Term
| An adverse drug event is a general term that |
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Definition
| encompasses all types of clinical problems related to medication use |
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Term
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Definition
| a preventable adverse drug event involving inappropriate medication use by a patient or health care professional; they may or may not cause the patient harm |
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Term
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Definition
| unexpected, unintended, or excessive responses to medications given at therapeutic dosages |
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Term
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Definition
| any abnormal and unexpected response to a medication, other than an allergic reaction, that is peculiar to an individual patient |
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Term
| In the 2006 Institute of Medicine Study, it was estimated that |
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Definition
| some form of medication error resulted in harm to 1.5 million patients per year, including 400,000 in hospitals and up to 800,000 in long-term care settings |
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Term
| Intangible losses resulting from such adverse outcomes include |
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Definition
| patient dissatisfaction with, and loss of trust in, the health care system. |
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Term
| Medication errors can occur at any step in the medication process: |
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Definition
| procuring, prescribing, transcribing, dispensing, administering, and monitoring. |
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Term
| One study noted that half of all preventable adverse drug events begin with |
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Definition
| an error at the medication ordering (prescribing) stage |
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Term
| The majority of fatal errors at home involve |
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Definition
| the mixing of prescription drugs with alcohol or other drugs |
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Term
| Drugs commonly involved in severe medication errors include |
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Definition
| central nervous system drugs, anticoagulants, and chemotherapeutic drugs |
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Term
| “High-alert” medications have been identified as those that? |
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Definition
| because of their potentially toxic nature, require special care when prescribing, dispensing, and/or administering |
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Term
| The major categories of medication error are defined by the 2005 National Coordinating Council for Medication Error Reporting and Prevention as |
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Definition
(1) no error, although circumstances or events occurred that could have led to an error,
(2) medication error that causes no harm,
(3) medication error that causes harm, and
(4) medication error that results in death. |
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Term
| Responding to and reporting medication errors are |
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Definition
| part of the professional responsibilities for which the nurse is accountable. |
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Term
| The nurse’s highest priority at all times during the medication administration process and during a medication error is? |
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Definition
| the patient’s physiologic status and safety. |
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Term
| Medication reconciliation involves three steps: |
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Definition
o Verification—Collection of the patient’s medication information with a focus on medications currently used including over-the-counter medications and supplements.
o Clarification—Professional review of this information to ensure that medications and dosages are appropriate for the patient.
o Reconciliation—Further investigation of any discrepancies and documentation of relevant communications and changes in medication order |
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Term
| What are some potential physical and emotional consequences of a medication error? |
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Definition
• This can lead to adverse health outcomes because patients are afraid to seek health services
• Patient dissatisfaction with, and loss of trust in the health care system |
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Term
| What are some of the various ethical dilemmas related to professional nursing practice associated with medication errors? |
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Definition
• A 2001 article in the Journal of Clinical Outcomes Management noted the obligation of institutions and providers to provide full disclosure to patients when errors have occurred.
• Health care organizations can choose to proactively apologize and accept responsibility for obvious errors and even offer needed financial support
• Research indicates that such actions help health care organizations to avoid litigation and potentially much larger financial settlements. |
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Term
| Identify agencies concerned with prevention of and response to medication errors. |
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Definition
• USP MERP (United States Pharmacopeia Medication Errors Reporting Program)
• MedWatch, sponsored by the FDA
• Institute for Safe Medication Practices (ISMP)
• The Joint Commission |
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Term
| What are the possible consequences of medication errors for professional nurses and other members of the health care team. |
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Definition
• Nurses may be named as defendants in malpractice litigation.
• Disciplinary action, including suspension or termination of employment, may also occur depending on the specific incident.
• Nurses who have violated regulations of their state’s nurse practice act may also be counseled or disciplined by their state nursing board, which may suspend or permanently revoke their nursing license.
• Many hospitals have implemented a non-punitive approach to medication errors |
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Term
What % of the adult human body is water?
This is referred to as what? |
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Definition
60% of adult human body is water
Total Body water (TBW) |
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Term
Total Body Water (TBW)
Is composed of what? |
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Definition
Composed of:
Intracellular fluid (ICF) 67%
Interstitial fluid (ISF) 25%
Plasma volume (PV) 8% |
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Term
| Intravascular fluid (IVF)- Where? |
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Definition
| Fluid inside blood vessels |
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Term
| Extravascular fluid (EVF)- Where and examples |
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Definition
Fluid outside blood vessels
Lymph, cerebrospinal fluid |
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Term
| Extravascular volume- What, Where and examples |
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Definition
Plasma
Interstitial fluid (ISF): fluid in space between cells, tissues, and organs |
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Term
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Definition
ISF (interstitial fluid)
ICF (intracellular fluid) |
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Term
| When fluid that has been lost must be replaced, there are three categories of agents that can be used to accomplish this: |
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Definition
1. Crystalloids
2. Colloids
3. Blood Products |
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Term
What are Crystalloids?
