Medication Administration and Calculation: Self-Study Review Flashcards
Admin of drugs
Nurses must follow all safety procedures when administering drugs
Check orders carefully; question any if needed
Educate patients carefully about timing of taking medications
Document accurately
Document accurately (Admin of drugs)
Details of medications administered—after they have been given
Refusal or omission of medication must be documented with reason
PRNs document assessment prior to administration and evaluation of client response afterward.
Common protocol for admin
Verify medication order: Check order and EMAR
Assess client, ask client about known allergies (may not be in record)
Wash hands and apply gloves, if indicated
Identify client (two forms of ID)
Educate client about drug and position client for safe administration
Remove prepackaged drug at bedside
Watch client take med.; Do not leave drugs at bedside/food tray, etc.
DO NOT give a medication prepared by another nurse
Document administration and pertinent patient responses
Follow-up evaluation/documentation of response to medication
Wash hands and apply gloves, if indicated (Common protocol for admin)
Use aseptic technique when preparing and administering parenteral medications
Drug orders and common acronyms
Types of orders
Drug-administration acronyms
Types of orders (Drug orders and common acronyms)
Single orders
Routine orders
Standing orders
Nurse must review all orders before initiating
Single orders (Types of orders (Drug orders and common acronyms)
Once at a specific time
Routine orders (Types of orders (Drug orders and common acronyms)
To be completed within 2 hours of receipt
Standing orders (Types of orders (Drug orders and common acronyms)
Written in advance of a situation to be carried out under specific circumstances
Written in advance of a situation to be carried out under specific circumstances (Standing orders (Types of orders (Drug orders and common acronyms)
Example: treatment for low blood glucose
Drug-administration acronyms (Drug orders and common acronyms)
STAT (statim =immediate)
ASAP— (as soon as possible)
PRN (pro re nata=as required)
STAT (statim =immediate) (Drug-administration acronyms (Drug orders and common acronyms)
drug ordered to be given once & immediately
ASAP— (as soon as possible) (Drug-administration acronyms (Drug orders and common acronyms)
drug ordered to be administered within 30 minutes
PRN (pro re nata=as required) (Drug-administration acronyms (Drug orders and common acronyms)
drug ordered to be administered as required by the patient’s condition
Time schedules
Before meals
After meals
In morning
Twice a day
Three times day
Four times a day
Every _ hours
Orders should be typed or written out – no abbreviations
Some drugs should be given with food and some should not
Rule of thumb for drugs on empty stomach:
Nurses often give drugs scheduled an hour apart together to save time
BE SURE TO CHECK RESOURCES
Rule of thumb for drugs on empty stomach: (Time schedules)
1 hour prior or 2 hours after a meal
Rights of med admin
Right Client Right Drug Right Route Right Dose Right Time Right Documentation
Additional rights of med admin
Right Preparation:
Right Storage:
Right Education:
Right Information:
Right Preparation: (Additional rights of med admin)
Using the correct syringe and needle, proper dilution, etc.
Right Storage: (Additional rights of med admin)
Examples: Room temperature, refrigerator, protect from light
Right Education: (Additional rights of med admin)
Patient needs to know information about a medication to take it properly!
Right Information: (Additional rights of med admin)
The nurse needs to be informed about a medication to properly administer a medication and monitor the patient!
3 checks of drug admin
1.Check drug with EMAR when removing drug from storage
2.Check drug when preparing it, pouring it, taking it out of the unit-dose container, or prior to connecting IV tubing to bag
3.Checking drug before administering it to the patient
Nurses are held accountable for correct administration of drugs!
