479
Term
In the prehospital setting, the choice of IV solution is usually limited to two isotonic crystalloids, ___ and ___.
Definition
Normal Saline and LR 479
Term
Intravenous solutions that do not cause a fluid shift into or out of the cell.
Definition
Isotonic Crystalloids 479
Term
What are the two ports that an IV bag has?
Definition
Injection port for medication and Access port for administration set 479
Term
When does the IV bag have to be used after it has been removed from its sterile packing?
Definition
Within 24 hours 479
Term
A sealed hub on an administration set designed for sterile access to the IV fluid.
Definition
Access Port 479
Term
What are the fluid volumes commonly used in hospitals?
Definition
1000 mL, 500 mL, 250 mL, 100 mL, and 50 mL 480
Term
What are the fluid volumes commonly used in the prehospital setting?
Definition
1000 mL and 500 mL 480
Term
Moves the fluid from the IV bag into the patient's vascular system.
Definition
Administration Set 480
Term
The hard, sharpened plastic spike on the end of the administration set designed to pierce the sterile membrane of the IV bag.
Definition
Piercing Spike 480
Term
What are the two primary sizes for administration sets?
Definition
Macro and microdrip 480
Term
A unit of measure that indicates drops.
Definition
ggt 480
Term
The area of the administration set where fluid accumulates so that the tubing remains filled with fluid.
Definition
Drip Chamber 480
Term
Allows 60 ggt per mL through a neddlelike orifice inside the drip chamber.
Definition
Microdrip Set 480
Term
Allows 10 or 15 ggt/mL through a large opening between the piercing spike and the drip chamber.
Definition
Macrodrip Set 480
Term
A macrodrip administration set that is designed to facilitate rapid replacement by manual infusion of multiple IV bags or IV and blood replacement combinations.
Definition
Blood Tubing 482
Term
A special type of microdrip set that features a 100- or 200-mL calibrated drip chamber; used for fluid regulation in patients prone to circulatory overload, such as pediatric and elderly patients.
Definition
Volutrol or Buretrol 482
Term
___ can be recognized as small bumps located in the vein.
Definition
Valves 482
Term
___ are points where one vein may split into two.
Definition
Bifurcations 482
Term
What areas should you avoid when choosing an IV site?
Definition
Valves and Bifurcations 482
Term
The development of a stationary blood clot in the venous circulation.
Definition
Venous Thrombosis 483
Term
A blood clot or foreign matter trapped within the pulmonary circulation.
Definition
Pulmonary Embolism 483
Term
What are the 2 most common catheters used in the prehospital setting?
Definition
Over-the-needle and Butterfly 483
Term
A Teflon catheter inserted over a hollow needle.
Definition
Over-the-needle Catheter 483
Term
A hollow, stainless steel needle wit two plastic wings to facilitate its handling.
Definition
Butterfly Catheter 483
Term
Plastic catheters inserted through a hollow needle and are rarely used in the prehospital setting.
Definition
Through-the-needle (Intracaths) Catheters 483
Term
The internal diameter of an IV catheter or needle.
Definition
Gauge 483
Term
What are the most common lengths of over-the-needle catheters?
Definition
1 1/4" and 2 1/4" 483
Term
When a paramedic punctures his or her skin with the same catheter that was used to cannulate the vein of a patient.
Definition
Contaminated Stick 484
Term
A type of surgical drain often used as a constricting band.
Definition
Penrose Drain 484
Term
The area of the IV catheter that fills with blood to help indicate when a vein is cannulated.
Definition
Flash Chamber 484
Term
When should you change the IV bag?
Definition
About 25 mL left 487
Term
Special types of IV devices that eliminate the need to hang a bag of IV fluid. Used for medication therapy that does not need fluid.
Definition
Saline Lock 490
Term
How long will the tubing range on saline locks?
Definition
1 to 5 inches 490
Term
How much normal saline is kept in the saline lock to prevent blood clotting?
Definition
2 mL 490
Term
Veins on the leg that are large, twisted, and ropelike and can cause pain, swelling, or itching.
Definition
Varicose Veins 492
Term
What problems are associated with IV therapy?
Definition
Local or Systemic Reactions 492
Term
Reactions that affect systems of the body and can include; allergice reaction, circulatory overload, air embolus, vasovagal reaction, and catheter shear.
Definition
Systemic Complications 492
Term
Reactions that occur in a localized area and can include; infiltration and thrombophlebitis.
