Safe Medication Administration Oral/PO Medications Flashcards
Before administering a medication, the nurse should ask themselves what?
- Is this medication correct for this patient?
- Appropriate?
- Is it the right time?
Therapeutic effects
Expected or predicted physiological response.
Adverse drug reactions
- Unintended, undesirable, often unpredictable
- Allergic reactions: unpredictable, medication triggers antibodies
Side effects
Predictable, known, often unavoidable secondary effects
Toxic effects
Accumulation of medication in the bloodstream
Idiosyncratic reaction. Give an example.
Patient over or under reactions to medication or has a different reaction than normal. A common example is when a child gets agitated or excited instead of drowsy when given an antihistamine.
Time intervals of medication action
Onset: time it takes for a medication to produce a response
Peak: time at which a medication reaches its highest effective concentration
Trough: minimum blood serum concentration before next scheduled dose
Duration of action: time medication takes to produce greatest result
Plateau: blood serum concentration is reached and maintained
Medication Zip Code: 32111 (use to avoid medication errors!)
- Five rights x 3- two med checks at med cart and one med check in room at bedside.
- Allergies x 2- Med room and at bedside
- pharmacology critical assessments x 1: things you need to know about a patient/patient’s condition before administration- such as blood sugar before insulin
- expiration date x 1- anytime before you place the medication into the cup or syringe
- Documentation x 1- after the medication administration
What are the five rights of medication administration?
- right patient
- right medication
- right route
- right dose
- right time
Patient’s Rights
- right to be informed about a medication
- right to refuse a medication
- right to have a medication history
- right to be properly advised about experimental nature of medication/research study
- right to receive labeled medications safely
- right to receive appropriate supportive therapy
- right to not receive unnecessary medications
- right to cultural differences (use of herbal and homeopathic remedies in some cultures alters response to a medication)
Medication errors include:
- wrong patient
- Inaccurate prescribing
- wrong medication
- wrong route
- wrong time
- extra doses
When are oral medications contraindicated?
When the patient can’t swallow, alterations in GI function (vomiting), when patient is unconscious
When are topical medications contraindicated?
Skin abrasions- openings on skin, will cause systemic effect.
What are sublingual medications and how should a patient be instructed to take them?
Medications that are readily absorbed after being placed under the tongue to dissolve. Instruct patients not to swallow a medication given by sublingual route or drink anything until the medication is completely dissolved to ensure that the medication will have the desired effect.
What are buccal medications and how should a patient be instructed to take them?
A buccal medication acts locally on the mucosa or systemically as it is swallowed in a person’s saliva. Buccal route involves placing the solid medication into the mouth, against the mucous membranes of the cheeks until it dissolves. Teach patients to alternate cheeks with each subsequent dose to avoid mucosal irritation. Warn patients not to swallow the medication or to take any liquids with it.
Why is insulin’s administered by injection and not orally?
Because the GI tract breaks it down and destroys an oral form of insulin
What type of insulin is the only type that can be given intravenously?
Regular insulin
Why do we not shake insulin vials to resuspend insulin?
- preventing air bubbles: shaking the vial can create air bubbles that make it difficult to draw the correct dose into the syringe
- protecting the insulin structure: insulin is a delicate protein. Vigorous shaking can damage its molecular structure, reducing its effectiveness. This denaturation can cause the insulin to become less potent or inactive.
- avoiding foam formation: rolling the vial gently redistributes the suspended particles without damaging the insulin or introducing bubbles
How to roll insulin vial correctly:
- Place vial between palms
- Roll it back and forth gently for about 10-20 seconds
- Ensure the insulin looks uniformly cloudy (no clumps or patches stick into the vial walls) before drawing up the dose
Additional notes:
- clear insulins: do not need to be rolled or shaken, as they are already in a solution and do not contain suspended particles (e.g., regular insulin or rapid acting insulins like lispro)
Why can’t long-acting insulins like glargine (Lantus) and determir (Levemir) be mixed with other insulins?
You cannot mix long-acting insulins like glargine with other types of insulin because doing so can compromise its chemical structure, efficacy, and intended function.
Inject rapid-acting insulin insulins mixed with NPH insulin within ______ minutes before a meal.
15
How to mix insulins?
Use only ONE needle.
1. Inject air into vial A -how much? Should match the amount of fluid you are drawing out.
2. Withdraw the needle and aspirate air to inject into vial B - how much? Withdraw medication from vial B.
3. Insert needle back into vial A being careful not to push your plunger
(What happens if you push your plunger? You will need to start over)
4. Withdraw amount needed from vial A.
5. Apply a new needle before administering to your patient.
Best sites for SQ injections?
The outer aspects of the upper arms, the abdomen from below the costal margins to the iliac crests, and the anterior aspects of the thighs
Aspirate before administering IM injections except for?
Immunization, no aspiration needed (based on CDC recommendation)
