Ch.32 Oral Medications (FON)

Question 1

Define Medications

Answer 1

Chemical substances that change body function.

Question 2

Name the components of a drug order.

Answer 2

1. The client’s name
2. The date and time the order is written
3. The drug name
4. The dose to be administered
5. The route of administration
6. The frequency of administration
7. The signature of the person ordering the drug

Question 3

Explain the difference between trade and generic drug names.

Answer 3

A trade name is the name by which a pharmaceutical company identifies its drug.

A generic drug name a chemical name not protected by a company’s trademark.

Question 4

Name common routes for medications administrations.

Answer 4

• Oral Route
• Topical Route
• Inhalant Route
• Parenteral Route

Question 5

Describe the oral route and general forms of medication administered this way.

Answer 5

The oral route (the administration of drugs by swallowing or instillation through an enteral tube) facilitates drug absorption through the gastrointestinal tract.

Medications administered by the oral route come in both solid and liquid forms.

Question 6

Explain the purpose of a medication record.

Answer 6

Medication Administration Record; agency form used to document drug administration).

Use of the MAR ensures timely and safe medication administration.

Regardless of the type, all MARs provide a space for documenting when a drug is given, along with a place for the signature, title, and initials of each nurse who administers a medication or documenting the nurse who administers the medication automatically when barcodes are scanned electronically.

The MAR being used is usually kept separate from the client’s medical record, but it eventually becomes a permanent part of it.

Question 7

Name ways drugs are supplied.

Answer 7

• Individual Supply
  
  • a container with enough of the prescribed drug for several days or weeks, which is common in long-term care facilities such as nursing homes
• Unit-Dose Supply
  
  • A self-contained packet that holds one tablet or capsule.
• Automated Medication-Dispensing Systems
  
  • These systems usually contain frequently used medications for that unit, any as-needed (p.r.n.) medications, controlled drugs, and emergency medications.

Question 8

Give the formula for calculating a drug dose.

Answer 8

Desired dose / Dose on hand (Supplied dose) X Quantity

Question 9

Discuss nursing responsibilities that apply to the administration of opioids.

Answer 9

• Because controlled substances are usually delivered by stock supply, nurses are responsible for an accurate account of their use.
• They keep a record of each drug used from the stock supply.
• Nurses count controlled substances regularly, usually at each change of shift.
• One nurse counts the number in the supply, while another checks the record of their administration or amounts that have been wasted.
• Both counts must agree with inconsistencies accounted for as soon as possible.

Question 10

Name the five “rights” of medication administration.

Answer 10

1. Right Drug
2. Right Dose
3. Right Route
4. Right Time
5. Right Client

Question 11

Discuss guidelines that apply to the safe administration of medications.

Answer 11

• Prepare medications under well-lit conditions.
  
  • Light improves the ability to read labels accurately.
• Work alone without interruptions and distractions.
  
  • This promotes concentration.
• Check the label of the drug container three times:
  
  • When reaching for the medication,
  • Just before placing the medication into an administration cup, and
  • When returning the medication to the client’s drawer.
• Checking ensures attention to important information.
• Avoid using medications from containers with a missing or obliterated label.
  
  • This eliminates speculating on the drug name or dose.
• Return medications with dubious or obscured labels to the pharmacy.
  
  • This step facilitates replacement or new labeling.
• Never transfer medications from one container to another.
  
  • Such transfers could lead to mismatching contents.
• Check the expiration dates on liquid medications.
  
  • Doing so ensures administration at desired potency.
• Inspect the medication and reject any that appear to be decomposing.
  
  • This step promotes appropriate absorption.

Question 12

Discuss points to stress when teaching clients about taking medications.

Answer 12

• Inform the prescriber of all other drugs that you are currently taking.
• Have prescriptions filled at the same pharmacy so that the pharmacist can spot any potential drug interactions.
• Consider asking for a new prescription to be partially filled.
  
  • This provides an opportunity to evaluate the drug’s effect and side effects before purchasing the full amount.
• Read and follow the label directions carefully.
• Take the prescription medication for the full time that it has been prescribed.
• Check with the prescriber before combining nonprescription and prescription drugs.
• Dispose of old prescription drugs and outdated over-the-counter medications; they tend to disintegrate or change in potency.
• Consult with the prescriber if a drug does not relieve symptoms or causes additional discomfort.
• Ask the prescriber or pharmacist whether it is appropriate to take specific medications with food or on an empty stomach.
• Drink a liberal amount of water or other fluids each day to assist with the appropriate absorption and elimination of drugs.
• Do not take drugs prescribed for someone else, even if your symptoms are similar.
• Wear a MedicAlert tag if you are taking prescription drugs on a regular and long-term basis.
• Use a pill organizer if you have trouble remembering whether you took a medication.

Question 13

Explain the circumstances involved in giving oral medications by an enteral tube and commonly associated problem.

Answer 13

When a client cannot swallow oral medications, they can be instilled by enteral tube.

Some drugs may physically interact with the components in the formula, causing it to curdle or otherwise change its consistency.

A slow infusion would alter the rate of absorption of the drug.

Question 14

Describe appropriate actions in the event of a medication error.

