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Med Admin Objectives
Discuss the nurse's role and responsibilities in safe medication administration - โ -The nurse is responsible for having knowledge of federal, state local laws, and facility policies on how to prescribe, dispense, and administer med. -Preparing, administering, and evaluation response to meds. -Develop/Maintain knowledge of med. Given including, uses, actions, routes, adverse and side effects, precautions, contraindications, interactions -Maintain knowledge of skill of practice and competency -Determine accuracy of med. Prescriptions -Report medication Errors -Safeguard and properly storing meds *Nurses play an essential role in safe medication preparation and administration, and in evaluation of medication effects. In all settings, nurses are responsible for evaluating the effects of medications on patients' ongoing health status, teaching them about their medications and side effects, ensuring adherence to the medication regimen, and evaluating the patient's and family caregiver's ability to self-administer medications Nurse's role: Assess patient Determine whether patient should receive Administer medication correctly Closely monitor effects; do not delegate this task Discuss and apply the "Six Rights of Proper Medication Administration." - โ 1. Right Med -a med order is required for every med you give -CPOE allows for DRs to order meds electronically... but you must compare these to written orders -compared labels 3x -never prepare meds from that are unmarked -check order with MAR
- Right Dose -have nurses check your math doses
-prepare meds using standard measurement devices such as graduated cups, syringes, scaled droppers... educate patients to use similar devices because household items are often inaccurate
- Right Patient -2 identifiers -maybe medical record number -must match MAR
- Right route -always seek help if an order doesn't include the route of administration. Recent evidence shows that medication errors involving the wrong route are common -recommended that PHARMACISTS to prepare oral meds that aren't prepared commercially as a unit to enhance patient safety
- Right Time
- Right Documentation -before administering a md, ensure that the MAR clearly reflects a patient's full name, the name of the ordered med, the time to be given, the dosage, route and frequency -After administering a med, immediately document the med on the patients MAR to verify it was given. Document the site of any injections and the patient's response to the med, positive/negative. Describe the process of individualizing medication administration for each patient and specific to the routes administered. - โ 1. must have a complete, legal order by a doctor
- determine if appropriate
- know the action, dosage, route, adverse effects & should be considered and compared against the PT current meds
- CI and DI
- Lab results, vital signs
- Current status
- allergies
- medical hx
- past/current health hx
- decrease workarounds
- do not use error prone abbreviations or symbols slide 57- what do you document? - โ -med, dose, route, time -effects, why given or not -how the PT tolerated Reporting medication errors/near misses - โ important to feel comfortable in reporting an error and not fear repercussions from managerial staff. Even when a patient suffers no harm from a medication error, the institution can still learn why the mistake occurred and what can be done to avoid similar errors in the future When an error occurs,* the nurse first assesses and examines the patient's condition* and notifies the HCP of the incident as soon as possible. Once the patient is stable, the nurse reports the incident to the appropriate person in the institution (e.g., manager, supervisor). The nurse is responsible for preparing a written occurrence or incident report that usually needs to be filed within 24 hours of the error. The report includes patient identification information; the location and time of the incident; an accurate, factual description of what occurred and what was done; and the signature of the nurse involved. The occurrence report is not a permanent part of the medical record and is not referred to anywhere in the record. This legally protects the nurse and the institution. Agencies use occurrence reports to track incident patterns and initiate quality improvement programs as needed. Demonstrate effective patient teaching regarding medication administration. - โ โขMany patients take meds incorrectly because they don't understand their meds. โขYou should include side effects, dosages, the purpose, actions, timing of medication. The patient should know how to take the med properly and the risks if they don't! For example, if patient is prescribed an antibiotic, they should know if they don't finish it, it could lead to the worsening of their condition.