How are they given? |
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Definition
| They supply water and Na to maintain the osmotic gradient between (EVF) and (IVF) |
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Term
| What are the 4 Crystalloids? |
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Definition
Normal Saline
Hypertonic Saline
Lactated Ringer's
D5W |
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Term
| What are Crystalloids best for treating for? |
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Definition
| Better for treating dehydration rather than expanding plasma volume |
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Term
Crystalloids are used as__________ ________?
List some reasons |
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Definition
Used as maintenance fluids to:
Compensate for insensible fluid losses
Replace fluids
Manage specific fluid and electrolyte disturbances
Promote urinary flow |
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Term
| Name 5 crystalloid solutions |
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Definition
Normal saline (0.9% sodium chloride)
Half normal saline (0.45% sodium chloride)
Hypertonic saline (3% sodium chloride)
Lactated Ringer’s
D5W- has free water |
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Term
| Do not use Lactate Ringer if the patient? |
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Definition
Has hyperkalemia
Hypernatremia
cerebral edema |
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Term
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Definition
they are protein substances
increase colloid oncotic pressure |
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Term
| Where do colloids move fluids? |
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Definition
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Term
When do you give colloids to patients?
Example? |
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Definition
When the patients has experienced a large protein loss
ex. Burn victims
and patients that crystalloids did not work for |
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Term
| Name three types of colloids. |
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Definition
Albumin 5% and 25%
Dextran
Hetastarch |
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Term
| When do you NOT use colloids? |
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Definition
| If the patient is allergic, or has hypovolemia |
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Term
Blood Products can carry _______
Plasma volume? |
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Definition
The only product that can carry oxygen
increases plasma volume
is a "plasma expander" |
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Term
Type of Blood Product.
Cryoprecipitate- |
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Definition
Acute bleeding over 50% steady blood loss
or 20% rapidly |
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Term
Type of Blood Product.
Fresh Frozen Plasma (FFP) |
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Definition
+++ Increases the clotting factor
Used in patients with deficient clotting |
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Term
Type of Blood Product.
Packed Red Blood Cells (PRBCs) |
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Definition
++ Oxygen carrying
Used for patients with anemia
Hemoglobin deficits
or 25% of total blood volume loss |
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Term
Type of Blood Product.
Whole Blood |
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Definition
Used in extreme cases
Over 25% Blood volume loss
+contains plasma
+contains plasma proteins |
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Term
Fluids that are outside of the cell are =
inside of the cell= |
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Definition
Outside= Sodium cations (Na+)
chloride anions (Cl-)
Inside= potassium |
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Term
Potassium belongs where?
What is the % that is in the cell? |
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Definition
Belongs in the cell
(intercellular space)
95% in the cell |
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Term
| Potassium's content outside of the cell should ONLY be within ? |
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Definition
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Term
| At minimum, _____ potassium needs to be consumed per day? |
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Definition
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Term
| Potassium is responsible for what? |
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Definition
-Muscle contraction
-Transmitting nerve impulses
-regulation of heart beat
-maintaining acid-base balance
-iconicity |
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Term
| What is Potassium used for? |
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Definition
treatment or prevention of K+ depletion
Potassium salts |
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Term
| Potassium can be used to stop ______ ______? |
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Definition
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Term
| Potassium can be used for the management of ? |
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Definition
| tachydysrhythmias after cardiac surgery |
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Term
| What are some of the adverse effects of Potassium? |
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Definition
Most GI issues:
-Diarrhea
-Nausea
-vomiting
-GI Bleeds
-Ulcerations |
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Term
| What are some of the adverse effects of Potassium when given via IV? |
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Definition
Pain and burning at the site
phlebitis |
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Term
| What are some of the adverse effects of Potassium when given in excess? |
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Definition
Hyperkalemia
and toxic effects |
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Term
| Sodium is the counterpart of ? |
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Definition
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Term
| What is the normal concentration for sodium that is outside of the cell? |
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Definition
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Term
| What are some of the signs of HYPOnatremia? |
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Definition
| lethargy, hypotension, stomach cramps, vomiting, diarrhea, seizures |
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Term
| What are some of the causes of HYPOnatremia? |
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Definition
| excessive sweating, prolonged diarrhea or vomiting, renal disorders and adrenocortical impairment |
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Term
| What are some of the signs of HYERnatremia? |
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Definition
| red flushed skin, dry-sticky mucous membranes, increased thirst, elevated temperature, water retention (edema), hypertension, decreased or absent urine |
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Term
| What are some of the cause of HYERnatremia? |
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Definition
| poor kidney function, not drinking enough water, dehydration |
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Term
| What does Sodium (Na+) do for the body? |
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Definition
-controls water distribution
-Fluid and Electrolyte balance
-Diuresis
-Osmotic pressure of body fluids
-acid-base balance |
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Term
| What is sodium given for? |
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Definition
It is given for treatment/prevention of sodium depletion
-mild hyponatremia -in tablet form
-Fluid restriction |
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Term
| When a patient's sodium is depleted, what IV solutions can be given? |
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Definition
-Normal saline
-lactated ringer solution
-hypertonic saline (3% NaCl) for severe cases (but high risk) |
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Term
What are the adverse effects of Sodium treatment?
for oral admin?
for IV admin? |
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Definition
Nausea, vomiting, cramps
phlebitis |
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