Answer 14

• As soon as an error is recognized, the nurse checks the client’s condition and reports the mistake to the prescriber and the supervising nurse immediately.
• Health care agencies have a form for reporting medication errors, called an incident sheet or accident sheet
• The incident sheet is not a part of the client’s permanent record, nor does the nurse make any reference in the chart to the fact that he or she has completed an incident sheet.
• The completed incident report is generally reviewed by the agency’s risk management committee
  
  • The purpose of the incident sheet is to understand the circumstances surrounding the error and prevent them in the future
  • It is not intended to accuse or blame the involved health care provider.
  • The desired outcome is to ensure the safety of clients and identify ways to prevent a similar reoccurrence.
  • However, if the same person makes repeated errors, the agency may recommend a period of retraining or supervision.

Question 15

Medications are ____________ substances that change body function.

Answer 15

Chemical

Question 16

A(n) ____________ tablet is convenient when only part of a tablet is needed.

Answer 16

Scored

Question 17

____________ orders are instructions for client care that are given during face-to-face conversations.

Answer 17

Verbal

Question 18

Decreased blood albumin levels reduce ____________ binding of medications.

Answer 18

Protein

Question 19

Older people taking more than one medication are more likely to develop ____________ changes as an early and common sign of adverse effects.

Answer 19

Mental

Question 20

____________ therapists are helpful in evaluating dysphagia and recommending safe and effective methods of administering oral medications.

Answer 20

Speech

Question 21

____________ name is the chemical name not protected by a company’s trademark.

Answer 21

Generic

Question 22

The oral route facilitates drug absorption through the ____________ tract.

Answer 22

Gastrointestinal

Question 23

A(n) ____________ supply remains on the nursing unit for use in an emergency so that a nurse can give a drug without delay.

Answer 23

Stock

Question 24

The nurse accesses the computerized system by using a(n) ____________ and then selects the appropriate choice from a computerized menu.

Answer 24

Password

Question 25

Identify the figure shown here.

Answer 25

The figure shows unit dose medication

Question 26

What is the purpose of this method of supplying medications?

Answer 26

A unit dose supply, a self-contained packet that holds one tablet or capsule, is most common in acute care hospitals that stock drugs for individual clients several times in 1 day.

Question 27

The name by which a pharmaceutical company identifies its drug.

Answer 27

Trade Name

Question 28

Administration of drugs by swallowing or instillation through an enteral tube

Answer 28

Oral Route

Question 29

Solid drug covered with a substance that dissolves beyond the stomach

Answer 29

Enteric-coated tablets

Question 30

Agency form used to document drug administration

Answer 30

Medication administration record

Question 31

A simple-to-use medication management system

Answer 31

Pill organizer

Question 32

What is meant by frequency of drug administration?

Answer 32

The frequency of drug administration refers to how often and how regularly the medication is to be given.

Frequency of administration is written using standard abbreviations of Latin origin.

Question 33

What are the components of a medical order?

Answer 33

All medication orders have seven components:

• The client’s name, date
• Time the order is written
• Drug name
• Dose to be administered
• Route of administration
• Frequency of administration
• Signature of the person ordering the drug.

If any one of these components is absent, the nurse must withhold the drug until they have obtained the missing information.

Question 34

What is the importance of health teaching with regard to the administration of medication?

Answer 34

Health teaching is especially important before discharge because the client often receives prescriptions for oral medications.

Providing health teaching helps to ensure that clients administer their own medications safely and remain compliant.

Compliance means that the client follows instructions for medication administration.

Even clients who purchase over-the-counter medications may benefit from instruction.

Question 35

Why is the client’s medication not added to the formula during tube feeding?

Answer 35

Nurses can give medications while a client is receiving tube feedings, but they instill the medications separately—that is, they do not add the medications to the formula.

This is done for two reasons.

• First, some drugs may physically interact with the components in the formula, causing it to curdle or otherwise change its consistency.
• Also, a slow infusion would alter the drug’s dose and rate of absorption.

Question 36

How does the computerized documentation of medication help at the health care agency?

Answer 36

Health agencies are using computerized medication documentation, which involves scanning bar codes on the medication container, the medication administration record (MAR), and the client’s ID bracelet, before administering each drug.

The computer validates that the nurse is about to give the right dose of the right drug, through the right route, at the right time, and to the right client.

The computer also documents the drug’s administration based on a password provided by the nurse.

Question 37

What should the nurse do when a medication error occurs?

Answer 37

As soon as the nurse recognizes a medication error, they check the client’s condition and reports the mistake to the prescriber and supervising nurse immediately.

Health care agencies have a form for reporting medication errors called an incident sheet or accident sheet.

The incident sheet is not a part of the client’s permanent record nor does the nurse make any reference in the chart to the fact that they have completed an incident sheet.

Question 38

A nurse is providing health teaching with regard to the administration of medication for a senior client who is being discharged from the health care facility.

What should the nurse do if the senior client is having difficulty comprehending information about the medication routines?

Answer 38

If an older person has difficulty comprehending information about medication routines, the nurse should include a second responsible person in the discharge instructions to ensure client safety.

A referral for skilled nursing visits is appropriate for homebound older adults who need additional instructions about medication routines after discharge.

Question 39

A nurse is providing health teaching with regard to the administration of medication for a senior client who is being discharged from the health care facility.

What should the nurse include in the health teaching for this client?

Answer 39

Education regarding medications must include:

• A visual description of the drug;
• Action, dose, and time of administration;
• Instruction whether food or liquid should accompany administration
• A list of potential side effects
• A telephone number for a health care provider to contact should side effects occur.