โขTry to use the Teach Back method, in which you explain the medication to the patient and have them tell you about it afterwards, so you can confirm they understand. Maybe even inform their family member who may be acting as a caregiver! consider their knowledge, readiness to learn, and environment slide 62 Accurately calculate dosages for medication administration. (DA Module 1 and 2) - โ review other quizlets and do practice problems medication = - โ a substance used in the diagnosis, treatment, cure, relief, or prevention of health problems. principles of medication therapy: meds modify what? meds do not create what? all meds are? no meds produce? - โ Medications modify existing physiological functions on cells, tissues or a body organ Medications do not create new functions All medications are potential poisons when taken in sufficiently high doses No medication produces one and only one effect Acetaminophen (Tylenol) Actions: Adverse effects: CI: Cautions: - โ actions: -Acts on hypothalamus to produce antipyresis -Works peripherally to block pain impulse generation -Inhibits prostaglandin synthesis in CNS 22 adverse effects CI: -hypersensitivity -severe active liver disease (cirrhosis, jaundic) Cautions: -available in many dosages and products, so check label carefully to avoid overdose
T or F. Medications produce one and only one effect - โ False! There is no such thing as a selective medication; all medications can cause side effects. Which organizations are involved in medication legislation and standards? - โ Federal level -Pure food and drug act -FDA -MedWatch program State -TX board of nursing- NPA Federal and National Regulation Set standards for medication purity, quality, labeling, etc chemical name: - โ - provides the exact description of medication's composition Chemical: N-acetyl-para-aminophenol generic name: - โ the manufacturer who first develops the medication assigns the name, and it is then listed in the U.S. Pharmacopeia Generic: acetaminophen trade name: - โ - also known as brand or proprietary name. This is the name under which a manufacturer markets the medication
- Trade: Tylenol, Panadol, Tempra *Many companies produce the same medication, and similarities in trade names are often confusing. Therefore be careful to obtain the exact name and spelling for each medication you administer to your patients Therapeutic effect: - โ Expected or predicted physiological response Some medications have more than one therapeutic effect adverse effect: - โ Unintended, undesirable, often unpredictable Idiosyncratic reaction: - โ Unpredictable Over-reaction or under-reaction or different reaction from normal
side effect: - โ Predictable Often unavoidable adverse effect produced at usual therapeutic dose toxic effect: - โ Accumulation of medication in the bloodstream due to impaired metabolism or excretion can develop after prolonged intake of a med see SI notes allergic rxn: - โ Unpredictable response to a medication morphine sulfate: classification: indication: action: side effects: - โ Classification: Therapeutic - Opioid, Analgesics Indication: For severe pain Action: To relieve pain Side Effects: Confusion, sedation, respiratory depression, constipation onset - โ Time it takes for a medication to produce a response trough - โ Minimum blood serum concentration before next scheduled dose plateau - โ Point at which blood serum concentration is reached and maintained peak: - โ Time at which a medication reaches its highest effective concentration duration: - โ Time medication takes to produce greatest result biological half-life: - โ Time for serum medication concentration to be halved parenteral means - โ in the vein, in the fat, in the muscle so these are IM, subcuteanous, and IV injectables oral - โ by mouth (PO)
Standing or Routine: - โ Administered until the dosage is changed or another medication is prescribed or the prescribed number of days elapses. It often indicates a final date or number of treatments or doses. single - โ (one-time): Given one time only for a specific reason now - โ When a medication is needed right away, but not STAT prn - โ Given when the patient requires it STAT - โ Given immediately in an emergency Prescriptions: - โ Medication to be taken outside of the hospital which medications are on high alert and require a 2 RN check? - โ insulin, anticoagulants which meds are high alert but do not need to be verified by 2 RNs? - โ narcotics, opioids, pain meds, K+ what guides the nurse in administering meds safely? - โ 6 rights and the nursing process slide 48- non-medication measures - โ Lifting the head of the bed, ice packs, physical therapy (movement), distractions, compression *often enhances medication therapy always know what about adverse effects: - โ The major adverse effects the medication can produce The time when these reactions are likely to occur Early signs that an adverse reaction is developing Interventions that can minimize discomfort and harm review other quizlet on conversions - โ
