Week 4 Drug Admin Flashcards
Drug Administrations
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Indications
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Appropriate dosage
Round up decimals at or above 0.5
Precaution
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Contraindications
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Nursing indications
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Therapeutic effects
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Adverse effects
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Toxic effects
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Idiosyncratic
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Age
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Organ system function
–Nephrotoxic
–Hepatotoxic
–Ototoxic
Height & Weight
BSA
Generic Name
–Salicylic acid
–Morphine sulfate
–Acetaminophen
Trade Name
–Bayer, aspirin
–Morphine
–Tylenol
All Drug Classification
–Antipyretic –Antihypertensive –Antiemetic –Diuretic –Analgesic –Anticoagulant –Antihistamine –Bronchodilator
What does the FDA do?
- Responsible for public safety
- Regulates the manufacture, sale & effectiveness of drugs
- Prevents unsafe drugs from being marketed
- Recalls dangerous drugs off the market
- Identifies which meds require a prescription
- Controls drug advertisement
Drug Classifications
- Schedule l – Schedule V
- Based on abuse potential
- Most narcotics are Class II
- Special handling requirements for narcotics
Drug Order Components
–Patient’s name –Date and time order written –Medication name –Medication dose –Frequency of administration –Route of administration –Signature
Types of Orders
- Standing
- Prn – pro re nata
- Stat
- One time
- Repeat
Administration Precautions
- Wash hands before and after
- Prepare medications for 1 patient at a time
- Do not touch medications
- Do not use unmarked or illegible containers
- Be aware of changes in liquid clarity
- Be aware of presence of sediment
- Check expiration dates
- Do not allow interruptions
- Double check all calculations
- Never crush SR or EC meds
- SR: sustained release
- EC: enteric coated
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How to prevent dosage errors
•Use leading zeros
–0.52 mg NOT .52 mg
•No trailing zeros
–2.5 mL NOT 2.50 mL
How do pour granulated cylinder
- Pour liquid medications at eye level
- Read dose at base of meniscus
- Pour away from label
Assessment before Medication Administration
- Check the Medication Administration Record (MAR)
- Diet and fluid orders
- Laboratory values
A nurse is conducting an interview with a patient to collect a medication history. Which of the following questions would be used to ensure safe medication administration?
a. “Have you noticed any change in your bowel habits?”
b. “How do you feel about taking medications?”
c. “Do you have any allergies to medications?”
d. “At what times do you take your medications?”
Assessment before Medication Administration
•Patient identity –2 forms •Ability to swallow •GI motility •Body system assessment •Vital signs
5 Patient Rights
- The right drug
- The right dose
- The right client
- The right route
- The right time
3 checks
- When you reach for the container or unit dose package
- After retrieval from the drawer, compare with the MAR
- When replacing the container or before giving the unit dose to the patient.
Avoid Errors
- Follow five rights
- 3 checks: Read labels at least 3 times
- Review preadministration assessments
- Identify patient by 2 routes
- Record all medications and pre-administration data as soon as the medication is given
- Never administer a drug prepared by another nurse or an unfamiliar drug
During the administration of medications to a patient, the priority nursing action is
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Documentation
•Document as soon as given •Document if not given and reason –Patient refusal –Medication held •Document response to medication
Patient Education
- Type of med and dose
- Time of administration
- Potential side effects
- When med can be stopped
- When med needs to be gradually stopped
- What adverse effects to report
The nurse is preparing medications for administration. Of the following actions, which would be inappropriate.
a. Prepare medications for one client at a time
b. Calculate correct drug dosage
c. Open unit tablets and place medications in medication cup
d. Avoid touching tablets or capsules with the hands
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Oral Medications Administration
•PO –Tabs –Capsules –Caplets –Spansules –Liquids –Suspensions •Sublingual •Buccal
Oral, how to administer
- Ensure patient can swallow
- Position patient properly
- Explain purpose of medication
- Open unit doses at bedside
- Do not leave medication at bedside
- Remain with patient while taking meds
What would a nurse instruct a patient to do after administration of a sublingual medication?
a. “Take a big drink of water and swallow the pill.”
b. “Try not to swallow while the pill dissolves.”
c. “Swallow frequently to get the best benefit.”
d. “Chew the pill so it will dissolve faster.”