Definition
Local Reactions 492
Term
What is the escape of fluid into the surrounding tissue, which causes a localized area of edema?
Definition
Infiltratiion 492
Term
What is the physical blockage of a vein or catheter?
Definition
Occlusion 493
Term
What usually causes vein irritation?
Definition
Too-Rapid Infusion Rate 493
Term
What is inflammation of the vein?
Definition
Thrombophlebitis 493
Term
What is an accumulation of blood in the tissues surrounding an IV site, often resulting from vein perforation or improper catheter removal?
Definition
Hematoma 494
Term
What are foreign proteins cable of producing a fever?
Definition
Pyrogens 494
Term
What is characterized by an abrupt temperature elevation with severe chills, backache, headache, weakness, nausea, and vomiting?
Definition
Pyrogenic Reaction 494
Term
How much extra fluid can a healthy adult handle without compromise?
Definition
2-3 L 495
Term
What is the most common cause of circulatory overload in the prehospital setting?
Definition
Failure to readjust the drip rate after flusing an IV line immediately after insertion 495
Term
What are signs and symptoms of circulatory overload?
Definition
Dyspnea, JVD, and Hypertension 495
Term
How much air can a healthy adult tolerate being introduced into the circulatory system?
Definition
200 mL 495
Term
Feature of an IV catheter (or any other object) that allows it to appear on a radiograph.
Definition
Radiopaque 495
Term
What order are the blood tubes?
Definition
Red, Blue, Green, and Lavender 496
Term
Which blood tube contains no additives and is intended to clot if blood typing is needed?
Definition
Red-Topped Tube 496
Term
Which blood tube contains the preservative EDTA and is used to help determine a patient's prothrombin time and parital thromboplastin time (calculate patient' blood clotting time)?
Definition
Blue-Topped Tube 496
Term
Which blood tube is filled with heparin to prevent clotting and is used to elevate the patient's electrolyte and glucose levels?
Definition
Green-Topped Tube 496
Term
Which blood tube is filled with sodium citrate and are often used for a complete blood count, including hematocrit and hemoglubin values?
Definition
Lavender-Topped Tube 496
Term
Which blood tube should you avoid shaking?
Definition
Red-Topped Tube 496
Term
How full should blood tube be filled to be viable for testing?
Definition
3/4 Full 496
Term
What means within the bone?
Definition
Intraosseous 497
Term
What is a technique of administering fluids, blood and blood products, and medications into the intraosseous space of the proximal tibia, humeral head, or sternum?
Definition
Intraosseous (IO) Infusion 497
Term
What is the SHAFT of the long bones?
Definition
Diaphysis 497
Term
What are the ends of the long bones?
Definition
Epiphyses 497
Term
What is the growth plate of long bones?
Definition
Epiphyseal Plate 497
Term
What collectively comprises the spongy cancellous bone of the epiphyses and the medullary cavity of the diaphysis?
Definition
Intraosseous (IO) Space 497
Term
What is the IO space commonly referred to?
Definition
Noncollapsible Vein 497
Term
When doing an IO, what could happen from undetected extravasation?
Definition
Compartment Syndrome 500
Term
What is inflammation of the bone and muscle caused by an infection?
Definition
Osteomyelits 500
Term
What is the percent that osteomyelitis occurs when performing an IO?
Definition
Fewer than 0.6% 500
Term
When should you suspect a patient might be having a PE?
Definition
Acute shortness of breath, pleuritic chest pain, and cyanosis 500
Term
What is a congenital disease rusulting in fragile bones?
Definition
Osteogenesis Imperfecta 501
Term
What is the first rule of medicine?
Definition
Do no harm 501
Term
The amount of fluid you have on hand, such as the amount of fluid in an IV bag or the amount of fluid in a vial of medication.
Definition
Volume on hand 505
Term
Medcation administration that involves the medication passing through a portion of the gastrointestinal tract.
Definition
Enteral Medication 508
Term
Tubes that are commonly inserted in patients in the prehospital setting to decompress the stomach; can also be used to administer certain enteral medications.
Definition
Gastric Tubes 509
Term
A route of medication administration that involves any route other than the gastrointestinal tract.
Definition
Parenteral Route 511
Term
Breakable steril glass containers that are designed to carry a single dose of medication.
Definition
Ampules 512
Term
What are small glass or plastic bottles with a rubber-stopper top; they may contain a single or multiple dose of a medication?
Definition
Vials 513
Term
What involves injecting the sterile water from one vial into the vial that contains the powder, thereby makeing a solution for injection?
Definition
Drug Reconstitution 514
Term
What is a single vial divided into two compartments by a rubber stopper?
Definition
Mix-o-vial 514
Term
What are single-dose disposable medication cartridges that are inserted into a reusable syringe commonly referred to by?
Definition
Brand names (Tubex, Aboject, and Carpuject) 515
Term
What are injections that involve administering a small amount of medication-typically less than 1 mL-into the dermal layer, just beneath the epidermis?
Definition
Intradermal 515
Term
What is the correct angle to insert administer medication via the intradermal route?
Definition
10-15 degree angle bevel up 516
Term
What are injections given into the loose connective tissue between the dermis and the muscle layer?
Definition
Subcutaneous 517
Term
What is the correct angle to insert administer medication via the subcutaneous route?
Definition
45 degree angle 517
Term
What are common sites for subcutaneous injections?
Definition
Upper arms, anterior thighs, and abdomen 517
Term
What is usually the volume administered via the subcutaneous injection?
Definition
1 mL or less 517
Term
What is the volume administered via the intramuscular injection?
Definition
Up 5 mL 518
Term
What are common sites for the intramuscular injection?
Definition
Vastus laeralis muscle, rectus femoris muscle, gluteal area, and deltoid muscle 519
Term
What injections are given by penetrating a needle through the dermis and subcutaneous tissue and into the muscle layer?
Definition
Intramuscular 518
Term
What is the correct angle to insert administer medication via the intramuscular route?
Definition
90 degree angle 519
Term
A term used to describe "in one mass"; in medication administration, a single dose given by IV or IO route; may be a small or large quantity of the drug.
Definition
Bolus 521
Term
A sleeve placed around the IV bag and inflated to force fluid from the IV bag.
Definition
Pressure infuser device 524
Term
What route of administration are medications applie to and absorbed through the skin and mucous membrane?
Definition
Percutaneous route 525
Term
What are some percutaneous routes fo medication?
Definition
Transdermal, sublingual, buccal, ocular, aural, and nasal routes 526
Term
Medications that are applied topically-that is, on the surface of the body.
Definition
Transdermal 526
Term
What are the network of veins called under the tongue?
Definition
Venous Plexus 526
Term
What is the highly vascular region between the cheek and gums?
Definition
Buccal Region 527
Term
How long should you advise the patient to close their eyes for after assisting with ocular medication?
Definition
1-2 minutes 528
Term
What are the two types of long-term vascular access devices?
Definition
Non-tunneling and Implanted 532
Term
What are devices that have been inserted by direct venipuncture through the skin directly into a selected vein?
Definition
Non-tunneling Device 532
Term
Devices that are implanted in surgery, sutured under the skin, for the purpose of long-term medication administration.
Definition
Implanted Vascular Access Device (VAD) 533
Term
What is the onset of action via the intraosseous route?
Definition
30-60 seconds 536
Term
What is the onset of action via the intravenous route?
Definition
30-60 seconds 536
Term
What is the onset of action via the endotracheal route?
Definition
2-3 minutes 536
Term
What is the onset of action via the inhalation route?
Definition
2-3 minutes 536
Term
What is the onset of action via the nasal mucosal atomization (MAD) route?
Definition
3-5 minutes 536
Term
What is the onset of action via the intramuscular injection?
Definition
3-5 minutes 536
Term
What is the onset of action via the subcutaneous injection?
Definition
10-20 minutes 536
Term
What is the onset of action via the rectal route?
Definition
5-30 minute 536
Term
What is the onset of action via the oral route?
Definition
30-90 minutes 536
Term
What is the onset of action via the topical route?
Definition
minutes to hours 536
Term
What are the 6 rights of medication administration?
Definition
Patient, Drug, Dose, Route, Time and Documentation 469
Term
What are the 3 ways to make sure the drug is correct?
Definition
What it is still in the drug box it came in, when you prepare the drug for administration, before actually administering the drug to the patient 470
Term
What is the last step before administering a medication?
Definition
Making sure the expiration date has not passed 470
Term
What 2 things make up a solution?
Definition
Solvent and Solute 473
Term
What 2 things make up solutes?
Definition
Electrolytes and nonelectrolytes 473
Term
What kind of molecules contain carbon atoms?
Definition
Organic Molecules 473
Term
What molecules do not contain carbon atoms?
Definition
Inorganic Molecules 473
Term
What are the body's main cations?
Definition
Sodium, Potassium, Calcium, and Magnesium 473
Term
What are the body's main anions?
