Chapter 10 - Med. Administration - book notes

Question 1

What are the consequences of medication errors?

Answer 1

• 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

Question 2

What is the most common causes of client injury?

Answer 2

• 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

Question 3

What are causes of medication errors?

Answer 3

• 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

Question 4

What are some other contributing factors to medication errors?

Answer 4

• 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

Question 5

What is the best solution to the problem of medication errors is what…?

Answer 5

prevention

- need meticulous planning and implement the task properly, paying close attention to detail

Question 6

What should a nurse know about medication?

Answer 6

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

Question 7

Nurses must use the nursing process when administering medications. This process is what..?

Answer 7

assessment, nurse diagnosis, planning, implementation, evaluation, and teaching clients a out safe administration

Question 8

What is critical thinking?

Answer 8

a process of thinking that includes being reasonable and rational

Question 9

What skills does critical thinking encompass that is relevant to medical administration?

Answer 9

• 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

Question 10

What are the factors that influence drug dosages and action?

Answer 10

1. route of administration
2. time of administration
3. age of the client
4. nutritional status of the client
5. absorption and excretion of the drug
6. health status of the client
7. gender of the client
8. ethnicity and culture of the client
9. genetics

Question 11

What are the 6 rights of medication administration that serve as a guideline?

Answer 11

1. the right medication
2. the right dosage
3. the right client
4. the right route
5. the right time
6. the right documentation

Question 12

How many times should a medication be checked and when should it be checked?

Answer 12

three times

before preparing, after preparing, and before replacing the container

Question 13

What is used as identifiers for identifying a client?

Answer 13

name, client’s armband, birth date, identification number

Question 14

Never chart a medication as given before..?

Answer 14

administering it or without documentation as to why it was not given

Question 15

A client has the right to refuse medication and if they do a nurse should..?

Answer 15

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

Question 16

What is Kendra’s Law?

Answer 16

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

Question 17

What is responsible for up to 50% of all medication errors & 20% of adverse drug events in the hospital?

Answer 17

poor communication about medications at transition points (admission, transfer, and discharge)

Question 18

In the context of the goal (National Patient Safety goal) what is reconciliation?

Answer 18

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

Question 19

What is the purpose of reconciliation (Patient Safety goal) is…?

Answer 19

to avoid errors of transcription, omission, duplication of therapy, or drug-drug & drug-disease interactions

Question 20

What is one of the most important nursing functions?

Answer 20

teaching the client

Question 21

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…?

Answer 21

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

Question 22

Medications come in several forms for administration, what are they?

Answer 22

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)

Question 23

What equipment is used for medication administration?

Answer 23

• 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

Question 24

A medicine cup has _________, __________, and ___________ measures on it.

Answer 24

metric, apothecary, and household

Question 25

The ________ and _________ need special considerations regarding medication dosages

Answer 25

elderly and children

Question 26

________ refers to the way in which a drug is administered.

Answer 26

Route

Question 27

Children and the elderly usually require _______ dosages.

Answer 27

smaller

Question 28

A _________ cup is used for dispensing solid forms of medication.

Answer 28

souffle

Question 29

Application of medication to the external surface of the skin is referred to as the ________ route.

Answer 29

topical

Question 30

Medication administration is a process that requires critical thinking and the nursing process, which includes?

Answer 30

• 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

Question 31

Being an autonomous thinker is an example of __________?

Answer 31

critical thinking

Question 32

_____________ droppers should be used for medication administration

Answer 32

calibrated

Question 33

When medications are placed next to the cheek, they are administered by the _________ route.

Answer 33

buccal

Question 34

The Joint Commission requires that clients be identified using __________client identifiers, neither of which can be the ___________.

Answer 34

Two unique

I.e., name, birth date, identification number