Risk - Med Administration Flashcards
The six rights for medication administration
Right drug
Right dose
Right time
Right route
Right patient
Right documentation
If medication errors do occur
Determine the effect on the patient and intervene to offset any adverse effects.
Actions: immediate and ongoing assessment, notification of the prescribing health care provider, initiation of interventions as prescribed, and documentation
Error reporting is essential to patient safety and should be done as soon as patient is assessed and stable
Nurse should follow facility guidelines on how to report
What information is needed on a prescription to make it valid?
Patients name
Date/time order is written
Name of drug to be administered
Dosage of drug
Route
Frequency
Signature of person writing order
Allergic reaction
Stop meds immediately.
Administer epinephrine (antagonist), IV fluids, steroids, antihistamines and provide respiratory support.
Patients must wear identification bracelet identifying drug/substance to alert staff
Drug overdose and poisoning
Closely monitored, especially kidney and liver function
Adverse events
Reported to FDA by using MedWatch program
Health literacy
About consumers being able to understand the medical information their caregivers give them or they find through the internet and being able to use that information to make good decisions about their own course of care
Dependent nursing order
Tasks the nurse undertakes that are within the nursing scope of practice but require the order of a primary care provider to be implemented.
Requires nurses to pay strict attention to details of what is ordered.
Administering patient medication or oxygen are examples of dependent nursing interventions that require clinical judgement before implementation.
Based on collaborative effort of nurse and PCP to provide patient care
Independent nursing order
Nurse initiated tasks
Tasks within the nursing scope of practice that the nurse may undertake without a physician or PCP order.
Repositioning patient in bed, performing oral hygiene, provide emotional support through active listening.
The extent to which nurses can implement independent nursing interventions is often determined by the area in which care is taking place
Administering meds to children
Liquid forms of oral meds are preferred for younger than 5 y.o
Parents/caregivers may need instruction with pictures and directions about home administration
Uncontested tabs or soft capsules may be crushed and sprinkled over a small amount of food - don’t use favorite food or formula
Warn child of unpleasant tastes.
Praise child after med is taken
Infant med administration
Calibrated dropper
Place med between gum and cheek to prevent aspiration
Older adult med administration
Do not rush med administration. Allow time for understanding of treatment and slower swallowing
Crushed or liquid forms are easier
Normal aging process (decreased renal and hepatic function) may affect dosage needed - drugs are metabolized slower
Adverse effects may increase
Give instructions for home use. Focus on name and purpose of drug
Loss of dexterity and ability to open pill bottles, visual impairment, cognitive impairment
Oral medication
Drugs administered by this rote are intended to be absorbed in the stomach and small intestine.
The patients ability to sallow, level of consciousness, gag reflex, and whether the patient is experiencing nausea and vomiting are assessed to ensure ability to take meds by oral route and prevent aspiration
Sublingual and buccal
Sublingual is placed under the tongue and allowed to dissolve. The patient should not eat or drink anything until dissolved.
Buccal (antiemetic, sedative, opiate) placed in side of mouth against cheek. Patients are taught to alternate cheeks to avoid mucosal irritation. Should not be chewed, swallowed or taken with liquids.
Topical
Topical meds are placed on the skin surface, mucous membrane, or in body cavity
Transdermal
Medications designed to be absorbed through the skin for systemic effect are administered transdermally, usually in the form of a patch.
The skin site must be cleansed because the skin oils may interfere with the adhesive on these products
Previously placed patch and remaining medication are removed
Patches are disposed of according to facility policy, especially if controlled substance
Placement sites are rotated to avoid skin irritation
New placement and removal are recorded in MAR
