Week 7 medication administration

Question 1

area of potential liability for nurses

Answer 1

Failure to assess/evaluate
failure to ensure safety
medication errors
fraud

Question 2

Components of a Medication Order

Answer 2

 Patient’s name
 Medication name
 Dose with unit measurement (size )
 Frequency
 Route
 Prescriber’s signature w/date and time
 Indication may not be indicated with PRN

Question 3

What is missing?
1. acetaminophen 650mg q6h prn pain
2. Vicodin tabs PO q4h prn pain
3. morphine sulfate 2 q2h prn pain
4. furosemide 40 mg one tab PO

Answer 3

1. route
   2/ doses unit
   3/ route
   4/ frequency

Question 4

Rights of Medication Administration

Answer 4

 Right Patient?
 Right Drug?
 Right Dose?
 Right Time?
 Right Route?
 Right Documentation?
 Right Reason?
 Right Form?
 Right Response?

Patients Do Drugs Round The Day: PPDRTD

P: Right Patient
D: Right Drugs
D: Right Dose
R: Right Route
T: Right Time
D: Right Documentation

RFR

Question 5

Causes of Medication Errors

Answer 5

 Not obtaining a thorough medical history
 Lack of knowledge
 Dosing miscalculations
 Drug administration
 Work-arounds
 Environmental factors

Question 6

Drugs and Tallman Lettering

Answer 6

OxyCODONE oxyCONTIN
HumuLIN HumaLOG
CeleBREX Cerebyx
Plavix Paxil
Miralax Mirapex

Question 7

Adverse Drug
Events (ADE)

Answer 7

Question 8

Preventing Medication Errors 11 in total part 1

Answer 8

 Assess drug allergies, vital signs, and lab data
 Use at least two patient identifiers
 Never administer drugs you did not prepare yourself
 Understand rationale for drug order

 Never use trailing zeros for amounts > 1 (Ex: 1.0mg misinterpreted as 10mg)
 Use leading zeros for amounts < 1 (Ex: .25mg misinterpreted as 25mg)
 Recalculate doses for high-alert and pediatric patients and second RN

Question 9

Preventing Medication Errors 11 in total part 2

Answer 9

 Use generic names to avoid sound-alike, look-alike names
 Use authoritative sources
 Question the need for overriding systems
 Investigate patient concerns

Question 10

Reporting & Documenting Errors

Answer 10

 Assess patient first!
 Report to the instructor and nurse
 Monitor changes in condition
 Notify physician and follow-up orders
 File incident report for errors and “near misses”
 Provide full disclosure to the patient
 Filing of the report is not documented in chart

Question 11

List at least four ways a drug could be named.

Answer 11

Answer:

Drugs can be named in these four ways:
o Chemical name

Generic (nonproprietary) name
Official name

Brand (trade, proprietary) name

It is usually most important to know the brand name and
the generic name.

Question 12

Right drug

Answer 12

The right medication/drug (right action)—giving the patient the medication prescribed on the medication administration record (MAR) and checking the label three times before giving the drug. Ensure that the drug is being given for the appropriate reason.

Question 13

The right patient

Answer 13

© —identifying the patient using their iden- tification band, asking for their name so the medication is not given to the wrong patient.

Question 14

The right dose—

Answer 14

giving the correct amount of the medica- tion (this includes giving the prescribed amount, as well as being certain that this amount makes sense in light of the patient’s weight or other condition).

Question 15

The right route

Answer 15

giving the medication by the
prescribed route (e.g., oral, intramuscular, IV). Question-
ing the prescription if the drug is not available in the form
needed for the prescribed route or if the patient’s status
requires a route different from what is prescribed (e.g., an
oral medication is prescribed, but the patient is vomiting).

Question 16

right documentation

Answer 16

the medi-
cation is documented on the MAR. There is additional
documentation in the narrative notes if the medication is
prescribed prn, if the patient had a reaction to the medicine, or if the patient refused the medicine.

Question 17

right to know

Answer 17

telling the patient the name of the
medication, what it is being given for, and the side effects
that could occur.

Question 18

right to refuse

Answer 18

accepting that the patient has the
right to refuse a medication regardless of their reasons
and regardless of the consequences. Therefore, an example
might be that a nurse caring for a patient who has end-
stage cancer understands and complies with their decision
not to pursue chemotherapy.

Question 19

3 checks

Answer 19

Answer: The medication should be checked against the MAR at the following times:
o Before you pour, mix, or draw up a medication, you must check its label against the entry on the MAR, ensuring that the name, route, dose, and time match the MAR entry.

o After you prepare the medication and before you return the container to the medication cart or discard anything, you check the label against the MAR entry again.
o At the bedside, you check the medication before you actually administer it.

Question 20

What strategy could you use to help you remember side effects?

Answer 20

eo Central nervous system—dizziness, headache, fatigue,
depression, paresthesia, and lethargy
Cardiovascular—hypotension and chest pain
Gastrointestinal—diarrhea, nausea, and dyspepsia
Genitourinary—decreased libido, impotence, and hypokalemia
Eyes, ears, nose, throat—nasal congestion and cough