Clinical Topics # 3

Medication Administration Part 1 Student Guide

Objectives: Students will: Identify practices to maintain safety in medication administration. Prepare and administer oral, topical, eye, ear, rectal, vaginal, & inhalant medications. Document medication administration. Understand the role of the nurse in medication administration errors Other: Math ee! "#

Nursing Diagnosis: Deficient $nowledge vs. %on&compliance Discussion Questions: '. hat should (e included when o(taining a complete medication history) pg*+, Allergies Inform the other mem(ers of the health care team if the patient has a history of allergies to medications and foods. Many medications have ingredients also found in food sources. Medications -ssess information a(out each medication that the patient ta!es, including length of time the medication has (een ta!en, the current dosage, and whether or not the patient e.periences side effects or has had adverse effects from the medication. Diet istor! - diet history reveals a patient/s normal eating patterns and food preferences. -n effective dosage schedule is planned around them. "atient#s "erceptual or Coordination "roble$s - patient with perceptual fine&motor or coordination limitations has difficulty self&administering medication. "atient#s Current Condition 0he ongoing physical or mental status of a patient affects whether a medication is given or how it is administered. hat needs to (e included in a medication order) Pg *12 3 "atient%s &ull na$e: 0he patient/s &ull na$e distinguishes the patient from other persons with the same last name. 3 Date and ti$e that the order is 'ritten: 0he day, month, year, and time need to (e included. Designating the time that an order is written helps clarify when certain orders are to start and stop. 3 Medication na$e: 0he health care provider orders a medication (y its generic or trade name. 4orrect spelling is essential in preventing confusion with medications with similar spelling. 3 Dose: 0he amount or strength of the medication is included. 5all #2''

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3 (oute o& ad$inistration: 0he health care provider uses accepted a((reviations for medication routes. 3 Ti$e and &re)uenc! o& ad$inistration: 0he nurse needs to !now what time and how fre6uently to administer medications. 7rders for multiple doses esta(lish a routine schedule for medication administration. 3 Signature o& health care provider: 0he signature ma!es an order a legal re6uest. 8. hat are some steps to ta!e to prevent medication errors) 3 Prepare medications for one person at a time. 3 5ollow the si. rights of medication administration. 3 9e sure to read la(els at least three times :comparing medication administration record ;M-<= with la(el> (e&ore administering the medication. 3 Use at least two patient identifiers and review the patient/s allergies whenever administering a medication. 3 Do not allow any other activity to interrupt administration of medication to a patient :e.g., phone call, pager, discussion with other staff>. 3 Dou(le&chec! all calculations and other high&ris! medication administration processes :e.g., patient&controlled analgesia> and verify with another nurse. 3 Do not interpret illegi(le handwriting? clarify with prescri(er. 3 @uestion unusually large or small doses.

A. Identify the si. rights and three chec!s of medication administration. pg*BA& pg*+B (ight Medication (ight Dose (ight "atient (ight (oute (ight Ti$e (ight Docu$entation hen preparing medications from (ottles or containers, compare the la(el of the medication container with the MA( three ti$es* +,- (efore removing the container from the drawer or shelf, +.- as the amount of medication ordered is removed from the container, and +3- at the patient/s (edside (efore administering the medication to the patient. *. hat is a unit dose system) Pg *+' 0he unit&dose system uses carts containing a drawer with a #A&hour supply of medications for each patient. Cach drawer is la(eled with the name of the patient in his or her designated room. Cach ta(let or capsule is wrapped in a foil or paper container. B. hat is a multi&dose system) ,. Descri(e the difference (etween scheduled medication :standing order> and P<% medication documentation. hat is a S0-0 order) pg*,,&*,+ Standing Orders - standing order is carried out until the prescri(er cancels it (y another order or a prescri(ed num(er of days elapse. /0a$ple* 0etracycline *22 mg P7 6Bh "(N O(D/(S 0he prescri(er orders a medication to (e given only when a patient re6uires it. 5all #2''

/0a$ple* Morphine sulfate #mg ID 6#h prn for incisional pain +. 9riefly descri(e these pharmacological concepts: Drug %ame, 4lassification, Medication forms, -(sorption, Distri(ution, Meta(olism, C.cretion, therapeutic effects, and side effects. Drug Na$e - drug has three different name forms. 0he 0rade %ame :so that the drug is easy to pronounce, spell and remem(er>, the chemical name, and the generic name. Classi&ication Medication classification indicates the effect of the medication on a (ody system, the symptoms the medication relieves, or its desired effect. Medication 1or$s Medications are availa(le in a variety of forms, or preparations. 0he form of the medication determines its route of administration. Absorption Absorption is the passage of medication molecules into the (lood from the site of medication administration. Distribution -fter a medication is a(sor(ed, it is distri(uted within the (ody to tissues and organs and ultimately to its specific site of action. Metabolis$ -fter a medication reaches its site of action, it (ecomes meta(oliEed into a less active or inactive form that is easier to e.crete. 2iotrans&or$ation occurs under the influence of enEymes that deto0i&!, (rea! down, and remove (iologically active chemicals. /0cretion -fter medications are meta(oliEed, they e.it the (ody through the !idneys, liver, (owel, lungs, and e.ocrine glands. 0he chemical ma!eup of a medication determines the organ of e.cretion. Therapeutic /&&ects 0he therapeutic e&&ect is the e.pected or predicted physiological response that a medication causes. Side /&&ects Side e&&ects are predicta(le and often unavoida(le secondary effects produced at a usual therapeutic dose. 1. hat are the different routes of medication administration) Oral (outes Su(lingual F Under 0ongue 9uccal F mucus mem(ranes of the chee! "arenteral (outes 3 4njection into bod! tissue Intradermal Su(cutaneous Intramuscular Intravenous /pidural +via catheter4ntrathecal 3 administered through catheter in su(&arachnoid space or one of the (rains ventricles 5all #2''

4ntraperitoneal 3 -dministered into peritoneal cavity 4ntrapleural 3 meds administered to pleural spaces 4ntraaterial Topical 4ntraocular 4nhalation '2. hat must you do if a medication error occurs) pg*+#&+8 hen a medication error occurs, the nurse should first assess the patients well& (eing and notifies the patientGs health care provider as soon as possi(le. 0he nurse should then inform the proper person within the institution :i.e. manager> and then file an incident report within #A hours.

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