medication administration Flashcards

(40 cards)

1
Q

what nursing actions support safe medication administration

A
  • Review patient allergies.
  • Review and reconcile prescribed medications.
  • Identify possible adverse effects of medications.
  • Identify potential interactions with other medications.
  • Determine route of administration.
  • Determine time of administration.
  • Develop patient education regarding medication administration.
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2
Q

what actions can help reduce the risk of medication errors

A

making sure to check all of the 10 rights of medication administration

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3
Q

compare and contrast the various routes by which medication can be administered

A

oral (PO)
Sublingual (SL)
rectal (PR)
Intravenous (IV)
Buccal
Inhalation
Intramuscular (IM)
subcutaneous (Subcut)
transdermal
otic
opthalmic
nasal

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4
Q

what role does the nurse play in relation to educating the clients about their medications

A

A nurse plays a critical role in educating clients about their medications by providing clear, understandable information about the purpose, dosage, administration method, potential side effects, and interactions of each prescription

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5
Q

The six rights of medication administration

A
  • Right client: Verify the client’s identity using two client identifiers. (DOB and name)
  • Right medication: Confirm the name and form of the medication is correct. (transcribing and read back, MRS)
  • Right dose: Check the medication you have against the order in the medical record.
  • Right route of administration: Confirm the route (IV, IM, SC, etc.).
  • Right time of delivery: Confirm the time the drug is to be given and the last time the drug was administered.
  • Right documentation: Document the time the drug was given and any pertinent remarks.
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6
Q

Right to refuse

A

Client has the right to refuse the medication

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7
Q

Right assessment

A

Confirm that the medication is appropriate for the clients condition
- make sure to check the medication and double check for allergies

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8
Q

Right education

A

Provide adequate education addressing
what medication the client is taking, expected benefits, and side effects.
- make sure they know what to expect when taking it

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9
Q

Right response/evaluation

A

Observe the client’s response to the rug
- check for adverse reactions and if it is working

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10
Q

Additional safety strategies for medication administration

A
  • checking the medication against the Medication administration Record or medication information device upon removal of the drug from the dispensing device
  • checking the drug upon preparation
  • checking the drug just prior to administration
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11
Q

Medication reconciliation

A
  • performed anytime the care of the client is transferred from one health care professional to another, such as when a client returns or from one physical location to another
  • involves reviewing the client’s current medications, then addressing omissions and duplications
    • ensure continuity of care (make sure all medications are correct)
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12
Q

Pharmacodynamics

A

The study of how a drug works, its relationship to drug concentrations, and how the body responds to

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13
Q

Examples of pharmacodynamics

A

Therapeutic range
Peek blood level (highest)
Trough blood level (lowest)
Half-life (half of duration)
Onset of action (when it starts working)
Peek effect
Duration of action (how long it stays in the body)

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14
Q

Drug-drug interactions

A

The effect that two or more drugs that the client is administered have on each other
- enhance actions or block actions, increase or decrease ADR, etc).

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15
Q

Drug-food interactions

A

Effects of nutrients on the absorption, distribution, metabolism, or excretion of medications
- iron and orange juice
- warfarin and diflucin

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16
Q

Serious adverse drug event (ADE)

A
  • a life-threatening reaction that requires medical intervention to prevent death or permanent disability, or congenital anomaly.
  • must be reported to the FDA to improve safety outcomes, revising drug labels and warnings, and, when needed, to withdraw drugs from the market
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17
Q

What is a black box warning

A

A warning issues on medications that may produce lethal and iatrogenic results

18
Q

Allergic reactions

A
  • allergic or hypersensitivity reaction develops when the body perceived a foreign substance (medication) as an allergen, producing antibodies to counteract the allergen
    • the adverse reaction produces histamines in response to tissues injury
19
Q

Anaphylaxis

A

A severe, life-threatening reaction resulting from histamine release producing dyspnea, hypotension, and tachycardia

20
Q

Steven’s-Johnson syndrome

A

A potentially fatal drug reaction
- develops 1-14 days following drug administration. SJS is manifested by respiratory distress, fever, chills, a diffuse fine rash, and then blisters

21
Q

What is a pharmacokinetic

A

The study of the absorption, metabolism, distribution, and excretion of drugs in the human body

22
Q

The parts to pharmacokinetics

A
  • the dissolution of a medication is dependent upon its initial state and route of administration
  • most medications are administered by the oral or enteral route, which provides for a much slower rate of absorption
  • distribution is the process of drug delivery to the target organ or tissues that occurs before metabolism and excretion
23
Q

Metabolism defined

A

Metabolism or bio transformation is the process of converting a medication to a form that is easily excreted from the body

24
Q

Examples of how metabolism works

A

Most drugs are metabolized by the liver.
• Kidneys and sections of the small intestines may also be responsible for drug
metabolism.
• Prodrugs are inactive chemicals that are transformed through metabolism to become
active before they have therapeutic effect.
• Oral medications pass from the small intestine to the hepatic circulation via the
mesenteric vein and portal vein flowing into the liver. This is the first-pass effect,
resulting in a lower concentration of the medication in the systemic circulation.

25
Define excretion
Is the process of removing drugs from the body
26
The primary parts of excretion
The kidneys are the primary organ responsible for drug excretion. • The skin, lungs, exocrine glands, mammary glands, and intestines excrete medications to a lesser extent. • Drug toxicity develops when the body is unable to metabolize and excrete a drug.
27
Teratogenic medications
Known to cause fetal defects, pregnancy loss, developmental disabilities, or prematurity
28
Examples of teratogenic medications
o Cocaine o Alcohol o Angiotensin-converting enzyme inhibitors (ACE) o Gentamycin o Lithium o NSAIDs o Tetracycline
29
Medication order
The order must have the client’s name, DOB, date and time the order was written, and the providers name and title
30
A medication order written by the provides must include
o The name of the drug, o The amount to be given o The route of administration o The frequency of administration
31
What are high alert medications
Drugs that are associated with an increased risk of causing considerable client harm when they are administered in error
32
Parts and types of high-alert medications
Insulin, opiates, narcotics, intravenous heparin, and injectable potassium chloride are high-alert medications. • One strategy to reduce the risk of harm is manual independent double checks with two nurses verifying identical information before these drugs are administered.
33
Oral or enteral route
via mouth, stomach or intestine – absorbed in GI tract first, then to the circulatory system
34
Subcutaneous
Delivered into the fat layer under the dermis - usually slower absorption than IM due to small blood vessel size
35
Intramuscular
Faster absorption due to larger blood vessels in muscle tissue
36
Intravenous
Most rapid absorption – directly administered into the circulatory system
37
Topical and transdermal
Applied directly to the area being treated – absorbed through mucus membranes or skin into capillaries and then to the bloodstream
38
Time
* Time-critical medications are those that when administered either 30 minutes before or after the scheduled administration time can cause harm to client or substandard pharmacological effect. * Non-time critical medications are defined as medications that can be administered between one and two hours early or late without causing harm or substandard pharmacological effects to the client.
39
The formula method
Dose ordered or desired X quantity (tablet or ml) / available dose or what is available
40
examples of medications with black bow warnings
loop diuretics estrogen iron supplements naproxen birth control aspirin