Lecture 8 - Medication Administration

Question 1

CNO’s Practice Standards for Medication Administration (3)

Answer 1

1. Authority
2. Competence
3. Safety

Question 2

Authority

Answer 2

nurses must have the necessary authority to perform medication practices
- nurses can accept orders for medication
administration that are clear, complete and
appropriate
- orders can be direct (one patient) or directives
(multiple) –> controlled substances require direct
orders

Question 3

Competence

Answer 3

nurses ensure that they have the knowledge, skill, and judgement needed to perform medication administration practices safely
- nurses must never perform medication practices that
they are not competent in

Question 4

Safety

Answer 4

nurses promote safe care, and contribute to a culture of safety within their practice environments when involved in medication practices

Question 5

Prescriber (role)

Answer 5

issues a legal authorization for a medication to be dispensed to a designated individual by writing or odering a prescription for a medication

Question 6

Pharmacist (role)

Answer 6

prepares, dispenses, labels, monitors, and evaluates the effects of prescribed medication

Question 7

Nurse (role)

Answer 7

administration of the medication to the client
needs to know:
1. what med is prescribed
2. medication purpose
3. appropriate dosages and routes
4. therapeutic and adverse effects
5. assessment and monitoring requirements
6. patient education needs
7. appropriate timing for administration

Question 8

Routine Medication Prescriptions

Answer 8

med administration orders that are carried out until canceled by:
a) writing a new prescription
b) the prescribed number of doses or days have elapsed
c) the medication stop date has passed

Question 9

PRN Prescriptions

Answer 9

medication is administered only when the patient requires it
- prescriber sets a minimum interval between doses
- prescriber sets a maximum dosage per day
- nurse documents assessment findings, evaluations
(effects) and dosages given

Question 10

One Time Prescriptions

Answer 10

a single dose of medication to be given one time only, at a specific time
- “on call” medications provided on the way to the OR

Question 11

STAT Prescription

Answer 11

a single dose of medication to be given immediately and only once
- usually in emergency situations

Question 12

NOW Order

Answer 12

a single dose of medication is to be administered within 90 minutes of order being given
- to be administered quickly, but not immediately (less
urgent)

Question 13

Prescription

Answer 13

medication orders given to patients to self-administer outside of the hospital setting

Question 14

10 Rights of Medication Administration

Answer 14

1. Right Medication
2. Right Dose
3. Right Patient
4. Right Route
5. Right Time and Frequency
6. Right Documentation
7. Right Reason
8. Right to Refuse
9. Right to Patient Education
10. Right Evaluation

Question 15

Right Medication

Answer 15

verification that the medication being prepared is the correct medication, and the correct one for the patient (according to prescription)
- administer ONLY medications that you prepare
- compare against patient record, prescription

Question 16

Right Medication: When to check

Answer 16

1) before removing the container from the storage location
2) when the medication prescribed is removed from the container
3) before returning the container to storage location

Question 17

Right Dose

Answer 17

medicine dosage calculations should be checked by another nurse prior to administration
- only scored medication can be broken
- crushed medication can be mixed with small amounts
of liquid or food (NOT the patient’s favourite food)

Question 18

Right Patient

Answer 18

verify patient’s full name and date of birth against their chart, name on the prescription, and patient bracelet prior to administration

Question 19

Right Route

Answer 19

the medication must be administered in compliance with the designated route of adminstration per the prescription
- if a designated route is not specified, consult with the
prescriber

Question 20

Right Time and Frequency

Answer 20

understand the designated administration frequency and schedule –> understand whether or not it can be altered
- routine, on call, pc, STAT NOW orders

Question 21

Right Documentation

Answer 21

accurate documentation to communicate:
- patient name and date of birth
- prescribed medication (written in full) –> time of
administration, dose, route and frequency
- accurate administration of the medication –> evaluate
effects

Question 22

Right Reason

Answer 22

verify medical rational for prescribed medication
- verify expected onset of action, effects, desired
responses
- verify the requirement of pre-administration and
follow-up nursing assessments

Question 23

Right to Refuse

Answer 23

ensure that the patient is aware of the medications being administered to them, and that they can make an informed decision to refuse
- patient must be informed of rights
- patient must be informed of consequences of refusal

Question 24

Right to Patient Education

Answer 24

patients need to be educated about their medications, desired effects, potential side effects, and consequences of medication refusal

Question 25

Right Evaluation

Answer 25

pre-administration and follow-up nursing assessments are vital to ensure that:
a) medications are given at the right time, for the right
reason
b) ensure administration is possible and is the correct
intervention
c) to monitor the effectiveness, adverse effects, and
signs of adverse reactions post administration

Question 26

Patient Rights (7)

Question 27

Medication Errors

Question 28

Assessment - Med Administration

Answer 28

the assessment is used to determine the appropriateness and safety of medication administration

Question 29

Nursing Diagnosis - Med Administration

Question 30

Planning - Med Administration

Question 31

Implementation - Med Administration

Question 32

Evaluation - Med Administration