Topic 14 Flashcards
Rights of medication administration
*Right patient
*Right drug
*Right dose
*Right time
*Right route
Five additional rights
*Right assessment
*Right documentation
*Patient’s right to education
*Right evaluation
*Patient’s right to refuse
what is needed to determine the right patient
Two forms of identification (name and DOB)
what is needed ti determine the right drug
*Order must be prescribed by licensed health care provider.
*Drug label must be read three times.
*Nurse should be familiar with patient’s health record, allergies, lab results, and vital signs.
*Nurse should know why the patient is receiving medication.
what is needed to determine the right dose
Nurse should check dosage calculation
before adminitering oral medication, what should you do
assess the patients ability to swallow
how should antibiotics be administered
*at even intervals throughout the day to maintain therapeutic drug levels
nurses should always offer water only when taking medications, what is the exception?
iron may be taken with orange juice
Right assessment
requires collection of appropriate data before administration of the drug (health history, allergies, VS, Labs
ight documentation
*Record drug administration immediately.
*Document patient’s response to medication
right to education
*Teach patient accurate and complete drug information.
right evaluation
*Determine drug effectiveness.
*Determine side effects and adverse drug reactions.
right to refuse
*Nurse should explain risks involved.
*Nurse should reinforce reasons and benefits of the drug.
*Nurse should document refusal immediately.
*Follow-up is required.
what are the nurses rights when administering medications
*Right to a complete and clear order
*Right to have the correct drug, route (form), 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
culture of safety
*ANA encourages organization to avoid punitive approaches in drug error reporting.
*Individuals should be encouraged to report drug errors, so the system can be repaired and fixed.
who developed the national patient safety goals
The Joint Commission
FDA’s black-box warnings
appears on a prescription drug’s label and is designed to call attention to serious or life-threatening risks. cause disability, are life-threatening, result in hospitalization or death, or are birth defects
drug reconciliation
*Develop an accurate list of current medications.
what should the nurse advise the patients about with drug reconcilation
*carry a list of personal drug information in the case of emergency.
*Advise patient to update drug list whenever a change occurs.
*bring a list of medications to each doctor appointment.
disposal of medications
*Follow specific information on drug label or insert.
*Transfer drug from original container to undesirable substance (i.e., kitty litter).
*Place mixture in container (i.e., sealed plastic bag).
*Remove all identifying information on label before disposing of empty container.
*Do not flush drugs down toilet unless specifically instructed.
*Return drugs to community “drug take-back” program.
who do you contact if you have any disposal questions of medications
consult pharmacist
what are some examples of safety risks for medication administration
*Tablet splitting
*Buying drugs over the internet
Counterfeit drugs
*May look like desired drug
*May have no active ingredient
*May have wrong ingredient
*May be improperly package or contaminated
*Purchase drugs only from licensed pharmacies
what is important about extended- or sustained-release drugs
do not crush them
high-alert medications
*Can cause significant harm if given in error
what are examples of high alert medications
Epinephrine, insulin, opium tincture, nitroprusside, potassium chloride injection concentrate, heparin, warfarin
what are some other factors to prevent medication errors
*Distraction-free environment
*Medication safety zone
Guidelines for medication administration
*Check expiration date on drug labels and only use current drugs.
*Never leave medications unattended.
*Administer only drugs that you have prepared.
*Identify patient with at least two patient identifiers.
*Stay with patient until all medications have been taken.
*Record effectiveness and results of medication administered.
How do you administer eye drops?
gently pull down the skin below the eye ti expose the conjunctival sac
how do you administer eye ointment?
squeeze a 1/4 inch wide strip of ointment onto the conjunctival sac
how do you administer ear drops to children under 3 years old
straighten the external ear canal by pulling down and back
how do you administer ear drops to adults and children over 3 years
pull auricle upward and outward
what do you always need to do when putting in NG and G tubes
*Always check for proper placement and gastric residual before administering drugs
what is the placement position of NG and G tubes
*Place the patient in high Fowler position or elevate the head of the bed at least 30 degrees
intradermal sites
forearm
scapula
Intradermal angle of injection
10-15 degress
subcutaneous sites
Upper lateral arm, anterior thigh, upper back and abdomen.
Subcutaneous angle of injection
45-90 degrees
intramuscular sites
deltoid, vastus lateralis, ventrogluteal
Intramuscular angle
90 degrees
Z-track method
Pull the skin to one side and hold; insert needle. Holding skin to side, inject needle and medication. Wait for 10 seconds, then withdraw the needle and release the skin
IV common sites
cephalic
median cubital
basilic
radial
technological advances of medication administration
*Pain-free delivery of insulin through a transdermal patch
*Insulin pumps that deliver insulin based upon monitoring of glucose level
*Robotic mixing of antineoplastic drugs
Precautions when reading drug labels
◦Be aware some drug names sound or look alike.
◦Perform a minimum of three label checks with the patient’s medication record.
Drugs administered via nasogastric tube
◦Drug should not be mixed with feeding solution.
◦Dilute drug in 15 to 30 mL of water or other desired fluid.
◦Follow with another 15 to 30 mL of water or other desired fluid.
Calculating intravenous flow rate: milliliters per hour- Required information:
◦Volume to be infused
◦Drop factor of infusion set
◦Time frame
