Med Tech Day 1 Flashcards
4 rules of medication administration
- Unlicensed people can only administer medication AFTER completing MTTP and receiving certification from MBON.
- Only the RN, case manager delegating nurse may delegate medical administration to a CMT
- All medications must have a PMOF (doctors order) and pharmacy label.
- All OTC meds must have a PMOF (doctors order) and pharmacy label.
2 things ALL medications must have? Prescription and OTC meds
- A PMOF (doctors order)
2. Pharmacy label
What is needed before someone can administer medication.
MTTP certification and certificate from MBON
Who delegates medication administration to a CMT?
RN (registered nurse or a case manager delegating nurse (RM CM or DN)
8 components of medication administration cycle
- Observe for changes
- Report observations
- Assist with visits to HCP
- Obtain medications
- Store meds correctly
- Administer meds correctly
- Ensure meds are taken correctly.
- Document promptly/correctly
Reasons medications are used (4)
- To Cure
- To prevent
- To manage (disease or symptoms)
- To relieve symptoms
How to ensure personal rights, privacy, dignity?
Do not hang signs on wall. Do not line people up Offer privacy Address by name Support Self-medication as appropriate
Does the individual (guardian) have the right to refuse treatment? Y/N
Yes
What do you do if individual refuses medication?
Ask why? Overcome (discuss) objections. Educate why med is important. Report to nurse and supervisor. Document in MAR
Behavior modifying meds may be used as a substitute for programming? T/F
False
What do you do If there is a change in the physical or behavioral condition of an individual?
Call the RN
NOTATE
3 effects of medication
- Desired effect - medication is working.
- Unwanted/adverse effect - something unexpected happened.
- No apparent effect - nothing happened or med doesn’t seem to be working.
What is important to remember about drug interactions?
The more the meds the higher the chance of drug interactions.
Each medication you add increases likelihood of drug interactions.
*know the baseline of the individual.
Define: Objective
You can see it, touch it, measure it
Define: Subjective
Something that is not seen or measured but reported by the individual.
3 classifications of medications?
How often re-ordered?
- Somatic - used to treat medical conditions
- yearly - Psychiatric - used to treat psychiatric or mental health related conditions.
- 90 days - Class II - controlled substances (addictive)
- 30 days
What is a PMOF
Doctor’s order form
Somatic and psychiatric meds must be on separate PMOF’s
3 reporting categories. Give examples
- EMERGENCY medical condition. Call 911. Inform nurse as soon as logically possible (post crisis)
- heart attack, stroke, seizure - Non-emergency - call nurse and inform supervisor.
- headache, minor injuries, flu - Other or behavioral changes. Inform nurse and supervisor.
- change in weight or sleep patterns
What documents to bring to medical appointments?
Appointment record Photo ID Insurance card (or photocopy) Medical records Doctors orders List of meds
What questions to ask when a new med is prescribed?
- Purpose of medication
- How much (dosage)
- How often
- How long
- Potential side effects
- Route
- Drug interactions
- What is required before taking (vitals or tests etc)
- What happens if individual refuses (missed dose)
Define refill and reorder
Refill - # of times pharmacy will re-supply medication before a reorder is needed.
Reorder - when a doctor is required to re-issue or re-write the prescription.
Somatic = yearly
Psychiatric = 90 days
Schedule II = 30 days
What is generic vs brand name of medication?
Generic = original or actual name of drug
Brand name = given by manufacturer.
Sample medications require:
- Doctor’s orders
2. Pharmacy label
3 important things to remember about the pharmacy.
- All medications should come from the same pharmacy.
- Pharmacists are a valuable member of the team
- Pharmacists are excellent resources for information about drugs, uses, side effects, interactions etc
Factors that can influence a persons response to medications?
Age
Weight
Hormones
Physical condition
Most common routes of medications
Oral
Topical
Forms of medications
Tablets Drops Patches Suppositories Capsules Sprays Ointments Liquids Creams
What is a suspension?
