Week 2: Oral Medications Flashcards
What is the most common medication error in Ontario acute care hospitals?
Dose omissions
What is the most frequent drug class involved in drug errors?
CNS agents
The client is to receive a medication via the buccal route. What should the nurse do before administering?
a. crush medication
b. place medication inside the cheek
c. offer client glass of orange juice after administration
d. use sterile techique to administer the medication
b. place medication inside cheek
10 Rights for Safe Medication Administration
Right medication
Right dose
Right time
Right route
Right patient
Right reason
Right documentation
Right evaluation
Right patient education
Right to refuse
What are the 3 principles of medication administration?
Authority: nurses must have level of authority to perform medication practiced. Orders must be clear and appropriate
Competence: Nurses ensure they have knowledge, skill and judgement needed to perform practices safely
Safety: Nurses promote safe care and contribute to a culture of safety within their practice environments
Routes of PO medications
- Sublingual: This is where the medication is placed under the patient’s tongue. They dissolve there and their ingredients are quickly absorbed into the bloodstream. There are tablets, sprays and film sublingual’s. Fluids cannot be taken for sublingual medications.
- Buccal: This is a medicine given between the gums and the inner lining of the mouth cheek. It is recommended to switch the capsule from cheek to cheek to prevent mucosa breakdown. This can be delivered by mouthwashes, sprays, chewing hums, tablets, gels and patches. Fluids cannot be taken for buccal medications.
- Powdered: Drugs may also be crushed up to prevent choking. Powdered medications may be mixed with foods such as apple sauce to help with digestion.
- Other routes by PO can be taken with pills, and liquids.
What does the nurse need to assess before medication administration?
- History of allergies
- History of medications (indications and contraindications)
- Medication data: info about each med to make sure its correct such as normal dosage, routes, adverse effects
- Diet history: reveals patients normal eating patern
To prevent medication errors, the three checks are an expected standard; what are they?
Obtaining the container, removing the med, replacing the container
How do you avoid ME’s?
- Prepare drugs alone
- Dont leave drugs alone
- Prepare and administer
- Lock med cart
- Supervise swallowing
What is MAR? What is included in the MAR?
Medical Administration Record.
- Includes medication name, dose taken, special instructions, and ate and time.
For a NP or doctors drug order to be complete what must it include?
Patient name, date and time, drug name, drug dosage
When administering narcotics (controlled substance) what must you include?
- Pt. name
- Amount
- Time
- Physician
- Nurse signature
- Waste/ witness
- Count
- Discrepancies
When documenting your medication what must be included?
Med name
Dosage
Route
Time
Nurse initials
Nurse signature
Site of injection
Other info
If any omitted drugs describe reason and notify MD
Refused drugs
What drugs must not be crushed?
Enteric coated drugs
What are ways to dispose of medications such as narcotics?
- Pick-up and mail back
- Destruction; medications placed in bottle and dissolved in solution
- Incinerating: placing materials in hazardous waste containers
- Transferring to reverse distributers
