Medication Errors, Nursing Process & Drug Administration

Question 1

Medication administration, like all other nursing care activities follows the nursing process. This process comprises five steps:

Answer 1

1. Assessment
2. Nursing diagnosis
3. Planning
4. Implementation
5. Nursing Evaluation

Question 2

The method by which patient care and patient needs are me

Answer 2

Nursing Process

Question 3

• Involves the gathering of information to be used in identifying the patient and the patient needs from a nursing standpoint.
• Involves the systemic collection of data (via interviews and physical examination and observations, the inspection of lab reports, other data sources) and the analysis of collected data
• Provides the basis for the patient’s drug therapy

Answer 3

Assessment

Question 4

Data Collected and analysed:(8)

Answer 4

1. Medical history during initial contact with patient
2. Establishing baseline data including weight, height useful for effective drug therapy
3. Patient knowledge about his/her diagnoses and medication and the patient readiness to learn about these matters.
4. Is the drug in the proper/suitable form for the patient (e.g., if it is an oral drug is the patient NPO, liquids only, or no problem swallowing)
5. Assessing the therapeutic and adverse effect of drug therapy.
6. Assess for drug hypersensitivity. Examine family history for adverse drug reactions.
7. Assess the patient’s need for medication (e.g., assess pulse rate before administering heart drug, assess pain before administering analgesics).
8. Determine patient needs for p.r.n. medication

Question 5

Are those diagnoses for which the nurse can act independently according to the nursing practice act, (e.g., act on administration of pain meds.; prepare patient teaching plan).

Answer 5

Nursing diagnoses

Question 6

Nursing Diagnoses Involves making ____ about a patient, family or community responses to actual and potential health problems.

Answer 6

Clinical judgement

Question 7

Nursing diagnoses provides the basis for selection of _____, in order to achieve the most favourable outcome possible through nursing care.

Answer 7

Nursing intervention

Question 8

Nursing diagnoses involves _____ collected data and stating the nursing diagnosis (ses)

Answer 8

Analyzing

Question 9

The purposes of Planning are:(3)

Answer 9

i. to established priorities for the patient’s diagnosed health problem
ii. to determine appropriate interventions
iii. to set expected patient outcomes

Question 10

• Includes discussing patient’s medication needs with health care providers.
• Determines appropriate schedule for medication administration
• Setting client care goals
• Setting patient goal and designing educational programme for self-administration of drugs.

Answer 10

Planning

Question 11

• Is the actual administration of medication or/and initialling a medication schedule and patient’s education. The Nurse may not administer the medication but is responsible for its administration.
• Here the nurse with or without assistants carries out the plan of care.
• Involves patient education (general education about the diagnosis, the medication, adverse effect, and specific instructions on patient activities while on the medication)

Answer 11

Implementation

Question 12

• Tthe comparison between actual patient outcomes and expected patient outcomes.
• Here the nurse determines the results of administering care, e.g., the effectiveness of the medication in relieving pain, the adverse effects of the drug therapy or the ability of the patient to self-medicate.
• May be used to modify nursing care, assess patient’s compliance and plan

Answer 12

Evaluation

Question 13

Assessment in Administering the Medication(4)

Answer 13

i. Take/examine medical history (e.g., history of Pr, OTCs and homeopathic medication, allergies to drugs and/or foods, drug-drug interaction)
ii. Assess patients understanding about the illness/diagnosis and therapy/past experiences
iii. Conduct a physical examination (incl. weight, height, BP, temperature, pulse, respiration, nutrition, physical conditions, hearing, vocal, vision,)
iv. Assess patients family/friends support (e.g., persons available to fill prescription, provide meals on time)

Question 14

Nursing Diagnosis in Administering the Medication(4)

Answer 14

i. Identify risk of injury
ii. Identify risk of noncompliance with drug regimens
iii. Check of deficiency in knowledge about drug regimens and illness
iv. Others

Question 15

Planning in Administering the Medication (4)

Answer 15

i. Focus on why the drug is needed
ii. Focus on how the drug will be administered (incl. 2nd nurse verification)
iii. Common adverse effects
iv. Other nursing care to enhance patient comfort and desired outcomes

Question 16

Implementation in Administering the Medication (7)

Answer 16

i. Ensure cleanliness: hands, work area, supplies
ii. Check prescription for completeness
iii. Verify prescription for medication to be administered (incl. date, time, drug name, dose, route, frequency, length of administration, authorization). Follow facilities procedure for emergency situations.
iv. Remember the RIGHTS: Right drug, Right dose, Right Patient, Right Time, Right Route, Right documentation, Patient’s right to know reason for and details about medication, Patient’s right to refuse.
v. Ensure all supplies available
vi. Ensure proper lighting
vii. Decrease environmental distractions.

Question 17

Rights in Medication

Answer 17

The Right patient must receive the
Right drug for the 
Right reason in the
Right amount by the 
Right route in the 
Right site and the 
Right time and
Right frequency followed by the 
Right documentation. 

• Right to Refuse

Question 18

True or False?

If you don’t do a complete assessment, you can’t do a good evaluation

Answer 18

True

Question 19

In these kind of Medication, a certified nurse must check before administration

Answer 19

High Alert Medications eg. Insulin

Question 20

It is any preventable event that may cause or lead to the inappropriate use of medication or the harm of a client while the medication is in the control of the health care professional, client or consumer. They are the most common single preventable cause of adverse events in medication practice

Answer 20

Medication errors

Question 21

An error of _____ occurs when the administration process is not completed; for example, not administering an ordered medication.

Answer 21

Omission

Question 22

An error of ______ is something that happens in the administration of the medication; for example, giving the wrong medication.

Answer 22

Commission.

Question 23

An error can also result in a “_____” In this situation, an error does not reach the client, but if it had, it could have resulted in harm.

Answer 23

Near miss.

Question 24

Measures that could be taken by a nurse to limit Medication errors.

Answer 24

i. Report errors and to track near misses
ii. Examine system issues at your workplace
iii. Recognize any individual accountability when an error occurs.

Question 25

Abbreviations not accepted or used in drug administration!

Answer 25

U, IU, QD/QOD, OD, OS/OD/OU, D/C, cc, mg, @, >, <, Trailing zero, lack of leading zero.

Question 26

7 Parts of a Drug Order

Answer 26

1. Name of Pt
2. Name of Drug
3. Dosage of the Drug
4. Drug Route
5. Drug Frequency, time and special instruction related to administration
6. Dame and time when order was written
7. Signature of the person who wrote the order