Med Admin Flashcards
Medication Errors can lead to
-deaths
-life threatening situations
-hospitalization
-disabilities
-birth defects
Points of medication error- when
-Ordering/Prescribing
-Transcribing
-Dispensing
-Administering
-Monitoring
Types of medication errors- What
Wrong:
-patient
-drug
-route
-time
-dose/omitted dose
-dosage form
-technique
-documentation
-compliance
Black box warning
Alert of increased risk- may result in death or serious injury
Strictest labeling requirements FDA can mandate for prescription drugs
When an error occurs, what is your priority?
Assess/monitor patient continuously for adverse reactions
Notify charge nurse and physician
Complete incident report
Standing or routine
Administered until the dosage is changed or another medication is prescribed
Single (one-time)
Given once only for a specific reason
Now
When a medication is needed quickly, but not STAT
Range order
Medication order is written with dosage having a range
PRN/Contingency
Given when the patient requires it
STAT
Given immediately in an emergency and only once
Prescriptions
Medication to be taken outside of the hospital
7 rights
Right patient
Right medication
Right dose
Right time
Right route
Right reason
Right documentation
Right patient
Use two identifiers- name and DOB
Right medication
Check label for spelling, expiration date
Right dose
Know what the appropriate dose ranges are based on the route and patient
Right route
Know how the drug can and cannot be given, order determines route
Right time
Know medication schedules
Right reason
Is the order/medication appropriate
Right documentation
In the eMAR
Non-Parenteral Medications
-oral
-topical
-suppository
-eye drops/ointment
-ear drops/ointment
-inhalant
Toxicity
Severe Adverse Drug Reaction
-excessive drug dosing or therapeutic drug dosage
Idiosyncratic Effect
Uncommon drug response because of genetic disposition
Paradoxical effect
Opposite effect than drug was intended for
Iatrogenic effect
Disease caused by drug
Teratogenic effect
Causing birth defects
Adverse Reactions indentification
Thorough comprehensive assessment
-Did symptoms occur shortly after drug use?
-Did symptoms leave after drug discontinued?
-Did symptoms reappear when drug was reinstituted?
Ways to minimize adverse reactions
-Education (you & pt)
-Early identification (hourly rounding)
-Monitoring (lab values, signs/symptoms)
Oral (PO)
-Tablets/caplets/capsules
-Modified release
-Syrups
-Suspensions
Modified release
Delayed release- enteric coated
Extended release- controlled release, sustained release and long-acting
Oral disintegrating- disintegrates in mouth
Patient position for administering oral meds
Semi- High Fowler (30º or higher)
Avoid PO meds if
-Changes in LOC
-NPO status
-Altered GI function (NG tube, N/V)
-Dysphagia
PO Meds NOT to crush, split, or chew
-Enteric coated- EC
-Sustained release- SR
-Time released- TR
-Controlled delivery- CR
-Sublingual- SL
-Buccal
Where do you split pills?
At bedside
Types of topical meds
-Powders
-Creams/Pastes/Gel/Ointments
-Drops
-Aerosols/Sprays
-Medicated patches
-Suppositories
Avoid shaving when applying topical medications. Why?
Razorburn or cuts, use electric razor instead of
What to use when administering suppositories?
Water soluble lubricant
What position should the patient be in when giving vaginal medications?
Lithotomy
What position should patient be in for rectal suppositories?
Left lateral side-lying (SIMS)
Administering Inhalers
Shake 5-6 times. Deep breath then exhale, tilt head back slightly, depress canister x1 and then inhale slowly.
Verification Steps
- Acknowledge prescriber’s order(s)
- Check eMAR vs meds in Pyxis
- Check eMAR vs meds with patient at bedside
Components of Drug Label
-expiration date
-lot number
-drug form
-manufacturer
-generic name
-brand name
-dosage
What to teach for medications
-Name of med (brand & generic)
-dosage
-route
-frequency
-reason
-side effects
Don’t dilute meds
Unless ordered
Peg tube- long term use:
-Dysphagia
-Cancer/Radiation affecting GI tract
-Neurological deficits
-Bowel diseases/dysfunction
-Cranio-facial abnormalities, trauma
-Malnutrition
Tube placement confirmation
X-Ray = GOLD STANDARD for initial confirmation
-after initial confirmation,assess placement by tube measurement
Deviations
-An increase in length (pulled out): From intestines to stomach, from stomach into esophagus, from GI into lungs
-Decrease in length (pushed in): From stomach into intestine
