FRESENIUS NEW HIRE, EXAM QUESTIONS AND
ANSWERS 100% CORRECT. Buy Quality Materials!
5 rights of med administration
RIGHT patient, drug, dose/amount, time, route
Bonus: right documentation and right to refuse
30 grams
1 oz
16 oz
1 lb
1 mg
1000 mcg
1000 mg
1 gram
1000 gram
1 kilogram
1 kg
2.2 lbs
30 ml
1 oz
1000 ml
1 quart
500 ml
1 pint
240 ml
8 oz (1 cup)
16 oz
1 pint
1 gallon
4 quarts
1 liter
1000 ml
5 ml
1 tsp
strategies to reduce errors when handling look alike- sound alike meds
1. limit inventory
2. separate storage
3. tall man letters
4. high alert stickers
5. double check med spelling and indication
drugs that can be administered outside specialty care areas, but need VS at the
following intervals: before admin, 15 mins after admin, and 1 hour after admin
these drugs are administered IV:
-enalaprilat (vasotec)
, -hydralazine (apresoline)
-metoprolol (lopressor)
-labetalol (normadyne)
-diltiazem (cardizem)
-verapamil
INSULIN
- vials are for single patient use only
- only regular insulin can be given IV
- double check doses esp with infants and peds
- you CANNOT use "u" to refer to units (something about it being confused with a zero.
idk)
- never hold basal doses of insulin without MD order (basal doses meaning levemir and
lantus)
- a witness is required for insulin gtt initiation, rate changes, and IVP insulin (insulin
requires a 2 RN signature anyway?)
anticoagualants
heparin
lovenox
warfarin/coumadin
direct thrombin inhibitor
Argatroban
It is usually used with aspirin. It is also used to treat and prevent harmful blood clots and
increase platelets in patients who have had a reaction to heparin (e.g., heparin-induced
thrombocytopenia-HIT). Argatroban works by blocking a certain natural substance
(thrombin) that the body uses to form blood clots.
An infusion of 2 μg/kg/min argatroban is expected to increase aPTT 1.5-fold, whereas
an infusion of 10 μg/kg/min can prolong a PTT up to 3-fold. ... Argatroban furthermore
decreases the endogenous thrombin potential in a dose/concentration dependent
manner (Harder et al 2004).
NO KNOWN REVERSAL
coumadin
used when pt. goes home. can be PO. Typically only initiated after heparin therapy has
allowed pt. to be therapeutically anticoagulated.
LABS- PT/INR
PT: 11 to 13.5 seconds.
INR: 0.8 to 1.1
antidote: Vitamin K
Reversal of Warfarin Effects
Omit 1-2 doses, or hold warfarin; monitor INR and adjust warfarin dose accordingly
INR 4.5-10, no bleeding: 2012 ACCP guidelines suggest against routine use; 2008
ACCP guidelines suggest considering vitamin K1 (phytonadione) 1-2.5 mg PO once
INR >10, no bleeding: 2.5-5 mg PO once; INR reduction observed within 24-48 hr,
monitor INR and give additional vitamin K if needed
ANSWERS 100% CORRECT. Buy Quality Materials!
5 rights of med administration
RIGHT patient, drug, dose/amount, time, route
Bonus: right documentation and right to refuse
30 grams
1 oz
16 oz
1 lb
1 mg
1000 mcg
1000 mg
1 gram
1000 gram
1 kilogram
1 kg
2.2 lbs
30 ml
1 oz
1000 ml
1 quart
500 ml
1 pint
240 ml
8 oz (1 cup)
16 oz
1 pint
1 gallon
4 quarts
1 liter
1000 ml
5 ml
1 tsp
strategies to reduce errors when handling look alike- sound alike meds
1. limit inventory
2. separate storage
3. tall man letters
4. high alert stickers
5. double check med spelling and indication
drugs that can be administered outside specialty care areas, but need VS at the
following intervals: before admin, 15 mins after admin, and 1 hour after admin
these drugs are administered IV:
-enalaprilat (vasotec)
, -hydralazine (apresoline)
-metoprolol (lopressor)
-labetalol (normadyne)
-diltiazem (cardizem)
-verapamil
INSULIN
- vials are for single patient use only
- only regular insulin can be given IV
- double check doses esp with infants and peds
- you CANNOT use "u" to refer to units (something about it being confused with a zero.
idk)
- never hold basal doses of insulin without MD order (basal doses meaning levemir and
lantus)
- a witness is required for insulin gtt initiation, rate changes, and IVP insulin (insulin
requires a 2 RN signature anyway?)
anticoagualants
heparin
lovenox
warfarin/coumadin
direct thrombin inhibitor
Argatroban
It is usually used with aspirin. It is also used to treat and prevent harmful blood clots and
increase platelets in patients who have had a reaction to heparin (e.g., heparin-induced
thrombocytopenia-HIT). Argatroban works by blocking a certain natural substance
(thrombin) that the body uses to form blood clots.
An infusion of 2 μg/kg/min argatroban is expected to increase aPTT 1.5-fold, whereas
an infusion of 10 μg/kg/min can prolong a PTT up to 3-fold. ... Argatroban furthermore
decreases the endogenous thrombin potential in a dose/concentration dependent
manner (Harder et al 2004).
NO KNOWN REVERSAL
coumadin
used when pt. goes home. can be PO. Typically only initiated after heparin therapy has
allowed pt. to be therapeutically anticoagulated.
LABS- PT/INR
PT: 11 to 13.5 seconds.
INR: 0.8 to 1.1
antidote: Vitamin K
Reversal of Warfarin Effects
Omit 1-2 doses, or hold warfarin; monitor INR and adjust warfarin dose accordingly
INR 4.5-10, no bleeding: 2012 ACCP guidelines suggest against routine use; 2008
ACCP guidelines suggest considering vitamin K1 (phytonadione) 1-2.5 mg PO once
INR >10, no bleeding: 2.5-5 mg PO once; INR reduction observed within 24-48 hr,
monitor INR and give additional vitamin K if needed
