pharmaaa Flashcards
continuous process carried out during all phases of the
nursing process
ASSESSMENT
CHARACTERISTICS OF AN EFFECTIVE GOAL
Expected results
SE and AR
DD, DF, DL, DE
ADL Changes
Return Demonstration
Taper
- most frequent malpractice claims
against hospitals and nurses
Medication errors
- often referred to as the “sharp edge”
in the medication-use process
Drug administration
Drug administration - often referred to as the “sharp edge”
in the medication-use process
Errors introduced at the ____ if not intercepted, will result in adverse
drug reactions and some can lead to patient’s death
prescribing, dispensing, or
transcribing step,
= SPENT administering medications
40% of TIME
Hospital medication error rates =
= 1.9 % per patient/day
___% preventable medication error at administration step
38
NURSING RESPONSIBILITIES in
DRUG ADMINISTRATION
Administer drug by using 10 RIGHTS’s
Assessing drug effects
Intervening to make the drug treatment more tolerable
Health teaching about the drug
Monitoring overall patient care plan to prevent
medication error
Utilizing the nursing process
NURSES’ RIGHTS ON
SAFE MEDICATION ADMINISTRATION
Right to a complete and clear order
Right to have the correct drug, route, and dose
dispensed
Right to have access to information
Right to have policies to guide safe medication administration
Right to administer medications safely and to identify
system problems
Right to stop, think and be vigilant when administering
medications
10 RIGHTS OF DRUG ADMINISTRATION
Right Medication
Right Amount/Dose
Right Patient/Client
Right Route
Right Time and Manner
Right Time and Manner
Right Client Education
Right Documentation
Right to Refuse to Medication
Right Assessment
Right Evaluation
Right Medication
the medication given was the
medication ordered.
Right Amount/Dose
the dose ordered is appropriate for
the client
Right Patient/Clien
- medication is given to the intended
client
Right Route
- give the medication by the ordered route
Right Time and Manne
- give the medication at the right
frequency and at the time ordered according to agency
policy.
Right Client Education
explain information about the
medication to the client. (e.g., why receiving, what to
expect, any precautions).
Right Documentation
- record the drug administered
Right to Refuse to Medication
- adults clients have the
right to refuse any medication.
Right Assessment
- some medication requires specific
assessments prior to administration (e.g., apical pulse,
blood pressure, lab results).
Right Evaluation
- conduct appropriate follow-up (e.g.,
was the desired effect achieved or not? Did the client
experience any side effects or adverse reaction?
Make a habit of reading the label on the medicine and
comparing it with the Medication Administration Record
(MAR) or medicine sheet carefully at least 3 times
first
second
third
First, when removing the drug from the supply drawer
or medication cart
Second, when placing the medicine in a soufflé cup,
ounce cup, or syringe
Third, just before administering it to the patient
before the container is discarded
Technics to identify clients:
Ask client to state his full name
Check wrist/ID band
Check tag on bed/door
Superscription: Rx
includes patient’s details
Inscription
Ingredients, quantity of each used
Subscription
Directions to the dispenser
Directions to the patient
Signature of the prescriber
Date of writing the prescription
(RA 5921)
ELEMENTS OF A DRUG ORDER
The drug order (written by a physician), has 7 essential parts
for the safe administraion of drugs. The nurse should know
how to read a drug order.
Patient’s full name
Date and time when order is written
Drug name to be administered
Dosage
Route of administration and special directives
Time of administration and frequency
Signature of the person writing the order
TELEPHONE/VERBAL ORDER
Repeat order to physician
Emergency only, or without opportunity
Write details of orders in Physician Order
Require MD to co-sign in 24 hours
Identify client for whom the order is made
Two nurses verify/listen to order is safe
Evening shifts usually
PRESCRIBED DRUG DOSE MEASURES:
Being familiar with various measurements
Use appropriate measuring device
Shake suspension and emulsions
Hold dropper in vertical position
Inject air into vial when withdrawing drug
Don’t attempt to cut unscored tablet
Stock method
METHODS OF DRUG DISTRIBUTION
drugs are dispensed to all clients from the
same containers
Unit dose method
METHODS OF DRUG DISTRIBUTION
- drugs are individually wrapped and
labeled for single doses
Enteral
Oral, buccal, Sublingual
Solid
Liquid
Meds by NGT
Enteral feedings
Parenteral
Intradermal
Subcutaneous
Intramuscular
Intravenous
Percutaneous
Topical
Creams, lotion, ointments
Patch testing for allergies
Nitroglycerin Transdermal (NTG)
Medication to Mucus membranes
Topical powder
CLIENT TEACHING
therapeutic purpose
possible side effects of the drug
any dietary restrictions or requirements
skill of administration
laboratory monitoring
Medication Error
- defined as any preventable event that
may cause or lead to inappropriate medication use or harm
to a patient
NATIONAL PATIENTSAFETY GOALS
(EFFECTIVE JANUARY 2017)
Improve the accuracy of patient identification.
Improve the effectiveness of among caregivers
Improve the safety of using medications.
Reduce the harm associated with clinical alarm systems.
Reduce the risk of health care-associated infections
The hospital identifies safety risks inherent in its patient
population.
Prevent mistakes in surgery
FACTORS INFLUENCING / MODIFYING
DRUG RESPONSE (EFFECTS AND ACTIONS)
Absorption
Distribution
Metabolism
Weight
Age
Gender
Physiological factors
Pathological factors
Genetic factors
Immunological factors
Psychological factors
Environment factors
Tolerance
Cumulation
Drug-Drug interaction
Drug and Food interaction
Drug-Laboratory test interactions
