Medication Administration Flashcards
t/f: Nurses are responsible for their own actions (including orders by provider)
true
process of checking home meds vs. meds ordered in the hospital when patients are admitted and discharged
medication reconciliation
7 components of a medication order
pt name date/time of order med name dosage route frequency provider signature
(not medical record number)
Who can write an order?
MD/DO
NP, Nurse Midwife, CRNA
Physician Assistant
Pharmacist
Which type of order is only to be used in an emergency situation?
- written
- verbal (VO)
- telephone orders (TO)
- protocol
verbal orders
RBVO
read back verbal order: the practice of repeating back an order that is given verbally in person or over the phone
- write it down
- read back what you wrote
Frequency: Cephalexin 500 mg PO every 6 hours x 7 days
Routine (until order to stop or pre-written in order)
Frequency: Morphine 2 to 4 mg IV q4 hours prn pain
PRN
Frequency: Morphine 4 mg IV stat
Stat (immediately)
Frequency: Atropine 0.3 mg subcut on call to OR
One time
Frequency: Reglan 10 mg IM now
Now (ideally within 15 minutes, but generally ASAP)
Checks on med after provider order
- checked by pharmacy
- checked by RN
- if paper system, may be transcribed by unlicensed person
What drug info do you need to know before administering?
- mechanism of action
- normal dosage
- adverse effects
- contraindications
- drug/drug or food/drug
- prescribed for…
- how to eval a therapeutic effect
- patient teaching
- nursing considerations
Patient assessment before administering med
- alert
- ability to swallow (crush)
- NPO
- ability to follow instructions
- GI motility (post-op)
- muscle mass (IM)
- water at the bedside
what to assess before administering HTN med
blood pressure
what to assess before administering cardiac drugs like digoxin
pulse
what to assess before administering pain med
pain rating
what to assess before administering antipyretic
temperature
what to assess before administering insulin
blood glucose
window of time for on time drug administration
30 minutes before to 30 minutes after (there’s discussion on changing it, some hospitals have changed)
labs for Lasix
electrolytes (K+ levels)
labs for Digoxin
drug level
Pyxis
automated medication-dispensing systems
locked cassette/drawer for each patient
mobile cart (workstation on wheels)
controlled substance protocols
- locked with tracked access
- medication counted before removal and tally kept
- waste must be witnessed by 2 nurses
- inventory done by 2 nurses at set intervals
under what circumstances can pt self-administer
- ordered
- checked by pharmacist
5 Rights of Med Administration
Patient, Drug, Dosage, Route, Time
A medication is due at 0900, what is the acceptable time frame to give this dose?
0830-0930, plus or minus 30 minutes
Three medications that should NOT be crushed.
Sustained release, controlled release, enteric coated
More than ___ is a red flag.
More than 3 is a red flag. If you need more than 3 tablets/capsules/vials double check with the pharmacy.
Major benefit of sublingual administration.
There is no first pass effect with sublingual administration.
Three things to do when applying transdermal (topical) medication.
Remove any old patches.
Apply patches to intact hair-free areas, trim hair if needed.
WEAR GLOVES! (so you don’t absorb the medication)
