Medication Administration Notes
Medication Administration Notes NURS 1107
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This 4 page Class Notes was uploaded by Mikella Notetaker on Monday October 3, 2016. The Class Notes belongs to NURS 1107 at North Arkansas College taught by Gipson, Feighert in Fall 2016. Since its upload, it has received 11 views. For similar materials see Fundamentals of Nursing in NURSING at North Arkansas College.
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Date Created: 10/03/16
Learning Objectives Chapter 32- Medication Administration 1. Define key terms and abbreviations frequently used in medication administration. BID- 2 times a day QID- 4 times a day PO- by mouth NPO- nothing by mouth PRN- as needed HS-hours of sleep AC-before meal PC- after meal QH- every hour Q4H- every 4 hours TID- 3 times a day 2. Discuss principles of safe medication and the nurse’s responsibility. Determining medication order is correct Assessing patient’s ability to self-administer Determining whether patient should be given medication at that given time Administering mediation correctly Closely monitoring effects 3 checks: compare medication label to MAR 3 times o Before removing packaging/container o As medication is removed o After medication is removed 6 Rights: o Right medication My o Right dose Dog o Right route Rolls o Right time Through o Right patient Puddles o Right documentation Daily Prepare medications for only one person at a time 2 patient identifiers No interruptions 3. Discuss potential liabilities for the nurse administering medications. A nurse is responsible for following legal provisions when administering controlled substances such as opioids, which are carefully controlled through federal and state guidelines. Violations can be fines, imprisonment, and loss of nurse license. 4. Develop teaching guidelines for clients regarding medication administration in the home. Include information about the purpose, actions, timing, dosages, and side effects. Use Teach Back method. IV care at home: need to know how to recognize problems, when to notify home care nurse or provider, teach how to maintain IV administration equipment. 5. Explain procedures for the different methods of medication administration including the choice of route and site. Caplet, Capsule, tablet, enteric-coated tablet- oral route Elixir, extract, aqueous solution, aqueous suspension, syrup- liquids by mouth Troche (dissolve in mouth), Aerosol (sprayed and absorbed in mouth), sustained release- by mouth o Oral route: sublingual (readily absorbed after placed under tongue, no food or drink), buccal (against cheek, not to chew or swallow the med or drink) Ointment, liniment, lotion, paste, transdermal patch- topical route Solution, powder-parenteral route o Parenteral route: intradermal (just under the epidermis), subcutaneous (into tissues below dermis), intramuscular, Intravenous Intraocular disk (similar to contact lens), suppository- body cavities 6. Correctly calculate dosages for medications as prescribed. Ratio proportional method: 1:2=4:8 Formula method: Dose ordered X Amount on hand= Amount to administer Dose on hand Dimensional analysis: Factor-label or unit factor method 7. Safely demonstrate selected medication administration routes. Oral routes: easiest and most common. Slower onset of action and a more prolonged effect than parenteral medications. Semi- fowlers or Fowler’s. o Sublingual: place under tongue and readily absorbed. No swallowing, eating, or drinking with medication. o Buccal: placing medication on cheek until dissolved. Alternate cheek, no eating or drinking with medication. Topical: Use gloves, clean skin first, use sterile technique if open wound. Transdermal patches: remove old patch before applying new patch, document location, write on patch, rotate sites Eye installation: avoid cornea, avoid eyelids with dropper or tubes, never share Ophthalmic: sitting with head tilted back, 3-5 minute between each medication Ear- side-lying position, room temperature, pull ear up and back, Nasal: laying and head tilted back on edge, breath through mouth, not to blow out of nose until 5 minutes’ after Medications for inhalation: o MDIs- use spacer for mouth sores, need strength in hands, shake medication o BAIs- release depends on patient’s breath o DPIs- activated by patient’s breath, do not shake Parenteral: injecting into body tissues. o Intradermal: into dermis just under epidermis, slow absorption. TB and allergies. 5-15 degrees. Less than 1 mL. o Subcutaneous: arms, scapula, belly (2 in from belly button), lower back, thighs. Use a TB or insulin syringe. 25 g, 5/8 in, 45-degree angle-normal (thin); 90 degree (obese)- ½ needle at 90 degree Do not massage. Pinch skin. Do not aspirate. o Intramuscular: faster absorption than subc. 90 degrees. 2-5 mL for adults. Children, older adults, thin people- not likely to absorb more than 2mL. Ventrogluteal: #1 site, recommended for over 2 ML, less than 4 mL, avg needle size- 1 to 1 and half inch. Vastus Lateralis: adults and children, on thigh Deltoid: easy accessible, potential for injury, 2 mL or less, immunizations, don’t roll up tight sleeve; pull down. Relax arm. Z-track method: pull skin over, give shot, let go and it keeps medicine intact. o IV: large-volumes are the safest of the 3. 8. Discuss how to verify medications orders for accuracy. 3 checks on MAR: o Before removing package from wrapper/container o As medication is removed o After medication is removed 6 rights (in previous question) 9. Discuss how medications are classified according to actions within the body. Pharmacokinetics- study of how medications enter the body, reach their site of action, metabolize, and exit the body. Therapeutic classifications: o Effect of medication on body system o Symptoms the medication receives o Medications desired effect Ex: antibiotics, antihistamines, sedatives vasodilation, calcium channel blockers, laxatives. Aspirin is considered an anti-inflammatory, analgesic, and anti-pyritic.