Often opaque liquid in which medication is mixed in or “suspended”
Shake well - evenly distribute the medication
What is toxicity?
The body’s inability to eliminate or metabolize the amount of medication.
- often sue to poor organ function.
- more common in children and elderly.
What factors influence a person’s response to medication?
Age Weight Hormones Physical condition Route of delivery
Def
Medication allergy
An undesired physical reaction to a drug. Often causing swelling.
Emergency
Def
Tolerance
Medication no longer working.
Body has become accustomed to the drug. No longer as effective.
Def
Addiction
A physical or psychological dependence on a substance
Def
Desired effect
The intended effect of a medication
The medication is working
Def
Unwanted effect
An unexpected or undesired effect of a medication.
Def
No apparent effect
Medication is not working or stopped working.
Medication fails to provide any or the desired effect
How to store schedule II narcotics?
Inside a locked box, inside a locked cabinet.
3 ways medications are packaged?
Bottles
Blister packs
Syringe
3-way check
What must match?
Dr orders
Pharmacy label
MAR
What form is required to record the administration of medication?
MAR
Medication administration record
What information is included on the MAR?
Medication name Doctor’s name Start date Dose Route Diet Diagnosis Time
How should medication requiring refrigeration be stored?
In a locked box
T/F
Oral and topical medication should be kept separately in the medication cabinet
True
Is the MAR a legal document
Yes
Two ways medication should be stored?
- Locked storage area
2. In original container eg blister pack
When is it necessary to dispose of or not administer medication? CRED
- Expired
- Refused
- Contaminated
- Discontinued
(CRED)
Pharmacy label should never be _________ or _________.
Altered or changed
Who Should have access to the keys to the medication cabinet?
Only the RN and CMT
When do you perform the 3-way check?
Remove from cabinet
Prior to dispensing (before popping the blister pack)
Prior to giving the medication (when it is in the cup)
Permission for administering PRN medication can be obtained by:
- Referring to the administering PRN medication nursing delegation order.
- Calling the RN in call.
- Referring to the nursing care plan for instructions about administration
Examples of medication error
Any violation of the 6 rights.
- Person
- Medication
- Route (method)
- Dose
- Time
- Charting/documentation
T/F
A chemical support medication can be given without approval of the standing committee?
False
Medication Administration Safety
- Wash hands
- Read PMOF (doctor’s order), and compare with the MAR
- Pull out the medication (correct time: read label)
- First 3-way check completed. - Second 3-way check. Compare Dr order, pharmacy label and MAR.
- Check for allergies and/or pre-med directions.
- Dispense medication into med cup.
- do final 3-way check before giving meds to individual. - Introduce yourself and explain you are giving them their medication.
- Ensure they swallow their medication.
- Document on Mar
- ensure your name/signature is on back of MAR
6 rights of medication administration
- Right person
- Right medication
- Right route
- Right dose
- Right time
- Right documentation
3 way check uses
PMOF (doctors order)
Pharmacy label
MAR
Safety principles. 5
Wash hands Avoid distractions Check for allergies Full attention to task 3-way check
Is a CMT Licensed to give medication?
No. A CMT is NOT licensed
Where are schedule II drugs documented?
MAR
Controlled substance sheet
When does a medication error occur?
When there is a mistake with any of the 6 rights.
When a right becomes a wrong.
Blank box on MAR
Considered a medication error.
Notify nurse immediately (figure out why)
Needs to be documented on the back of the MAR.
Missing medication or
Missing document.
What do non-medicated OTC’s need before use?
Recommended by the nurse
Written instructions in the PCP or care plan
What do you need to be mindful of with OTC’s
Side effects
Ingredients
Usage
Storage
How to encourage an individual to participate in HCP appointment?
Encourage individual to speak up.
Discuss goals beforehand
Write down questions
Questions to ask HCP when new medication is prescribed?
Purpose Time Dose Route Interactions Side effects How long med to take effect Prior tests? Eg BP, blood sugar