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Common abbreviations
- a before
- p after
- ac before meals
- pc after meals
- AD right ear
- AS left ear
- AU both ears
- bid Two times a day
- tid Three times a day
- qid Four times a day
- h (hr) Hour
- OD right eye
- OS left eye
- OU both eyes
More abbreviations
- c with
- s without
- cap capsule
- dc (D/C) discontinue
- DS double strength
- EC enteric coated
- SR sustained release
- Elix elixir
- g gram
- gr grain
- mL milliliter
- gtt drop
- hs hour of sleep
More and more abbreviations
IM intramuscular •IV intravenous •SC subcutaneous •ID intradermal •PR per rectum •SL sublingual •po by mouth •NG nasogastric •GT gastrostomy tube •mEq milliequivalents •sol solution •liq liquid •ung ointment
Abbreviations you should NOT use
- U – use units
- cc – use mL
- IU – use international unit
- QD – use every day
- QOD – use every other day
- Drug names such as MSO4
Tetracycline (Broad spectrum antibiotic) 1g daily po in two divided doses
(Available as oral suspension 125 mg/5ml)
- How many mg would the patient receive per dose?
- How many mL would the patient receive per dose?
- How would you schedule the doses?
- This drug is nephrotoxic; what does this mean and what nursing considerations would it present?
Enteral tubes
–Nasogastric tube (NG)
–Nasoenteric tube (NET)
–Percutaneous endoscopic gastrostomy (PEG)
–Gastrostomy tube (GT)
Inhaled
medications
•Metered-dose inhaler (MDI)
–Dry powder
–Liquid
•Spacer (aerochamber)
Inhaled medications
•Uses:
–Administer drugs
•Bronchodilators
- Rinse mouth after
- Document response
Transdermal
- Remove previous patch and any remaining traces of medication
- Avoid touching med - Fold patch to be discarded into itself
- Apply new patch to a clean, hairless, dry intact area of skin
- Note date, time and your initials on patch
- Dispose of patch properly
- Rotate sites
How would you dispose of a transdermal patch with a narcotic medication?
In the sharps container
Topical Medications
- Creams
- Lotions
- Ointments
- Irrigation solutions
- Impregnated dressings
Ophthalmic
•Eye drops and ointment
•Provide patient with tissues
•Hyperextend head and have patient look toward ceiling
•Rest other hand on patient’s forehead and hold dropper ½ to ¾ inch above eyeball
•Pull down lower lid pressing on lower boney orbit
•Instill drops into the conjunctival sac, apply slight pressure to tear duct
–Instill ointment from inner to outer canthus
•Instruct patient to close eyes
Otic
- Turn head to unaffected side
- Ensure drops are at room temperature
- Pull pinna up and back in older children and adults
- Instill ordered number of drops ½ inch above ear canal
- Release pinna and gently massage tragus
- Wait a 2-3 minutes before instilling drops in opposite ear
Nasal Medications
- Atomizer and drops
- Have patient sit up and lean head back
- Place tip of bottle just inside nare
- Aim spray or dropper toward the midline of the nose
- When the patient inhales, squeeze the bottle once
- Instruct patient to keep heard tilted back for 2-3 minutes
Rectal Medications
Suppositories or enema
•Place patient on left side
•Don gloves
•Lubricate suppository or enema catheter tip
•Insert past the internal anal sphincter against the rectal wall
Vaginal Medications
- Foams, jellies, liquids (douches), creams, tablets, suppositories
- Position patient in dorsal recumbent or side lying position
- Don gloves
- Insert medication using an applicator
