Medication Administration Flashcards
Identify guidelines for safe administration of medications (8).
1) Seek information from the client about their medication, as needed
2) Provide education to the client regarding their medication
3) Collaborate with the client in making decisions about the plan of care in relation to medication practices
4) Promote and/or implement the secure and appropriate storage, transportation and disposal of medication
5) Promote and/or implement strategies to minimize the risk of misuse and drug diversion
6) Take appropriate action to resolve or minimize the risk of harm to a client from a medication error or adverse reaction
7) Report medication errors, near misses or adverse reaction in a timely manner
8) Collaborate in the development, implementation and evaluation of system approaches that support safe medication practices within the health care team
Describe the 10 rights of medication administration.
1) Right patient
2) Right time
3) Right medication
4) Right dose
5) Right route
6) Right assessment
7) Right education
8) Right to refuse
9) Right documentation
10) Right evaluation
Describe the most common factors contributing to medication errors and describe
ways of preventing medication errors (14).
1) Be vigilant when preparing medications. - Avoid distractions.
2) Check for allergies.
3) Use at least two patient identifiers (full name & date of birth) before administration and compare against the MAR.
4) Assessment comes before medication administration.
- pain, resp assessment, cardiac assessment, lab values
5) Be diligent in all medication calculations.
6) Avoid reliance on memory; use checklists and memory aids.
7) Communicate with your patient before and after administration.
- Educate the pt before administration, answer qs, evaluate if the intervention worked.
8) Avoid workaround
- Ex: a nurse may “borrow” a medication from another patient while waiting for an order to be filled by the pharmacy. These workarounds fail to follow agency policy to ensure safe medication practices.
9) Ensure medication has not expired.
10) Always clarify an order or procedure that is unclear.
11) Use available technology to administer medications.
- Ex: bar-code scanning (eMAR)
12) Report all near misses, errors, and adverse reactions
13) Be alert to error-prone situations and high-alert medications.
- Ex: opioids may result in resp depression.
14) If a patient questions or expresses concern about a medication, stop and do not administer it.
- If a patient questions a medication, stop and explore the patient’s concerns, review the physician’s order, and, if necessary, notify the practitioner in charge of the patient.
Identify common abbreviations and symbols used in medication orders and
medication administration
2 times a day = bid 3 times a day = tid 4 times a day = qid every 6 hrs = q6h immediately = STAT by mouth = PO subq= subcutaneous IM- intramuscular IV= intravenous ID= intradermal
What is the formula for determining medication doses?
Ex: Anthony Rivers has an order of 7.5mg of amlodipine. There is a bottle on hand of 5mg. How many tablets of amlodipine does he require?
Desired x Vehicle / On hand
DxV/H
7.5mg x 1 tablet / 5mg = 1.5 tablets
Describe how drug dosages and calculations vary in the pediatric population
The pharmacokinetics of many drugs are different in children compared to adults. The pharmacokinetic processes of absorption, distribution, metabolism and excretion undergo changes due to growth and development.
Many paediatric doses are based on the child’s age or weight. These may need adjustment depending on the child and the clinical response.
By weight: Child dose by weight = (mg/dose) = Adult Dose in mg/kg/dose x Child Weight in kg Ex: dose = 2mg/kg child weight = 15kg dose frequency = BID 2mg/kg x 15kg = 30 mg/day
Describe unique variances in the geriatric population including:
o Medication metabolism in the elderly
o Polypharmacy and drug toxicity
With increasing age and because of change in body weight, several changes in pharmacokinetics are present in many elderly people. Especially changes in volume of distribution and renal clearance are of clinical importance
Elderly people are at a greater risk for adverse drug reactions (ADRs) because of the metabolic changes and reduced drug clearance associated with ageing; this risk is furthermore exacerbated by increasing the number of drugs used.
Describe factors to assess before administering medications (2).
Full head-to-toe
Vitals
What are the steps of oral drug administration (14)?
1) Ensure you do a full head-to-toe and check vitals prior to any med administration (right assessment)
2) Ensure you have the MAR and appropriate order. Double check if the order is appropriate.
3) Check that the pt does not have an allergy to the medication
4) Approach the omni cell. Locate the pt and the meds to be ordered at that point.
5) Do the first of the 3 med checks. Check the MAR and the omni cell and confirm: right patient, right time, right medication, right dose and right route. Then remove the med(s) from the omni cell.
6) Complete drug calculations where appropriate.
7) Do your second med check. Confirm the medication taken from the omni cell matches the MAR. Check the expiry date. Confirm: right patient, right time, right medication, right dose and right route.
8) Enter the pt’s room. Do hand hygiene. Introduce yourself and state your role.
9) Ask pt for 2 identifiers (full name & date of birth). Scan their ID bracelet.
10) Provide pt education by informing them of the med(s) you will be giving and why. Answer any questions the pt may have. Allow them the right to refuse the medication.
11) Do your 3rd med check. Confirm: Confirm: right patient, right time, right medication, right dose and right route. Ensure to scan each med individually and put it in the medicine cup.
12) Watch the pt take all the meds before you document.
13) Educate pt on potential side effects. Answer any questions.
14) Evaluate the intervention. Ex: if it’s a pain med, did it work?
