chapter 3 (Medication Admistration) Flashcards
collection of patient data that affects drug therapy
assessment
oral tablet or capsule formulations that maintain consistent serum drug levels
controlled-release
form in which drugs are manufactured; includes elixirs, tablets, capsules, suppositories, parenteral drugs, and transdermal systems
dosage form
coating of a tablet or capsule that makes it insoluble in stomach
enteric-coated
determining a patient’s status in relation to stated goals and expected outcomes
evaluation
scientific evidence that yields the best practice in patient care
evidence-based practice
planned nursing activities performed on a patient’s behalf, including assessment, promotion of adherence to drug therapy, and solving problems related to drug therapy
interventions
list of perscription medications, over-the-counter medication, herbal supplements, or illegal substances taken by the patient (both current and past)
medication history
description of patient problems based on assessment data
nursing diagnosis
systematic way of gathering and using infrmation to plan provide individualized patient care
nursing process
injected administration; subcutaneous, intramuscular, or intravenous route
parenteral
expected outcomes of prescribed drug therapy
planning/goals
assist to ensure accuracy in drug therapy; rights include right drug, right dose, right patient, right route, right time, right reason, and right documentation
right of medication administration
application of drugs (e.g. solutions, ointments, creams, or suppositories) to skin or mucous memebranes
topical
absorption of drugs (e.g., skin patches) through skin
transdermal
forms in which drugs are manufactured vary according to the drugs chemical characteristics reason and rute of adminsistration some in or moreform in clude liquid, tablits, capsules
Dosage forms
tablets and capsules that are coated with a substance that is insoluble in stomach acid
enteric-coated
five rights
the basic requirements for accurare drug adminitration require knowledge of the drugs to be given and the pt who r receive them as well as specific nursing skills and interventions
parenteral
route of drug administration, injected
controlled release oral tablets or capsules slowly absorbed medication effects prolongrd usually12-24 hours contain relatively large amountsof active drug.
sustained release
application of drug to skin or mucus membrane
topical
absorption of drug through the skin
transdermal
FIVE RIGHTS
Right medication,Right dose,Right client,Right routeRight timeSixth “right”: Right documentation
Follow “rights” consistently
Learn essential information about medications to be passed
Interpret prescriber’s orders accurately
Read medication labels carefully
Minimize abbreviation use to prevent errors
Accurate Drug Administration Principles
Calculate doses accurately
Measure doses accurately
Use correct procedures and techniques for all administration routes
Learn about client’s diagnoses and condition in relation to medication administration
Accurate Drug Administration Principles (cont.)
Verify identity of clients before administering medications
Omit/delay doses as indicated by client’s condition and document accordingly
Be especially careful when administering medication to children due to high risk of medication error
Accurate Drug Administration Principles (cont.)
Nurses’ legal responsibilities
Safe, accurate medication administration
Recognizing and questioning erroneous orders
Refusing to administer unsafe medications
Delegating in compliance with the law
Common medication errors include
Common medication errors include
Giving an incorrect dose
Not giving an ordered medication
Giving an unordered medication
Medications often associated with errors includ
Insulin, heparin, warfarin
Medication ,Systems vary by healthcare facility
Unit-dose system
Computerized, locked cabinets
Additional security for controlled substances
Medication Orders inclued
Client’s full name
Name of the medication (brand, generic)
Dose, route, frequency of administration
Date, time, signature of prescriber
IM
intramuscular
IV
intravenous
PO
by mouth, oral
SL
sublingual
SubQ
subcutaneous
cc
cubic centimeter
g
gram
mg
milligram
mcg
microgram
mL
milliter
oz
ounce
tbsp
tablespoon
tsp
teaspoon
ad lib
as desired
PRN
as needed
q4h
every 4 hours
stat
immediately
Systemic medication forms include
Liquids
Tablets, capsules
Suppositories, transdermals
Injections ,pump dilvery system
given By mouth (PO)
Tablets
Capsules
Sublingual
What are Controlled release?
Why?
Enteric coated (to prevent stomach upset)
Maintain more consistent serum drug levels
Allow less frequent administration
More convenient for clients
Controlled release
Tablets, capsules
Contain high amount of drug
Intended to be absorbed slowly over prolonged period of time
Should never be broken, open, crushed, chewed
Systemic absorption through skin
Transdermal
External or implanted
Refillable or long-acting without refills
Insulin, opioid analgesics, anticancer medication
Pump delivery systems
Solutions
Creams
Suppositories
Frequently used for local treatment
Topical
Mathematic abilities
Knowledge of common units of measurement
Knowing how to use data in performing calculations
Calculating Medication Dosages
How do you Calculate Medication Dosages
D = desired dose (dose ordered, often in mg)
H = available dose (on drug label, often in mg per tablet/capsule/mL)
X = unknown (# of tablets/capsules/mL)
V = volume or unit
injected is
Parenteral
Routes of Administration
Oral (by mouth) Parenteral (injected) Subcutaneous (SubQ) Intramuscular (IM) Intravenous (IV) Topical (applied to skin or mucous membrane
___Must be prepared, packaged, and administered maintaining sterility
Typical medication containers
Vials (single- or multiple-dose)
Ampules
Prefilled syringes with attached needles
Medications for Injection
\_\_\_\_must be Sterile needles Various gauges (lumen size) Larger number = smaller lumen Various lengths, use depends on Route of administration Thickness (viscosity) of solution Size of the client
Equipment for Injections
____have been Developed to prevent injury and the spread of bloodborne pathogens
SYRINGES Calibrated to measure doses accurately
Insulin, tuberculin syringes for small doses
Needleless systems
SubQ common sites
SubQ common sites
Upper arms, abdomen, back, thighs
IM common sites
Deltoid, dorsogluteal, ventrogluteal, vastus lateralis muscles
IV common sites
Back of hands, forearms
Intradermal goes ____
Intradermal
Intra-arterial goes ____
into arteries
who performs Intra-articular (into joints)
Intrathecal (into spinal fluid)
Physicians must perform