Definition
Bicarbonate, Chloride, and Phosphorus 473
Term
What prevents the loss of water from the kidneys by causing its reabsorbtion into the tubules?
Definition
Antidiuretic Hormone (ADH) 475
Term
The healthy body maintains a delicate balance between intake and output of fluids and electrolytes, ensuring that the internal environment remain fairly constant.
Definition
Homeostasis 476
Term
What is the internal environment's resistance to change?
Definition
Homeostasis 476
Term
ha is the concentration of sodium in the cells of the body?
Definition
Approximately 0.9% 476-477
Term
What are examples of colloid solutions?
Definition
Albumin, Dextran, Plasmanate, and hetastarch (Hespan) 477
Term
What is the concentration of sodium?
Definition
Osmolarity 478
Term
What is generally used in the field for paitents who have lost large amounts of blood?
Definition
Lactated Ringer's (LR) 478
Term
What type of patients shoud not be giving LR solution?
Definition
Liver Problems, liver cannot metabolize the lactate 478
Term
What is considered an isotopic solution while still in the bag?
Definition
D5W 478
Term
What turns into a hypotonic solution when administered?
Definition
D5W 478
Term
What has a lower concentration of sodium (osmolarity) than the cell's sodium?
Definition
Hypotonic Solution 478
Term
What is an abnormal fluid shift into the serous lining?
Definition
Third Spacing 479
Term
What has an osmolarity higher than that of serum, meaning that the solution has more ionic concentration than serum and pulls fluid and electrolytes from the intracellular and interstitial compartments into the intravascular compartment?
Definition
Hypertonic Solutions 479
Term
What type of patient should not be administered hypertonic solutions?
Definition
Diabetic Ketoacidosis or Risk of cellular dehydration 479
Term
How far above the site should you place the constricting band?
Definition
4-8" 486
Term
How much of a patient's tidal volume can they draw in through an open external jugular vein?
Definition
As much as 10% 491
Term
What should you do if you accidentally cannulate an artery?
Definition
Immediately withdrawal, apply direct pressure for at least 5 mins or until bleeding stops 494
Term
What is pruritus?
Definition
Itching 494
Term
What are hives?
Definition
Urticaria 494
Term
How long after the IV has been started will the patient have a pyrogenic reaction?
Definition
Usually within 30 minutes 494
Term
What is a painful condition that occurs when pressure within the muscles builds to dangerous levels?
Definition
Compartment Syndrome 500
Term
What is the most common solution to be administered through gastric tubes during interfacility transports?
Definition
Tube Feeding 509
Term
What specially designed container is daiazepam (Valium) marketed for rectal medication administration?
Definition
Diastat 511
Term
Subcutaneous and intramuscular injections should not be given to what type of patients?
Definition
Inadequate Perfusion 520
Term
What drugs require an initial bolus and then may require a continuous IV infusion to maintain a therapeutic level of the drug?
Definition
Lidocaine and Amiodarone 521
Term
What drug can cause a burning sensation if given too fast?
Definition
Promethazine 521
Term
What drug may cause tinnitus if given too rapidly?
Definition
Furosemide 521
Term
What has a half-life of 10 seconds and must be pushed rapidly to reach the heart?
Definition
Adenosine 521
Term
What size bolus flush should you give after administering medication through IV bolus?
Definition
20 mL 522
Term
What is the amount of solution remaining to be infused?
Definition
Volume to be Infused (VTBI) 524
Term
What is the amount of solution that has already been administered?
Definition
Volume Infused (VI) 524
Term
How should you pull the ear in adults for the administration of aural medications?
Definition
Up and Back 528
Term
How should you pull the ear in infants and children for the administration of aural medications?
Definition
Down and Back 528
Term
What attaches to a syringe and allows you to spray (atomize) select medications into the nasal mucosa?
Definition
Mucosal Atomizer Device (MAD) 528
Term
What medications can be given intranasally?
Definition
naloxone (Narcan), midazolam (Versed), gucagon (GlucaGen), ketorlac (Toradol), flumazenil (Romazicon), and fentanyl citrate 528
Term
How much more should intranasal require compare to the IV route?
Definition
2-2.5 time 5228
Term
What are the only 4 medications that are approved to be given through the ET tube?
Definition
Lidocane, Epinephrine, Atropine, and naloxone (Narcan) (LEAN) 531
Term
How much saline should be mixed with medication when administering down an ET tube?
Definition
10 mL 531
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