Med Administration & Dosage Calc (Exam 2) Flashcards
What are ways to prevent medication errors (10)?
- Double check provider orders
- Check the Medication Administration Record (MAR)
- Look up ALL medications before administering!
- Read drug insert and contact pharmacist for any questions
- Check with clinical instructor
- Contact healthcare provider and charge nurse if still unsure
- Follow facility guidelines
- Never give meds you didn’t prepare yourself
- Follow the rights of safe med administration
- Follow up
How many times should you check medications before the patient takes them?
3 times! Before preparing, after preparing, and by client bedside before administering
Should you know your patients history, labs, and assess them before administering medication?
Yes! Also reassess and document afterwards
What do you need to know when looking up meds (7)?
- Drug name
- Action (what does it do?)
- Onset (how quickly does it work?)
- Side effects (common)
- Contraindications (focus only on ones that may affect patient)
- Nursing interventions (how do you handle/assess patient before/after admin with the medication?)
- Down and dirty report
What should you do for patients cleared for oral medications that have difficulty swallowing?
- Cut pills if scored
- Crush if able
- Mix with thickened liquids like applesauce
- Check to see if drug comes in a liquid form (check with pharmacy then healthcare provider)
What should you consider for topicals/dermals/injections?
check skin integrity
Should you consider the mental status of a patient before administering medication?
Yes! could be cognitive impairment
Examples of oral medications of POs
pills (tablets, capsules, “meltaways”-troche, buccal, sublingual)
syrups, liquids, elixirs, etc. (NEED TO BE PRECISE)
MOST COMMON FORM
What are some things to know when administering nitroglycerin?
- Check vitals (HR AND BP) BEFORE AND AFTER each dose and OLDCARTS
- 1 SL tab EVERY 5 MIN. for a MAX OF 3 DOSES
- MUST WEAR GLOVES!!!!
- Make sure patient hasn’t taken Cialis/Viagra or other ED meds cause they lower BP
- Hold med if pt HR is below 60 or SBP is below 90
- Warn pt of terrible headache side effect
- Med is SL, meaning they need to hold it under tongue and now chew or swallow it
Topical/Dermal/Patches
patches are clear or flesh colored (remove old one before applying new one)
ointments, creams, sprays, powders
ASSESS SKIN BEFORE AND AFTER
WEAR GLOVES!!!
Ophthalmic Meds
make sure dropper doesn’t touch, keep it sterile
SINGLE USE
pull eyelid down making a pocket with knuckle, block nasolacrimal duct for 30-60 sec (CONJUNCTIVAL SAC)
WEAR GLOVES
Otic Meds
if eardrum isn’t intact (ruptured tympanic membrane) it’s sterile but otherwise CLEAN
USE SOLUTIONS AT ROOM TEMP (too cold leads to dizziness)
push on tragus to instill meds
Vaginal suppositories
irrigations (douches), foams, gels, creams, tablets
KEEP REFRIGERATED TO AVOID MELTING
BE GENEROUS WITH LUBE (4 in.)
if they can do it themselves, let them!
Rectal suppositories
irrigations (enemas)
patient to hold for at least 5 min.
KEEP REFRIGERATED TO AVOID MELTING
BE GENEROUS WITH LUBE (4 in.)
if they can do it themselves, let them!
DPI (Dry Powder Inhalers) contain..
powder capsules
monitor patient for side effects after administration
MDI (Metered Dose Inhaler) contains…
aerosolized meds
monitor patient for side effects after administering
How to administer MDI meds?
- Have patient seal lips around inhaler mouthpiece
- Have pt exhale, then push down on inhaler when taking deep breath
- Hold breath for 10 sec.
- If more than one puff ordered, give patient a rest of 1 min. between breaths
- Have patient rinse mouth
What are intradermal injections?
injection into the dermis layer beneath skins surface
ONLY VERY SMALL AMOUNTS- 0.1 mL
EX. TUBERCULIN SYRINGE, ALLERGY TESTING
How to administer intradermal injections?
- Small 1mL syringe, fine gauge 26-28 G needle
- Insert at 5-15° angle
Sites: forearms, upper chest, upper back
How to administer subcutaneous injections?
- Use a 0.5 mL-3mL syringe, 25-30 G
needle that’s 3/8-1 in. in length - 45-90° angle unless very thin needle
MAX INJECTION AMOUNT IS 1 mL
Sites: back of upper arm, abdomen, upper back, lower back, top of thighs
if more than 2-in. pinch, use longer needle
