Med Administration Flashcards
What can med errors cause?
Death
Life threatening situations
Hospitalization
Disabilities
Birth defects
What are most med errors?
Wrong dosages
What are nurses considered for pt safety and why?
Last line of defense, we are the last people who can catch any errors made by: pharmacies, doctors, or even other nurses
When are likely times that there can be a med error?
- Ordering/Prescribing
- Transcribing
- Dispensing
- Administering
- Monitoring
What are 10 types of med errors?
Wrong pt
wrong drug
wrong route
wrong time
wrong dose
wrong dose form
wrong technique
deteriorated drug error
compliance
wrong documentation
Factors of med errors and what can cause them?
Provider/Pharm/Nurse
- Distraction
- Comm.
- Lack of training
- Inadequate knowledge on pt or drug
- Too tired
- Health issues or stress
Patients
- Personality
- Literact
- Language
- Health condition
- Polypharmacy
- Inconsistent method
Communication
- Names
- Handwriting
- Verbal order
- Labeling
How can we reduce med errors?
- Pt and family must be knowledgeable and well informed through nurse education
- Pt must be present and always willing to improve and work
What is there no place for in nursing?
Complacency
- You may forget or take shortcuts that can cause harm
What causes high alert for med errors?
Name similarities
WHEN an error occurs, what’s the priority?
Assess/monitor pt for adverse reaction
Notify the charge nurse
Contact physician
Complete incident report
What are 6 things nurses MUST know?
Med pros and cons
PT allergies
How to calc med doses
Factors of pt response
Nursing Process
NPA
If you don’t know who is going to be held responsible during a med error, who can you safely assume?
You
What are some responsabilities of pt’s?
- Understand treatment and ask questions
- Stick to the regiment
- Avoid to misuse
- Report adverse reactions
- Store meds safely
What does the pt have the right to be informed of?
Drug name
Dosage
Reason for drug
Frequency
Route
Potential Adverse Reaction
What does the pt have the right for?
Receive labeled meds
Receive meds properly
Not to receive unnecessary meds
Refuse meds
Components of a good med orders?
Pt name
Date and time
Name of med
Dosage
Route
Time and frequency
Signature
Some musts when taking verbal/phone orders?
Avoid abbreviations as much as possible
Read and spell back
Provider must approve in 24h
What are the 7 rights?
Right:
pt: 2 identifiers
med: check label
dose
time
route
reason
documentation: eMAR
What is diversion?
Use of drugs for reasons other than their original purpose
How to properly dispose of a narcotic?
ALWAYS have a witnessing other RN
Consequences of Med diversion
3 day suspension
Termination if necessary
Peer review
BNE report
Loss of RN license
TPAPN
3 main pharm concepts?
Med names
Classification
Med forms
Adverse drug reaction
Unintended and undesired effects at normal drug dose
Difference between Toxicity and Allergic reactions
Toxicity: Excessive drug dosing
Allergic: Immune response based
Types of adverse reactions
Idiosyncratic: Due to genetics
Paradoxical: Opposite effect of intended
Iatrogenic: Disease caused by drug
Teratogenic: Caused birth defects
Physical Dependence: Body adapted to drug exposure (Addiction)
How to identify ADR?
Symptoms start shortly after drug use?
Symptoms leave after drug discontinued?
Symptoms reappear after drug given again?
Ways to minimize ADR
Education
Early ID’ing
Monitoring
Black Box Warning
Types of modified releasing of drugs?
Delayed
Extended: Controlled to work over long periods of time
Oral
When should you avoid PO meds?
Change in LOC
NPO status
Altered GI function(NG Tube or N&V)
Dysphagia
What 6 types meds to you NOT crush split or chew?
Enteric coated
Sustained Release
Time Release
Controlled delivery
Sublingual
Buccal
Where can you apply topical meds?
Skin
Eye
Ear
Vagina
Rectum
Types of topical meds
Powders
Creams/paste/gel/ointment
Grops
Sprays
Patches
Suppositories
What should you do before applying topical meds?
Clean area and present it well
What can you NOT do to MOST transdermal patches?
DONT CUT them
When do you need to remove transdermal patches?
MRI’s and AED’s
When giving rectal meds, what position is needed, and what do you need to use and do?
Lay them sideways(SIMS)
Use lubricant
Relax pt to make insertion easier
What position is needed for giving vaginal meds?
Lithoyomy
If you want to clean ear out before administering meds, what must you do?
Ask physician and make sure they allow it
2 common types of inhalants?
Metered dose(MDI) or Dry Powder (DPI)
Who are spacer inhalants mostly for? And what do they do?
Children
Reduce med effects
How many times do you shake an MDI?
5-6
How do you properly use a MDI?
Deep breath then exhale
Tilt head back slightly
Puff one time
Breath slowly
Hold breath for 5-10 secs
Wait 1 min
Rinse mouth
How does a DPI differ from MDI?
Don’t tilt it
quickly inhale and hold
Mostly for at home use, rare in hospitals
Components of a Drug label (7)
Exp date
Lot number
Drug form
Manufacturer
Generic Name
Brand Name
Dosage
What do you need to teach for meds
Name
Dosage
Route
Frequency
Reason
Possible side effects
