Download Med Admin Review-Student Pre-Clinical Family Health Nursing I

Family Health Nursing I
Sims 1: Pre-Clinical
Medication Administration Review
*This is NOT a group assignment and therefore must reflect your own work*
Please refer to page 119-120 in the electronic BSN student handbook
or page 120-121 in the written BSN student handbook.
Student Name: _________________________
Date: __________
Simulation Center Facilitator Signature: ______________________________________
Learning Objectives:
 Review medication administration safety guidelines.
 Perform medication calculations.
 Initiate intravenous therapy to include site selection, insertion, dressing, and documentation.
 Administer primary IV solution and IV push (IVP)
 Administer subcutaneous and intramuscular injections
 Discontinue IV therapy.
Skills you will be expected to demonstrate in this session are noted below. Please review and be prepared
to perform these skills. The skills can be found in your basics textbook.
Skills:
 IM injection
 Mix and administer insulin, sub-q injection
 Insertion of IV
 Primary IV fluid administration
 Administration of IV push (IVP)
 Discontinue an IV
 Intradermal Injection


IVPB
FSBG
A handwritten critical thinking (drug card) for each assigned medication must be complete PRIOR to
SIMS. Use your Nursing Central resource: Davis Drug Guide, as a reference to research your assigned
medications.
Medications:
 Toradol (Ketorolac) 15mg IV Push, Q 8 hours PRN, not to exceed 3 doses
 Insulin: Novolog 5 units SQ before meals (AC) & Levemir 20 units SQ @ 0800
 Lasix (Furosemide) 40mg IV Push x 1 now
 Ancef (Cefazolin Sodium) 2gram IV Piggyback Q 8 hours
Supplies:
*You will have to pull these supplies BEFORE coming to the Simulation Lab*
 Lab bags with following supplies pulled PRIOR to lab:
3 mL syringe
1ml (tuberculin) syringe
Blunt needle
10mL normal saline vial
22 or 23 gauge needle for IM injection
Units 100 Insulin Syringe
Regular and NPH insulin
IV start kit
Primary Tubing Set
500ml NS bag
50ml NS bag
2 saline flushes
Angiocath – either 20 gauge (pink) or 22 gauge (blue)
Extension set
Alcohol preps
Box of Gloves THAT FIT YOUR HANDS (may have to be purchased)
 Nursing Central on an electronic device
 Stethoscope, calculator, pen, watch with second hand
References and pre-reading:
Ackley, B. J. & Ladwig, G. B. (2011). Nursing Diagnosis Handbook, (9th ed). St. Louis, MO, Mosby Elsevier.
Bowden, T. (2010). Perpheral Cannulation: A Practical Guide. British Journal of Nursing, Vol 5, No 3, pgs
124-131.
Lewis, S. L., Heitkemper, M. M., Dirksen, S. R., Camera, I. M., & Bucher, L. (2014). Medical Surgical Nursing:
Assessment and Management of Clinical Problems, (9th ed.). St. Louis, MO: Mosby, pgs.307-312.
Taylor, C., Lillis, C., & Lynn, P. (2014). Fundamentals of nursing (8th ed.). Philadelphia, PA:
Lippincott, Williams,& Wilkins.
Vascular Access Management Retrieved from http://picclinenursing.com/
Answer the questions and initiate a nursing care plan using ADPIE. You may use your Nursing Diagnosis
Handbook.
1. What nursing actions will you demonstrate within the clinical setting when you receive a medication order?
2. Identify all of the IM injections sites and briefly describe the anatomical landmarks.
3. What is the preferred IM injection site?
4. What priority nursing actions you should take prior to the administration of insulin?
5. When you are in the medication room, you note that insulin syringes come in two different sizes. Identify
these sizes and describe what each means.
6. Can you use a regular 1mL syringe to administer insulin? Why or why not?
7. List five indications for intravenous therapy?
8. How would you describe a hypertonic IV solution? Give one example.
9. A patient presents to the ER with signs and symptoms of dehydration. What type of IV solution do you
suspect will be given? Why?
10. Define CVC (central venous catheter). Where is a CVC inserted and advanced to?
11. Define PICC (peripherally inserted central catheters). Where is a PICC inserted and advanced to?
12. What is the difference between a central venous catheter (CVC) and a peripherally inserted central catheter
(PICC)? What makes them similar?
13. What are some indications for use of a PICC?
14. What are some of the complications that may be associated with Central Venous Access Device (CVAD)’s?
15. Define the terms below.
a. Intravenous bolus or Intravenous Push:
b. Intermittent infusions or IV piggybacks (IVPB):
c. Continuous infusion:
d. Volume to be infused:
16. Match the Col. A with choices from Col. B. (terms in Column A may be used more than once)
Col. A
a. Bolus injection
b. Intermittent infusion
c. Continuous infusion
Col. B
1. NS @ 150ml/hr continuous infusion
2. 1 Liter (1000ml) of NS over 30 min, one time only
3. Lasix (Furosemide) 40mg IV push x 1 now
4. Ancef (Cefazolin Sodium) 2 Gm IVPB over 30 min every 8 hours
5. D5NS with 20 mEq Potassium Chloride (KCL) @ 75 ml/hr continuous
infusion
17. Mr. George is admitted with dehydration. The physician orders a primary infusion of 1000 ml of NS to run
over 8 hours and 900mg of Clindamycin (Cleocin Phosphate) in 100ml NS to run over 30 min. Fill in the
blanks on the pump with rate and VTBI
This is your
primary,
continuous
infusion
What rate will
you set your
primary
infusion at?
What volume
will you
infuse for
your primary?
Line A
Line B
Rate
(ml/hr)
This is your
secondary,
piggyback
infusion
What rate will
you set your
piggyback at?
Volume Inf
(ml)
What volume
will you infuse
for your
piggyback?
18. As a nurse, you will be monitoring the patient’s IV site at least every two hours. You will assess for each of
the below complications. What assessment findings would indicate a complication?
Infiltration:
Phlebitis:
Infection:
19. Mrs. Allen is placed on maintenance IV Fluids D5 ½ NS with 20 mEq KCl on the first post-operative day.
She weighs 132 lbs. (60.9 kg). What assessments would you perform prior to and after initiation of this IV
fluid?
Use your Nursing Diagnosis Handbook to answer the following:
Pam Allen is a 65 year old female. She has endometrial cancer and had recent surgery to remove a large
cancerous tumor in her lower colon and upper rectum. S/P: colectomy and colostomy. She is scheduled to start
chemotherapy and has a peripherally inserted central catheter placed (PICC).
Identify four nursing diagnoses for Pam Allen
Write a nursing process for Pam Allen pertaining to vascular trauma
Nursing Diagnosis: Risk for vascular trauma
List three of Mrs. Allen’s risk factors for this nursing diagnosis.
Planning
Identify four client outcomes:
The client will:
Implementing
List three nursing interventions with rationales:
Home Care: