Unit 2 Safety Flashcards
Safety
- Communication
- Nursing Process
- Comfort
- Mobility
Definition of Safety
- Basic human need
- Freedom from danger, harm or risk
- Paramount concern that underlies all nursing care
Safety Exemplars
- Drug Dosage Calculation
- Asepsis
- Medication Safety
- Risk for Injury
- National Patient Safety Goals
- Risk for Infection
2017 National Patient Safety Goals
As related to medication administration:
- Identify patients correctly
- Improve staff communication
- Use medicines safely
- Prevent infection
Minimizing the risk of medication errors
- Systems approach & good communication between systems
- Strictly apply the Six Rights of medication administration
- Clarify unclear orders
- Have knowledge of each medication prior to administration
- Culture of Safety instead of blame
Six rights of medication administration
- Right drug
- Right dose
- Right client
- Right route
- Right time
- Right documentation
Generic name
nonproprietary or official name - Furosemide
Brand name
proprietary or trade name
- Lasix
Classification
- groups of drugs that share similar characteristics
* Effect on body systems, chemical composition, clinical indication, or therapeutic action
Action
how medications act & type of action
Indication
reason why medication is prescribed
Contraindications
why medication should NOT be given to certain client populations & disease processes
Dosage
- amount of medication given at one time to achieve a therapeutic effect
- Measured in mg, mEq, gram, mcg, etc.
- Varies according to age, gender, weight, type of disease, or administration route
- Too large a dose could be toxic
- Too little a dose could be ineffective
Frequency of administration
time interval between doses
Side effects
predictable & often unavoidable secondary effects produced at a usual therapeutic dose
Adverse reactions
unintended, undesirable, & often unpredictable severe responses to medications
Route
method of administering the medication
Drug interactions
effect of one medication on another, which may alter desired effect
Nursing implications
- Administration recommendations
- Lab values’ relation to medication
- Teaching points
Absorption
The process by which a medication is transferred from its site of entry into the body to the bloodstream
Distribution
Occurs after a medication has been absorbed into the bloodstream & distributed throughout the body
Metabolism
Change of a medication from its original form to a new form
Excretion
The process of removing a medication, or its metabolites, from the body
Factors affecting body’s response to medication
- Weight
- Age
- Gender
- Physiological factors
- Pathological factors
- Genetic factors
- Immunological factors
- Psychological factors
- Environmental factors
- Drug tolerance
- Interactions
- Cumulation
Half life
- The time it takes for excretion processes to lower the amount of unchanged medication by half
- Based on “healthy person”
- Increased in persons with liver or kidney impairment, also in very young & very old
Development consideration
- contraindicated during pregnancy due to effects on fetus
- cross breast milk to nursing infants
- Small size, reduced body weight & body water, ↓ cardiac output & ↓ organ perfusion alter distribution
- Infants & children require lower dosages than adults
Medication effects on older adults
- Slower to metabolize with ↓ excretion rate
- Due to ↑ gastric motility, ↑ adipose tissue, ↓ circulation
- Exacerbated response to cardiovascular medications
- More pronounced hypotensive effects
Peak concentration
The highest level of medication in a clients bloodstream
Trough
The lowest level of medication in a clients bloodstream
Allergies
- Immune system responds to medication as foreign substance & forms antibodies against the medication
- ALWAYS ask the client about any allergies when administering medications
- Client needs to be wearing red arm band if allergic to medications or any substance
- Do not administer medication if client states they are allergic to it
- Allergic reactions range from rash to anaphylactic shock
- If reaction occurs, notify physician
When anaphylactic shock occurs
- ↑ head of bed
- Administer oxygen
- Call Rapid Response Team
- Notify physician STAT
OTC Medications
- Prescription not required
- Allow people to treat common ailments without seeking medical attention
- It is wise to ask clients about OTC medications or herbs they take due to potential interactions with prescribed medications
Herbal remedies
- Rapidly growing area in self-care
- used since ancient times
- Placebo effect?
- The key: Balance herbal remedies & alternative therapies with the medical regimen the client is currently following
- Not controlled or tested by the FDA
- The Dietary Supplement Health & Education Act of 1994 classifies herbal products, vitamins, & minerals, & amino acids as dietary supplements
- Not required to go through premarketing testing
Issues with herbal remedies
- Not tested by FDA
- May interact with other medications
- Client doesn’t always tell HCP of use of herbal medications or alternative therapies
Substance abuse
- Refers to use of illicit & street drugs for recreational use
- Alcohol
- Addiction to prescription narcotics, such as opioids
Drug seeking behaviors
- Stealing
- Lying
- Making excuses which don’t make sense
Requirements of medication orders
- Client’s name
- Date & time order is written
- Name of medication to be administered
- Dosage of medication
- Route medication is to be administered
- Frequency of administration
- Signature of person writing the order
Telephone orders
- A medication order from the HCP which is received over the phone by a nurse
- Time, date, & other required order elements
- Be sure to repeat order back to HCP to assure accuracy
