Pharm One Final 3 - rights and routes Flashcards
1
Q
What are the Five Rights of medication administration
and
What needs to be included in an order -
A
5-TRAMP Right TIME RIght ROUTE Right AMOUNT (Dose) Right MEDICATION Right PATIENT can add 6th Documentation After the admin. you document.
Order must have
Med, amount, route, time
2
Q
How do you know you have the RIGHT PATIENT?
A
- ID Bracelet - Scan or ck for Full Name, DOB, and Patient ID#
2 Verbal - Have patient state full name and DOB - Photo ID - in records or patient shows you
CHECK FOR ALLERGIES
RED BRACELET for ALLERGIES,
CK if there are other ones.
3
Q
How do you know you have the RIGHT MEDICATION?
A
- Brand Names - by mfg
- Generic Names - by FDA
- Suffix - denotes class -“cillin” = penicillin
- Does it make sense for THIS patient?
- Is it appropriate for the DX or comorbidities?
- Is it safe for this age, gender, ethnicity, allergies, and other meds?
- If patient does not recognize the medication - explain why they need to take it.
- If nurse does not recognize the medication - CHECK IT.
4
Q
How do you know you have the RIGHT DOSE?
A
- Know the average dose of the med.
- If calculations needed. 2 people do separately and then compare
- Question doses of multiple vials or more than THREE PILLS.
- Med doses lower for liver and kidney disease.
- Med doses may differ for geriatric (lower) patients
- Some may be based on weight or body surface.
- Check if dose is g mg or mcg vs ml, tabs, caps
- Be clear if the dose if per day or multiple times per day.
5
Q
How do you know it is the RIGHT ROUTE?
A
- Know the usual route
- Know abbreviations and avoid them
- Do not confuse Otic (ear) and Opthalmic (eye)
- CANNOT change the ROUTE WITHOUT an ORDER
- DO NOT TRICK a patient into taking their meds
- Do NOT MIX or CRUSH MEDS with suffixes
ER, SR, SA, XR, XL, or CR (extended release or coated)
6
Q
How do you know it is the RIGHT TIME?
A
- Know agencies policies and use military time
- TIME SENSITIVE (given 1/2 hours of time scheduled)
- Know abbreviations.
- NOW and STAT are not the same. Stat is immediately.
- TID (3x day- awake hours usually before or after a meal) and q8h (every 8 hours) are not the same.
- Know med-med interactions
- Know med-food interactions
- Consider patient habits and sleep patterns.
- Know if patient has a test or going to the OR.
7
Q
What are the 5+ Rights?
A
- Right Assessment
- Right Documentation
- Right to Education
- Right Evaluation
- Right to Refuse
8
Q
What is Right to ASSESSMENT
A
RIGHT TO ASSESSMENT
- Know allergies, including food and hypersensitivities
- Know all other meds, including CAM’s, OTC’s and vitamins.
- Know patient’s comorbidities
- Know organ function, lab data, vital signs as needed.
- Lifestyle issues - diet, circadian rhythm, work, insurance, social support, culture.
- Know level of understanding of disease and treatment
9
Q
What is the RIGHT TO DOCUMENTATION
A
- Meds are signed for immediately after in the MAR
- MAR=Medication Administration Record
- Include the med response in RN notes.
- If response if unexpected, goes in RN notes and notify provider, timely
- All CHANGES should be recorded ASAP from when they are ordered.
10
Q
What is the RIGHT TO REFUSE?
A
RIGHt TO REFUSE
- Patients may refuse to take any meds.
- Determine the reason why, in case it is misinformation or fear.
- Reinforce rationale for taking the med and risk of refusal
- Document interventions and discuss with the prescriber.
11
Q
What is the RIGHT TO EDUCATION?
A
- Number 1 med error is non-adherence. Educate the patient.
- Always assess knowledge and attitude of the patient.
- Patients will be responsible for taking and monitoring thier meds at home.
12
Q
What is the RIGHT TO EVALUATION
A
Right to Evaluation
- Assess appropriate parameters and DOCUMENT.
- Assess for any untoward effects, DOCUMENT, discuss w provider, alter Tx as needed.
- Some side effects are minor and can be managed, other require stopping the drug and treating the side effects.
- MOST IMPORTANT - listen - patient’s do NOT always equate issues/symptoms with the medications.
13
Q
What are TALL MAN letter?
A
Used to enhance med safety
Helps to tell apart meds that look alike.
EXAMPE: BusPIRONE and buPROPion
14
Q
How do you CHECK a MEDICATION?
A
- Compare orig. order to EMAR
- Compare EMAR to med from drawer.
- Compare EMAR to med at bedside.
- Compare EMAR to used label after giving it. (may be too late)
15
Q
ORAL MED ADMIN. STEPS (before going to see patient)
A
- Ck order and allergies
- Hand hygiene
- Have MAR nearby
- Prepare ONE patient’s meds at a time.
- Remove MEDS and SCAN
- Calculate DOSAGE
- Prepare MEDS (crush, pour)
- Take MEDS to patient.
16
Q
ORAL MEDS ADMIN - with Patient
A
- Compare Name on MAR to Patient’s ID BAND Two IDS)
- Pre admin assessment. HR and BP
- Compare meds to MAR Recheck 6 rights
- Explain meds to patient
- High Fowlers and water
- Assist patient
- Make sure Pt swallowed med
- Dispose of garbage
- Wash hands
17
Q
Can you crush a med WITHOUT a score line?
A
NO
