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NUR1112- Nursing > 7: safe administration of medication > Flashcards

7: safe administration of medication Flashcards

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1
Q

Describe schedule 2 medications

A

Deemed to be low risk even on overdose

- In pharmacy and supermarket 
- It is deemed to have enough info on packet to be taken safely
- Maybe… Nurse can give this drug without referral or higher order
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2
Q

What is medication scheduling?

A

Scheduling determines who gets access to medicine.

Schedule levels determine where and who can give you the drugs.

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3
Q

Describe schedule 3 medications

A

Pharmacy only as they are higher risk. They may be bed if you overdose.
- E.g. life saving drugs where getting a script takes to long such as insulin and Ventolin
- Need health advice from pharmacist
Nurses and midwifes can typically administer these.

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4
Q

Describe schedule 4 medications

A

Prescription only
- Written from doctor, dentist, nurse practitioner, certified midwives
Have a higher degree of risk. Need someone to watch over and give advice to them.

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5
Q

Describe schedule 8 medications

A
  • supply, storage and prescription and disposal are controlled by law
    • Prescription is controlled by law
    • Very tightly controlled
    • Their hospital storage is controlled
    • Their factory production is controlled
    • Disposal must be verified by 2 nurses
      These are the drugs that have potential for abuse
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6
Q

Describe schedule 9 drugs

A

Schedule 9 (prohibited substances)

- Restricted to drug trials 
- Highly controlled
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7
Q

Schedule 11 drugs

A
  • Drugs of dependence that are not controlled by law

Hospitals treat these like schedule 8

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8
Q

Storage of schedule 4=

A
  • Must be locked and inaccessible for general public

Administered by registered, enrolled or midwives nurses

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9
Q

Storage of schedule 8 and 11=

A
  • Must be locked away and fixed to wall
    • Very tight laws on steel thickness
    • Partially used medications must be destroyed by 2 people.
      If a whole packet has been destroyed then a hospital pharmacist is the only person who can destroy it.
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10
Q

Generic name=

A

abbreviated from chemical name

e.g. paracetamol

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11
Q

Trade name=

A

brand or marketing name

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12
Q

administration abbreviation= BD

A

twice daily

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13
Q

administration abbreviation= TDS

A

Three times a day

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14
Q

administration abbreviation PRN=

A

as required

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15
Q

administration abbreviation QID=

A

four times daily

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16
Q

administration abbreviation Mane=

A

morning

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17
Q

administration abbreviation nocte=

A

at night

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18
Q

administration abbreviation AC=

A

before meal

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19
Q

administration abbreviation PC=

A

After meals

20
Q

administration abbreviation PO=

A

by mouth- per oral

21
Q

administration abbreviation sub cut=

A

subcutaneous- injection

22
Q

administration abbreviation subling=

A

sublingual- under the tongue

23
Q

administration abbreviation Buccal=

A

Buccal- under the tongue

24
Q

administration abbreviation IV=

A

intravenous- into vein

25
Q

administration abbreviation IM=

A

intramuscular- like immunisation that go into the muscle

26
Q

administration abbreviation PV=

A

per vagina

27
Q

administration abbreviation PR=

A

per rectum

28
Q

What are the 8 rights of medication administration?

A 
1- Right patient 
2-Right route 
3- Right time 
4- Right dose
5- Right documentation
6- Right reason 
7- Right drug 
8- right to refuse
29
Q

Role of nurse/midwife in the 8 rights

A

doctor/nurse practitioner or certified midwife= prescribes

pharmacist= stores, dispenses and reviews medication

nur/mid= administers medication
- the last line of defence nefore medication is given
-You must not just blinding follow every order given to you.
You must think critically about what it is that is being given.

30
Q

Process of following the 8 rights

A
  1. Check name bands and ask them name, DOB every time
    1. What it says on the drug chart is what it says on the packet. Check for allergies and drug chart
    2. Right dose. Is it what it says is on the chart? Is it rational? Does that sound right? Does that does work with their current state?
    3. Is it the right route
    4. Frequency= how may times a day. Time= what time? It doesn’t always have to be evenly spaced out
    5. Right reason? Does it suit their current vitals and state?
    6. Is the documentation clear, legal, valid. Have you signed off and recorded what you have done?
    7. A patient has a right to refuse medication. They may dye without it but what they say. A practitioner has the right to refuse administering a drug no matter who orders it.
      Do you feel comfortable giving this drug

Always stop if something is not right

31
Q

How many nur/mid check schedule 4

A

1 nur/mid

- parental route are often check by 2

32
Q

How many nur/mid check schedule 8 and 11 medication

A

2 nur/mid

33
Q

How many check paediatric med

A

always 2 nur/mid

34
Q

What should not be accepted on a medication order?

A
  • verbal order
  • illegible hand writing
  • fully filled out
35
Q

Describe a standing order

A

med is administered according to this order until cancelled by another order or is ceased.

36
Q

Describe a pro re nata (PRN)

A

administered as needed or requested according to limits set in the medication order.

37
Q

Describe a STAT order

A

single medication order that is carried out immediately, often during an emergency

38
Q

Describe a verbal or telephone order

A

medication order is provided verbally by the prescriber when they are unable to attend to the patient directly

39
Q

When should medical administration chart be filled out?

A

asap

  • should be done fully
  • be signed only once full drug is administered.
40
Q

List some common medication errors

A
  • inappropriate prescribing
  • wrong dose
  • wrong person
  • incorrect route
  • failure to give in time frame
  • incorrect preparation (issue with mixing or diluting)
41
Q

Causes of medication errors

A
  • interruptions
  • poor communication
  • environmental factors (poor lighting)
  • stress, fatigue and nurse/patient ratios
  • pressure from other health professionals
  • lack of compliance to 8 rights of medical administration
42
Q

List high risk drugs that must be closely monitored

A

Antimicrobials- hair cells may start to die
Potassium- change action potential and ICF concentration
Insulin
Narcotics
Chemotherapy
Heparin and anticoagulants- Prevent blood clots but wit no much falls can cause bleeding to death
System - The recording systems in hospital can cause mistakes as they are unfamiliar

43
Q

How should one respond to medication errors?

A
  • immediately check the patients’s condition and observe the development of adverse effects.
  • notify the nurse or midwife in-charge
  • write a description of the error in patients medical record, including the remedial steps taken.
  • record in incident and risk management system
  • engage ward or unit pharmacist to review medication incident to ensure safe medication delivery.
44
Q

What are some adverse effect that may appear with a medication error?

A

Look for the adverse effect
- Blood level, heart rate etc
- Tell the patient and tell them how you will move forward
- Tell the nurse/midwife in charge
- Record the error and all attempts of fix and reverse it.
Tell ward or unit pharmacist. They will go through storage, delivery and other factors to try and prevent it from happening again.

45
Q

Benefit for mathematic approach over specific dose formula (paediatric calculation)

A
  • only one standard approach to all medication calculations

- removes the need for remembering complex formulae

46
Q

Dose equation

A

dose= strength required/stock strength x volume

47
Q

Paediatric calculation

A

total dose= dose/kg x patient weight

NUR1112- Nursing (11 decks)

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