Routes of admin
Route affects absorption
Route affects absorption (Routes of admin)
Enteral
Parenteral (injection)
Topical application
Enteral (Route affects absorption (Routes of admin)
Oral, sublingual, buccal, rectal
Parenteral (injection) (Route affects absorption (Routes of admin)
IM, IV, SQ, ID, others
Topical application (Route affects absorption (Routes of admin)
Absorbed through the skin, eye, ears, nose, lungs (inhalation)
Admin of enteral meds
Administering oral drugs
Administering oral drugs (Admin of enteral meds)
Performing hand hygiene; maintain standard precautions
When admin follow points:
When admin follow points: (Administering oral drugs (Admin of enteral meds)
Requires special assessments; may require BP monitoring; be sure doc all parameters; do not forget check identification and allergies before giving oral med
If having dysphagia, some types tabs crushed for easier admin; crush one at a time; mix crushed med in small amount of food; pill crushing device should be clean before and after
Verify whether can be crushed
Position in sitting/side-lying position to make easier swallow and avoid risk of aspiration; provide aspiration prevention measures as needed
Offer full glass of water; best dissolution and absorption of oral meds; age-related considers: may not be able drink full glass water but need take enough fluid reach stomach
Can place in mouth with gloved hand
Oral lozenges need be dissolved slowly in mouth and not be chewed unless instructed
Powders and tabs need be mixed with water and then given immediately after dissolved
Remain with pat until med swallowed
Doc med given
Admin of parenteral meds
Preparing for Parenteral Drug Administration Removing Medication from Ampules Removing Medications from Vials Injections Overview Subcutaneous Injections Intramuscular Injections Preparing Intravenous Medications Intravenous Push Medications
Preparing for Parenteral Drug Administration (Admin of parenteral meds)
Bevel up on ID
Choose correct size and type syringe for drug and injection route ordered
Always use safety devices
Use the scoop method on unused needles
Larger guage number - smaller needle; choose correct needle - gauge and length
Some meds in prefilled sterile med cartridges
Removing Medication from Ampules (Admin of parenteral meds)
Perform hand hygiene and maintain Standard Precautions
Wear gloves
Use sterile filter needle; no filter needle for pat
Neck ampule broken carefully
Ensure to protect your hand
Do not allow needle tip/shaft to touch rim of ampule
Keep tip below fluid within vial
If air bubbles aspirated do not expel; remove needle and tap side
Removing Medications from Vials (Admin of parenteral meds)
single/multiple dose; mark multidose with date and time and discard date
Check facility policy regarding which type of needle to use withdraw fluid from a vial
Always wipe top of vial vigorously with an alcohol swab
Air must be first injected
Tap to remove air bubbles
Injections Overview (Admin of parenteral meds)
Needle insertion angles for IM, SubQ, ID - imp
Air-lock technique - withdraw med and additional .2 mL of air
Subcutaneous Injections (Admin of parenteral meds)
Avoid areas bruising, rashes, inflammation, edema, skin discoloration Ensure correct needle size; grasp skin fold with thumb and forefinger Cleanse with alcohol 45 degree 2 in from umbilicus Withdraw needle quickly Apply gentle pressure Doc
Intramuscular Injections (Admin of parenteral meds)
Cleanse site Pull skin taut 90 degree and insert quickly and firmly Apply gentle pressure at the site Doc
Preparing Intravenous Medications (Admin of parenteral meds)
Assess for drug allergies, patency of IV line, site for phlebitis/infiltration
Check compatibility if 1+ med given
Check expiration date
Choose correct solution for diluting IV meds
Do not squeeze IV bag
Intravenous Push Medications (Admin of parenteral meds)
Allow for rapid IV admin of drug
Med may have immediate effect
Follow instructions when preparing
Some diluted and some never given via push
Admin of topical meds
Administering Eye Medications
Administering Inhaled Drugs (this will be on exam 1!)
Administering Medications to the Skin
Administering Nasal Medications
Administering Eye Medications (Admin of topical meds)
No contacts; supine/sitting; tilt head back
Remove secretions with warm damp towel and wipe from inner to outer
Pull lower lid to see conjunctival sac
Administering Inhaled Drugs (this will be on exam 1!) (Admin of topical meds)
MDIs
Small-volume nebulizers
MDIs (Administering Inhaled Drugs (this will be on exam 1!) (Admin of topical meds)
Tilt head back slightly
Small-volume nebulizers (Administering Inhaled Drugs (this will be on exam 1!) (Admin of topical meds)
Closely monitor before, during, and after
Administering Medications to the Skin (Admin of topical meds)
Sterile gloves used if applying topic meds on open skin lesions
Avoid touching preps to own skin
Administering Nasal Medications (Admin of topical meds)
Explain procedure and that temp burning/stinging may occur; instruct imp clear nasal passages by blowing nose (unless contraindicated); assess for deviated septum and history of nasal fractures
Supine position
Posterior pharynx - head backward
ethmoid/sphenoid - head over top of bed/pillow under shoulders and tilt head back
frontal/maxillary - place head back and turned toward side to receive med
