Medications Flashcards
As per the CNO, what are the 3 standards of medication administration?
Authority – physicians order or medical directive (NP)
Competence – knowledge, skill, judgment to do it correctly
Safety – engaging in safe practices while administering medications; protocols & policies
What is the assessment portion of the nursing process in terms of medication?
Nurses use their knowledge, skill & judgment in the assessment of the client, the medications and the practice supports prior to administering medications
(Pain assessment / PQRSTU; what other meds are they on? Any medication interactions; allergies; can they swallow the pill? Or need to give meds another way?; timing of implementation)
Discuss the planning section of the nursing process in relation to medication.
Nurses are accountable for ensuring the accuracy, appropriateness & completeness of a client’s care plan in regard to medication orders
What is the implementation/evaluation of the nursing process in terms of medication?
Nurses prepare & administer medication in a safe, effective & ethical manner;
Nurses evaluate pt outcomes following medication administration & take appropriate steps to follow up
What are the 10 rights of patients receiving medication?
- The right medication
- The right dose
- The right patient
- The right route
- The right time & frequency
- The right documentation
- The right reason
- The right to refuse
- The right patient education
- The right evaluation
When receiving medications, the patient has the right to…
- Be informed of med’s name, purpose, action, potential undesired side effects
- Nurses & physicians assess medication history, including allergies & any herbal remedies
- Receive labeled meds safely, without discomfort, in accordance with rights of medication administration
- Not receive unnecessary medications
- Be informed whether meds are part of a research study
What are the pharmacological concepts of drugs?
Drug names – chemical, generic, trade
Classification – effects on body system, symptoms relieved, desired effects
Medication forms – solid, liquid, other oral forms, topical, parenteral, instillation into body cavities
What does the term ‘pharmacokinetics’ refer to?
Study of how medications…
- Enter the body
- Are absorbed & distributed to cells, tissues, organs
- Alter physiological function
Discuss the various routes of medication administration.
- Oral (sublingual, buccal)
- Parenteral (intradermal (ID), subcutaneous (SUBQ), intramuscular (IM), intravenous (IV))
- Epidural
- Intrathecal, intraosseous, intraperitoneal, intrapleural, intra-arterial
- Topical
- Inhalation
- Intraocular
Discuss the different systems of medication measurement.
Metric system – mg
Solution – mL
Household system (empirical) – teaspoon
What metric system measurements are used in HC?
Weight – micrograms (mcg); milligrams (mg); grams (g); kilograms (kg)
Volume – liters (L); milliliters (mL)
***cc should not be used
Which household measurements are used in HC? (empirical measurements)
- Weight (ounces (oz), pounds (lbs))
- Volume (drops (gtt), teaspoons (tsp), tablespoons (tbsp), cups (c), pints (pt), quarts (qt))
Discuss metric system conversions.
- To change (kg) to (g): multiply # of (kg) by 1000, or move decimal point 3 places to the right
- To change (g) to (kg): divide # of (g) by 1000, or move decimal point 3 places to the left
Discuss equivalent measurements between metric & empirical.
Weight:
1 kg = 2.2 lbs
If converting kg to lbs, multiply by 2.2
If converting lbs to kg, divide by 2.2
Volume:
15 gtt = 1 mL
1 tsp = 5 mL
1 tbsp = 15 mL ; 2 tbsp = 30 mL
1 cup = 250 mL
1 pt = 480 mL (or approximately 0.5 L)
1 qt = 960 mL (or approx. 1L)
What is the standard medication calculation formula?
(D ÷ H) × V = x
D – dosage ordered/amount you wish to give
H – on-hand dose, dosage strength available or “on hand”
V – vehicle or amount on hand; unit form that the dose on hand is available
x – unknown, the amount needed to give the dose ordered
What is the rounding rule for medication calculation?
Rounding rule: must round final answer to nearest tenth (1 decimal place) for doses greater than 1 mL or 1 mg; must round final answer to nearest hundredth (2 decimal places) for doses less than 1 mL or 1 mg
What is the medication prescriber’s role?
Prescriber can be a physician, NP, or pharmacists (in some provinces)
Must document the diagnosis, condition, or need for each medication
Orders should be written (preferred), verbal, or by telephone
Discuss the SIX types of medication orders in acute care agencies.
- Routine - administered until dosage is changed or another med is prescribed
- PRN - given when pt requires it (“as-needed”)
- Single - one time; given one time only for a specific reason
- STAT - given immediately in emergency
- Now - med is needed right away, but not STAT
- Prescriptions - medication to be taken outside of hospital
What are the different kinds of medication distribution?
Stock supply
Unit-dose system
Automated dispensing systems
What are the nursing responsibilities when dealing with medications & administration of meds?
- Knowing WHAT meds are prescribed
- Therapeutic dose range; therapeutic & non-therapeutic effects
- Medications’ associated nursing implications
- Knowing WHY pt needs the medicationW
- Determining WHEN a med is safe to administer based on physical assessment data
- Knowing HOW to safely administer the med
- Determining IF the pt requires supervision with administration and/or education
- Monitoring the effect of the drugs
Reporting & documenting administration & effects
What are the most common errors associated with medication administration?
Neglecting to check dose calculations
Administering unfamiliar medications
Neglecting to administer an ordered medication
Failing to comply with the rights of medication administration, or failing to perform necessary assessments before medication administration
Distraction
What are the components that should be on EVERY medication order?
Patient’s full name
Date (dd/mm/yy) and time the order was written
Medication name
Dose
Route of administration
Time & frequency of administration
Signature of prescriber
Explain…
QAM
QPM
Q1H
Q2H
Q3H
Q4H
Q6H
Q8H
BID
TID
QID
Before meal
After meal
Every day before noon
Every day after noon
Every hour
Every 2 hours (0800 start)
Every 3 hours (0600 start)
Every 4 hours (0800 start)
Every 6 hours (0600 start)
Every 8 hours (0600 start)
Twice daily (0800, 1730)
3 times daily (0800, 1200, 1730)
4 times daily (0800, 1200, 1730, 2200)
30 mins before meal
30 mins after meal
What are precautions to take before administering medication orally? What are the different ways of administering medication orally?
Presence of gastrointestinal alterations; ability to swallow; use of gastric suction; positioning
P.O. ; sublingual; buccal
