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Pharmacology > Med Administration Part 1 > Flashcards

Med Administration Part 1 Flashcards

1
Q

Role of the nurse in med admin?

A
  • Last line of defense
  • Nurses are responsible for own actions
  • Assess patients know what meds they are on
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2
Q

What is Medication Reconciliation?

A

The process of checking what meds the patient takes at home already vs. what they take in hospital

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3
Q

What are the 7 components of a medication order?

A
  • Name of order, date & time of order, name of med, dosage, route, time, frequency, signature
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4
Q

Who can write orders?

A
  • Physicians, PA’s, and APRNs
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5
Q

Written order?

A

-Computerized orders increases safety with built in clinical tools

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6
Q

Verbal order?

A

-occasional, only done in clinical situation

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7
Q

Telephone order?

A

-occasional over the phone

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8
Q

Protocols

A

-nurses can initiate right away don’t need to notify a provider

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9
Q

Read back verbal order

A
  • done for accuracy
  • repeating an order that is given verbally in person or over the phone
  • It is done to ensure accuracy
  • Write down order first, read back what you wrote
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10
Q

STAT order

A
  • admin immediately!
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11
Q

Routine

A

-Continuous admin of medication until they are discontinued

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12
Q

One Time

A
  • admin one time only
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13
Q

NOW

A

-not an emergency order but needs to be admin soon!

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14
Q

PRN

A

-As needed within time interval and indication with order

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15
Q

Steps of Administration

A
  • Provider orders a medication
  • Checked by pharmacy
  • Checked by RN: verify for allergies, contraindications?
  • Prep and assess
  • wash hands
  • assemble meds in medication room / mobile med cart
  • Remove the meds from the drawer
  • Do checks against MAR
  • Prepare on med at a time
  • leave meds in package
  • use appropriate measuring devices
  • label syringes
  • Check MAR by bedside
  • ask about allergies
  • open packages while performing pt education
  • Administer meds in high fowlers position
  • Document in MAR
  • Monitor for Effect
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16
Q

What info do you need to know before giving a drug?

A
  • Be familiar with the drug guide

- know action of mechanism, indication, dose range, normal route, ADRs, contraindication, interactions,

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17
Q

What to Physically assess

A
  • are they alert?
  • ability to swallow
  • need to crush meds
  • NPO or NPO except meds?
  • Ability to follow instructions
  • Gi motility
  • Muscle mass
  • Water at bedside
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18
Q

What are some assessment data?

A

BP (HTN med)-
Pulse (cardiac drugs)-
Pain rating( pain med)
Temp?

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19
Q

What is the time frame for administering drugs?

A

30 min before and 30 min after

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20
Q

What labs may be important to check

A

Drug levels, Electrolytes, other lab values

21
Q

What are two places you can find drugs?

A

Mobile Cart: Locked cassettes/ drawers for each patient

PYXIS: automated medication dispensing system

22
Q

What to do for drugs that can be self- administered?

A

order and checked by pharmacist - send med to pharmacy

- it is more common to bring meds from home

23
Q

Controlled substances

A
  • locked with limited access
  • medication counted before removal and tally kept
  • Waste of meds needs to observed and documented by another nurse
  • Inventory done by 2 nurses at set intervals
24
Q

When do you check do your 3 checks?

A
  • against MAR before med prep
  • against MAR after med prep
  • at the bedside
25
Q

What are the 5 rights?

A

Right drug, right patient, right dose, right route, right time

26
Q

Right Patient

A
  • have the patient state their name and date of birth

- compare with armband and medical record

27
Q

Right Drug

A
  • Compare drug to MAR
  • Not expiration date
  • Know indication
  • Know nursing considerations
28
Q

Right dose

A
  • Validate calculations of divided doses with another nurse
  • Check high alert meds with another nurse
  • Know the usual dose and question any dose outside the safe range (more concern for toxicity)
29
Q

Right Route

A
  • Right route or method of admin

- If a change in route is needed, request a new order from physician

30
Q

Right Time

A
  • Medication 30 min before or 30 mins after
  • May differ at different facilities
  • Know the last time of administration for any PRN drug
31
Q

What happens if a client refuses a drug?

A

Document reason

32
Q

What to document after admin?

A

Time administered, document client response, document especially for PRN meds and first time a new med is ordered

33
Q

What happens if you make an med error?

A
  • Assess the patient first
  • Notify the provider
  • Notify the nurse manager
  • Quality Assurance
34
Q

You only crush a med that is….

A
  • not an extended release, controlled release, enteric coated
35
Q

T/F capsules can be split

A

False

36
Q

How to admin a oral med?

A
  • Place into paper cup/without touching med
  • May use pudding or apple sauce if patient has trouble swallowing
  • Stay with patient until all medications are taken
37
Q

Forms of oral meds

A
  • Elixir, capsule, pill ,tablet, time released, troche, suspension, powder
38
Q

With liquid meds…..

A
  • Hold med so medication doesn’t spill on label
  • measure at eye level
  • may draw up syringe but only admin if they are special “oral” syringe
39
Q

Buccal

A
  • med goes between cheek and teeth
40
Q

Sublingual

A
  • underneath the tongue
41
Q

Lozenge

A
  • Dissolve in mouth
42
Q

Topical

A
  • Make sure previous dose is removed before applying new ones
  • apply patches to non-hairy intact areas of the body
  • make sure not to touch topical meds with ungloved hands
43
Q

optic

A
  • instruct patient to look toward ceiling
  • make a pouch in the lower lid by pulling skin downward over bony orbit
  • instill in conjunctival pouch
  • Clean/dry from inner to outer canthus
  • needs to be a waiting time between drops
44
Q

Otic

A
  • Have patient side lying
  • Straigten ear canal
  • In adults pull ear up and back
  • in kids under 3 down and back
  • make sure drops are room temp
45
Q

Nasal

A
  • Head down and forward
46
Q

inhalant route

A
  • MDI (meter dose inhalant): coordinated way for use. Breathe out and then inhale slow and steady, push and inhale same time. Hold breath and exhale slowly. Wait a min btwn puffs
  • Spacer: Don’t have to coordinate, get a higher % of drug with each inhalation
  • Nebulize: aerolized air given by handheld or face mask
47
Q

Eneteral

A
  • Use liquid form
  • crush pills individually and mix with 15-30 mL of water have it sit there
  • If med should be given, stop tube feeding 15-30 min before and after med admin
  • Check tube placement first look at external tube length
  • flush with water check for patency
  • admin med
  • flush with water
  • flush with water is last step and is more than other flushes
  • make sure it is counted in I &O count
  • Check with provider before first pass of med and inital hold of enteral feeding
  • tube feeding is pause only if med needs to be given on empty stomach
48
Q

Vaginal

A
  • Lubricate
  • put patient in dorsal recumbent or Sims position
  • stay in position 15-20 mins after
49
Q

Rectal

A
  • Enema or suppository’s
  • Sims position
  • Lubricate
  • stay in position and hold it for bowel function (if taken for bowel fxn)
  • rectum will suck in suppository

Pharmacology (14 decks)

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