Medicines Administration Flashcards
For example, it is important to keep _in a locked fridge.
insulin
Once delivered to a patient care area, controlled medicines must be _ by an authorised practitioner and kept in a special locked cabinet within a locked drug cupboard.
counted
Controlled medicines must be counted _and on each occasion that any medicine is either _ or _.
daily supplied by the pharmacy taken from the cupboard to be used
If any medication is to be wasted, then _
the amount discarded must also be recorded
A large part of your role will involve educating the patient about using the prescriptions they have been given properly, and making sure they are not_
stockpiling medicines.
In community setting - 4 checks for medicine administration
what medicines the patient was taking? how the patient took their medication? whether the patient understood what their medicines were for? whether the patient had any medicines which they were not using?
8 rules of administering medications:
The right medication The right patient The right time The right data The right dose The right route The right preparation The right documentation
Gloves should be worn if contact with the medication is potentially harmful to the nurse – for example, in the case of_
topical steroid preparations.
Hand hygiene must be performed (5) (medicine administration)
before touching a patient, before clean/aseptic procedures, after body fluid exposure/risk, after touching a patient and after touching a patient’s surroundings.
slow-release’ tablets must be _to allow the medication to be released gradually
swallowed whole
Do not crush coated tablets as in doing this _
you are making their use unlicensed.
Do not break tablets that are unscored as you are _
likely to be giving an inaccurate dose.
If medication is to be administered via a _ or _, ask the pharmacist to dispense a suspension which will not block the tube
nasogastric (NG) percutaneous endoscopic gastrostomy (PEG) tube
If a medication is in liquid form, _
shake the bottle before you pour it out to ensure it is evenly concentrated.
As well as being ingested via an oral route, tablets may be administered via the _, which means they are placed under the tongue or _, which means they are placed between the cheek and the upper gum.
sublingual route buccal route,
Before you give any medication, you will need to complete a full assessment of your patient’s medication needs. This involves: (2)
a. Checking the patient’s care plan for specific requirements b. Checking the Medicine Administration Record (MAR) to determine the correct medicine to be given to the correct patient, taking account of all eight rights of medicine administration
If a number of medicines need to be given at the same time, _
prioritise which one to administer first Some medicines require specific conditions for best effect
Locate medicine to be administered, ensuring it is:
a. in date b. the correct formulation for the route to be given and appropriate for your patient’s preferences c. the correct dose strength for the prescription d. the correct medicine according to the prescription
If your patient is a child or the drug dose is calculated according to the patient’s weight, check that _
the prescribed dose is correct for the patient’s current weight or BMI
Monitor the effectiveness of the medication and any reactions, reporting these to _ and _
a registered nurse and the medication prescriber instigating treatment as appropriate
There are three stages of the nurse’s role in medicine administration
ensuring the safe and effective storage and administration of medications to patients (or supporting patients or their carers to self-medicate), recording the administration of the medication and the outcome, and evaluating the impact and effectiveness of the medication given and assessing any untoward effects
A subcutaneous injection is deposited _
just under the skin into the subcutaneous tissue (adipose tissue or fat).
Due to the poor blood supply of subcutaneous tissue, medication given by this route_
is absorbed more slowly than that given intravenously or intramuscularly.
Common medications given by Subcutaneous injection include _
insulin (as demonstrated here), low molecular weight heparins (for example, Fragmin) and growth hormones
It is important, however, when giving regular subcutaneous injections, to _
rotate the injection sites in order to prevent scarring and hardening of subcutaneous tissue.
Appropriate sites for subcutaneous injections are:
the deltoid areas of both arms (side of arm), the abdomen (bellybutton area) and the thighs (top middle area)
Skin decontamination is not advised when administering drugs via the subcutaneous route because _
alcohol causes the skin to harden, as many patients may require frequent subcutaneous injections, such hardening will interfere with the absorption of the medication.
Subcutaneous injection of insulin steps
- Check records, person, dose, allergies 2. Gloves on, prepare equipment using ANNT 3. Gloves on, Clean rubber side of medicine vial 4. Check syringe and leave amount of air = dosage Insert needle to vial, insert the air, draw the medication (slightly more than needed) 5. Tap the syringe, expel air and extra from the syringe, recap it 6. Go to patient - recheck everything, ask patient to position themselves 7. Wash hands, gloves 8. Grasp the skin (double the length of needle 9. Administer the needle (no aspiration), inject it slowly, wait 5-10 seconds before removing the needle, release the skin 10. Dispose of things, take gloves off, wash hands, and update the records
The aim of an intramuscular injection is to _, where there is a _that will allow the _
deposit medication into skeletal muscle rich blood supply medication to be absorbed quickly and effectively.
The four commonly used sites used for intramuscular injection are (4)
the deltoid muscle, the ventrogluteal muscle, the vastus lateralis muscle and the dorsogluteal muscle.
intramuscular injection Equipment
Medicines administration chart Medicine for injection Sterile swab (when opening ampoule) Gauze swab (to cover puncture site) Alcohol swab (for skin cleansing) 2x gloves and 1x apron Receiver Sharps bin 21G safety needle Appropriately sized syringe Blunt fill needle (no bevel) with filter if using glass ampoule
If using a glass ampoule - _. Covering the neck of the ampoule with a sterile swab, break off its top, by snapping it along the score line at its neck. Check_
- flick the top to ensure all medicine is at the bottom - whether there are particles of glass in the liquid; if present, use a new ampoule.
Use a _, as this is the needle of choice for an intramuscular injection. If you use a shorter needle, the drug will not reach the target muscle.
21G safety needle (often green)
Oil-based solutions or highly viscous medications can be administered with a needle such as _
an 18G, 19G or 20G.
Z-tracking: _This technique is known as Z-tracking; it reduces pain and leakage from the injection site
Stretch the skin. Stretch the skin 2 to 3 cm, using your thumb, as shown.
Intramuscular injection using the deltoid site - do we do flashback for blood?
There is no need to pull back on the plunger and check for flashback of blood, as there is no risk of striking a blood vessel at this site
Intramuscular injection using the deltoid site - While maintaining skin traction, inject slowly (approx 1 millilitre per 10 seconds). It is important to inject slowly in order to_
reduce the pain of the injection, and to allow the muscle fibres to stretch to accommodate the fluid.
Deltoid site - It is used to _and it is typically used only for_
inject small volumes (0.5 to 1 millilitres) vaccinations
The dorsogluteal site is located _
in the upper outer quadrant of the buttock
The dorsogluteal site injection: flashback for blood?
While maintaining skin traction, pull back on the plunger. If blood appears in the syringe, support the skin, withdraw the needle and start again from the beginning. If blood appears, the needle has entered a capillary.
The dorsogluteal site injection: flashback for blood?
While maintaining skin traction, pull back on the plunger. If blood appears in the syringe, support the skin, withdraw the needle and start again from the beginning. If blood appears, the needle has entered a capillary.
ventrogluteal site injection: flashback for blood?
There is no need to pull back on the plunger and check for flashback of blood, as there is no risk of striking a blood vessel at this site
If a patient is to receive both eye drops and eye ointment, always_, to ensure appropriate absorption.
instil the drops before administering the ointment
Note that eye drops and ointment often expire _
28 days after opening. Mark each bottle and tube with the opening date
Check the prescription - Eye medications can often be written as_
RE/LE/BE (right eye/left eye/both eyes) as the designated route.
O.d.
once daily
b.d.
twice daily
o.n.
at night
q.d.s.
4 times daily
Medicines record card: “o”
(to be taken) orally
