1.5 Medication Administration (Part 1) Flashcards
Drug Nomeclature
- Generic/Trade Names
Generic - Name of medication assigned by the manufacturer who first developed it
(Lowercase - How its identified in official publications)
Trade - Name given by manufacturer.
Drug Classifications
- Classified by the effect on body system
- Chemical composition, clinical indication, or therapeutic action
Class - Refers to Mechanism of Action, physiological effect, chemical structure of medication
Therapeutic Class - Clinical indication for the drug or therapeutic action
Side Effects/Adverse Effects
Side effect - Non-therapeutic reaction to a drug. Usually uncomfortable
Adverse effect - Often require lowering a dose or discontinuing the drug.
Contraindications/precautions - Condition where drug should be given with caution or not given at all
Pregnancy Categories
- Requires knowledge of gestational age
Category A - No risk to fetus in any trimester
Category B - No demonstrated adverse effects in animal studies
Category C - Studies with animals show no risk but cannot rule out issues in humans. Benefits outweigh the risk. (Most medications are in this category)
Category D - Definite Fetal Risk. Used only in life threatening condition. (Chemo-Therapy)
Category X - Never given during pregnancy
Mechanisms of Action
Action - How the drug works
Indication - Reason for using the drug
Allergic Reaction - Immunologically sensitive to medication so body releases antibodies. Severe allergies patient should wear medical alert bracelet
Nursing Implications of Drug Administeration
- Monitor interactions (drug taken with food)
- Monitor vital signs or labs to see if drug should be withheld
- Lab values also show if drug is in therapeutic range
Absorption
Factors that Effect Absorption
- Route of administration
- Ability for medication to dissolve
- Blood flow to site of administration
- Body surface area
- Lipid solubility
Absorption (cont)
- Medication applied to skin is usually slowly absorbed
- Oral is also slow due to going through GI Tract
- Respiratory and mucous membrane is quick
- IV is quickest
Distribution
- Depends on physical and chemical properties of medication
- Physiology of person using it (circulation, membrane permeability, protein binding)
- Rate/Extent of distribution depends on physical and chemical properties of medication and physiology of person
Distribution
- Speed depends on vascularity of organ/tissue
- Degree of medication binding to serum proteins affect medical distribution
Metabolism
Biotransformation - Influence of enzymes that break down and detoxify drugs. (Metabolism)
Excretion
Chemical makeup of medication determines organ of excretion
- Medication that enter hepatic circulation are broken down in liver and secreted into bile.
- Exocrine glands excrete lipid-soluble medications
Justice
Client has the right to receive
- Right Drug, Right Dose, Right Route, Right Time
In addition right to
- Nurse careful assessment, management, and evaluation of drug therapy
- Actions promoting clients safety and well-being
- Nurse obligation to maintain high standard of care
Fidelity
- Nurse should always keep their promise
Criminal Law
Offenses against the general public
- Unlawful use, possession, administration of controlled substance
- Alcohol/drug abuse
Civil Law
- Legal rights and duties of a single person
(Claims nurse has failed to meet required standards of care) - Mistakes in administering medication
Negligience
Medication error
- Assess the client
- Notify healthcare provider
- Error-in medication form or incident report
- Appropriate action taken under provider
Malpractice
Duty - Claim that nurse owed client special duty of care
Breach of duty - Nurse failed to meet standards
Harm/Injury - Claim resulted in harm of patient nurse did not meet standards of care
Damages - Claim of damages where compensation is sought.
Beneficence/Nonmaleficence
Beneficence - Nurse should act in patients best interest
Nonmaleficence - Nurse must not inflict harm or prevent whenever possible to patient.
Conversions to Remember
1 oz = 30 mL 1 lb = 16 oz 1 cup = 8 oz 1 tsp = 5 mL 1 TBSP = 15 mL 1 kg = 2.2 lb
Medical Reconciliation
- When patient is admitted to hospital you must compare medication of client has been taking before admission with medication organization will provide
- Gain thorough medication history to prevent interactions
Safeguards of medication administration
Always start with hand hygiene and wear gloves for medication that can be absorbed through the hand
- Mask/eye protection may be needed for respiratory particles released into the air
Controlled Substances
2 nurses must check medications to ensure they are administered correctly
Required information for controlled substances
- Name of patient
- Name of provider
- Name of nurse administering
- Name of medication
- Hour narcotic was given
- Name of nurse who double checked
Verify patient at bedside
- Verify Identification Bracelet
- Verify Name (First Identifier)
- Verify ID#, MRN#, Birth Date (Second Identifier)
- Comparing with MAR/CMAR
Combination Medications
Single Trade Name
Multiple generic names with slashes between
(May be different strengths for same medication)
Oral Medications
- Easiest way to administer
- 30 minutes before or after feeding if drug is given on empty stomach
- Drug-Drug interactions most risk
- Check with provider for NPO patients
Transdermal Patches
- Remove old patch before applying new one
- (Date and time of patch)
Eye instillation
- Pulldown conjunctival sac and apply drops
- Use gloves to avoid contaminating patient
- Avoid Cornea
- Avoid eyelid with dropper
- Never share medication with others
Ear drops
Adult - Pull pinna up and back
Age 3 or younger - Pull pinna down and back
- Do not drop directly into ear canal
- Use sterile stolutions
Rectal Instillation
1 1/2 inches
