Safe medication administration

Question 1

What is the nurse’s role related safe medication practices used to reduce errors?

Answer 1

Prior to administering any medication, it is important to understand the client’s medical condition and medication history. The nurse is also responsible for having up-to-date knowledge about medications. This includes knowing the purpose, mechanism of action, route of administration, safe dosage range, side effects, adverse effects, toxic responses, precautions, and contraindications for each medication you administer. Nurses also need to know about the legal implications of medication administration. The nurse should always apply the rights of medication administration when administering medications.

Question 2

What are the medication rights of medication administration?

Answer 2

The right client, medication, route, time, dose, documentation, assessment, education, evaluation, and right to refuse.

Question 3

What is the right client?

Answer 3

Make sure to administer the medication to the right client. Use at least two forms of identification to verify that you have the right client.

Question 4

What is the right medication?

Answer 4

Never administer a medication another nurse prepared. Check the prescription and expiration date. Never assume a prescription is correct. If you are in doubt or it does not make sense, check with the prescriber.

Question 5

What is the right route?

Answer 5

Many medications are available for administration via more than one route. Always use the route intended by the provider.

Question 6

What is the right time?

Answer 6

Administer medications at the right time. This could be at specific intervals or at a time of day that the prescription specifies, such as at bedtime.

Question 7

What is the right dose?

Answer 7

Ensure the right dose by checking the prepared dose against the prescription. Also, review a medication reference to ensure that it is an appropriate dose for the client.

Question 8

What is the right documentation?

Answer 8

Documentation of medication administration should occur immediately after administration.

Question 9

What is the right assessment?

Answer 9

The nurse assesses the client before administering the medication for contraindications, pertinent lab results, vital signs, allergies, and possible medication interactions to determine if the client requires the medication and if it is safe to administer it.

Question 10

What is the right to refuse?

Answer 10

All clients have health care rights that are defined by federal and state laws.

Question 11

What is the right education?

Answer 11

The nurse educates clients about their medications to ensure they understand them—a key aspect of safe and effective therapy

Question 12

What is the right evaluation?

Answer 12

After the medication has been administered, evaluate the effect of the medication to determine whether it matches what is expected.

Question 13

What are the types of prescriptions?

Answer 13

Routine, standing, single, stat, PRN, and now

Question 14

What is a standing prescription?

Answer 14

A standing prescription is protocol-based and contains directions for administration based upon specific situations, such as the development of a fever.

Question 15

What are the basics of medication administration?

Answer 15

The rights of medication administration include the right client, medication, route, time, dose, documentation, assessment, education, evaluation, and right to refuse.

Question 16

How can we use the nursing process when administering medications to minimize errors?

Answer 16

During the assessment or data collection phase, gather all of the client’s information about medication administration. This includes the client’s current status and history. Prior to administering some medications, the nurse might need to check the client’s vital signs. Withhold the medication if vital signs are not within a specific range.

Analyze cues to determine the indication for the medication to be administered to the client, identify any potential health problems based on assessment findings, and determine whether the medication and its prescribed dosage are appropriate for the client at this time.

Identify goals and criteria for success related to the client’s needs. Verify calculations for high-alert medications with another nurse and prioritize medication administration as needed.

The implementation phase, taking action, includes correctly calculating dosages and providing instructions and information about the medication according to the client’s needs. Only administer medications that you prepare.

Evaluating outcomes occurs when you identify and document the client’s response to medications you administered
Include the client in the evaluation process.

Question 17

What are the common medication errors?

Answer 17

Medication errors can occur at any time along the prescription continuum. There can be errors in the transcription process as well.
There can also be errors in dispensing
Common types of medication errors involve errors in medication administration. Examples include the following.

Administering the wrong medication
Administering the wrong medication strength
Infusing the wrong IV fluid
Diluting the medication with the wrong solution
Calculating the dose or infusion rate incorrectly
Administering the medication to the wrong client
Administering a medication by the wrong route
Administering medication at the wrong time
Administering a medication when the medical record indicates the client is allergic to it
Omitting a dose
Administering a medication beyond its expiration date
Erroneously discontinuing a medication or an IV fluid infusion

Question 18

When do you file an incident report?

Answer 18

As soon as the client’s needs have been addressed following the discovery of a medication error, fill out the incident or occurrence report and file it with the risk manager.

Question 19

What do you document on an incident report?

Answer 19

The required demographic information; an objective, factual account of what happened; details about the medication; what you did about the error; identify witness; client statements (recorded in exact words)

Question 20

What is the nurse’s responsibility related to adverse medication reactions?

Answer 20

Be aware of the potential adverse effects associated with the medications you administer and monitor clients closely for these. The nurse is responsible for being familiar with facility policy and assessing clients for individual responses to medications. The nurse can reduce the risk of clients developing an adverse reaction to medication by documenting a complete medication history. Understand each medication’s indications, intended effects, and possible adverse reactions. Anticipate adverse reactions when a client begins or stops medication therapy.

Question 21

How do you perform medication reconciliation?

Answer 21

1. List client’s current medications.
2. List new medications.
3. Compare and document changes.
4. Disseminate list to pharmacist, provider, and client.
5. Repeat when transitions in care occur.

Question 22

What are the required components of a prescription?

Answer 22

Clients name, generic medication name, dose, frequency, route, directions, provider signature, date, and time.

Question 23

Name two high alert medications

Answer 23

Anticoagulants, chemotherapeutic agents, opioids, hypoglycemic medications

Question 24

What are examples of high alert mediations?

Question 25

What is Tall Man lettering?

Answer 25

Practice of writing medication names with a mix of upper- and lowercase letters to decrease error with lookalike and soundalike medications

Question 26

Abbreviations that signify a medication is a delayed-release formulation

Answer 26

ER (extended release), XL (extended release), or SR (sustained-release)