Chapter 10 - Med. Administration - book notes Flashcards
What are the consequences of medication errors?
- can be harmful & threatening to a life of a client
- increased hospital stay
- acute or chronic disability or even death
- may affect nurse both emotionally & professionally, loss of position, legal consequences, or loss of license to practice
What is the most common causes of client injury?
- medication errors - errors most prevalent in infants & children - where dosages are calculated by body weight or body surface areas
errors occurring because of lack of education concerning over-the-counter drug use and interactions with prescribed medications
What are causes of medication errors?
- lack of information about the client (allergies, other medications the client is taking)
- lack of information about the drug
- communication & teamwork failures
- unclear, absent, or look-alike drug labels & packages & confusing or look-alike or sound-alike drug names
- unsafe drug standardization, storage, & distribution
- nonstandard, flawed, or unsafe medication delivery devices
- errors in mathematical calculation of dosages, incomplete orders, failure to observe the 6 “right” of medication administration when administering medications, failure to identify a client accurately & miscommunication of orders (poor handwriting, misuse of zeros & decimal points, confusion of metric & other dosing units & inappropriate abbreviations
What are some other contributing factors to medication errors?
- failure to educate clients properly about medications they are taking, administrations of medications without critical thought, and failure to comply with the required policy or procedure related to medication administration.
- high-alert medications
What is the best solution to the problem of medication errors is what…?
prevention
- need meticulous planning and implement the task properly, paying close attention to detail
What should a nurse know about medication?
the action, uses, side effects, expected response, and range of dosage for the medication being administered.
Also, knowing the activity, indications, and contraindications of the full range of medications
Nurses must use the nursing process when administering medications. This process is what..?
assessment, nurse diagnosis, planning, implementation, evaluation, and teaching clients a out safe administration
What is critical thinking?
a process of thinking that includes being reasonable and rational
What skills does critical thinking encompass that is relevant to medical administration?
- the ability to identify an organized approach to the task at hand
- the ability to be an autonomous thinker (challenging a medication order that is written incorrectly)
- the ability to distinguish irrelevant information from that which is relevant
- involves reasoning and the application of concepts (choosing the correct type of syringe to administer dosage)
- asking for clarification
- checking the accuracy and reliability of information
- the ability to validate information
What are the factors that influence drug dosages and action?
- route of administration
- time of administration
- age of the client
- nutritional status of the client
- absorption and excretion of the drug
- health status of the client
- gender of the client
- ethnicity and culture of the client
- genetics
What are the 6 rights of medication administration that serve as a guideline?
- the right medication
- the right dosage
- the right client
- the right route
- the right time
- the right documentation
How many times should a medication be checked and when should it be checked?
three times
before preparing, after preparing, and before replacing the container
What is used as identifiers for identifying a client?
name, client’s armband, birth date, identification number
Never chart a medication as given before..?
administering it or without documentation as to why it was not given
A client has the right to refuse medication and if they do a nurse should..?
make appropriate persons aware of refusal
The right to refuse may be denied to a client who has a mental health issue (danger to self and/or others
What is Kendra’s Law?
it is legislation designed to protect the public and individuals living with mental illness by ensuring that potentially dangerous mentally ill outpatients are safely and effectively treated
- it is court-ordered assisted outpatient treatment
What is responsible for up to 50% of all medication errors & 20% of adverse drug events in the hospital?
poor communication about medications at transition points (admission, transfer, and discharge)
In the context of the goal (National Patient Safety goal) what is reconciliation?
the process of comparing the medications that the client/patient/resident has been taking before the time of admission or entry into a new setting with the medications that the organization is about to provide
What is the purpose of reconciliation (Patient Safety goal) is…?
to avoid errors of transcription, omission, duplication of therapy, or drug-drug & drug-disease interactions
What is one of the most important nursing functions?
teaching the client
To ensure that the client takes the right medication in the right dosage, by the right route at the right time, client education should include…?
1- both the brand and generic names of the medication(s) being taken
2- clear explanation of the amount of the medication to be taken
3- clear explanation of when to take medication
4 - clear demonstration of measuring oral dosages, such as liquids
5 - clear explanation of the route of administration
Medications come in several forms for administration, what are they?
1- oral
2- sublingual (SL) - medications are placed under the tongue - should not be swallowed - absorbed from blood vessels of the cheek
3 - buccal -placed in mouth against the cheek - do not chew or swallow the medication - do not take any liquids with it
4 - parenteral routes include intravenous (IV), intramuscular (IM), subcutaneous (subcut), and intradermal (ID)
5 - insertion - medication is placed into a body cavity, where the medication dissolves at body temperature (suppositories) -vaginal medications, creams, and tablets may also be inserted by using special applicators
6 - instillation - medication is introduced in liquid form into a body cavity - eye, nose, ear
7 - inhalation
8 - intranasal
9 - topical - (percutaneous - applied to the skin, transdermal - patch or disk and applied topically)
What equipment is used for medication administration?
- medicine cup - 30 mL or 1 oz med. cup
- souffle cup - small cup used for solid forms of med. such as tablets and capsules
- calibrated dropper
- nipple
- oral syringe
- parenteral syringe
A medicine cup has _________, __________, and ___________ measures on it.
metric, apothecary, and household
The ________ and _________ need special considerations regarding medication dosages
elderly and children
________ refers to the way in which a drug is administered.
Route
Children and the elderly usually require _______ dosages.
smaller
A _________ cup is used for dispensing solid forms of medication.
souffle
Application of medication to the external surface of the skin is referred to as the ________ route.
topical
Medication administration is a process that requires critical thinking and the nursing process, which includes?
- the ability to identify an organized approach to the task at hand
- the ability to be an autonomous thinker (challenging a medication order that is written incorrectly)
- the ability to distinguish irrelevant information from that which is relevant
- involves reasoning and the application of concepts (choosing the correct type of syringe to administer dosage)
- asking for clarification
- checking the accuracy and reliability of information
- the ability to validate information
Being an autonomous thinker is an example of __________?
critical thinking
_____________ droppers should be used for medication administration
calibrated
When medications are placed next to the cheek, they are administered by the _________ route.
buccal
The Joint Commission requires that clients be identified using __________client identifiers, neither of which can be the ___________.
Two unique
I.e., name, birth date, identification number
