Medication errors and risk correct answers Abbreviations: know the approved and prohibited
med list
LASA medications
Distractions during preparation and administration= patients, people, family and alarms= ask
them to give you a minute to focus
Medication reconciliations at transition in care= current medications and comparing new orders
to home list of medication during times of admin, and transfer to different unit= list to whole
new orderset...have them bring in their medications to compare with what they take
NEVER ENGAGEMENT IN WORK AROUNDS
We are the last line of defense and thus the last person to prevent error!!! Thus investigate any
differences!
What is a work around correct answers A temporary solution for an error while a permanent
solution is confirmed.
Always use a barcode scanner for meds and patient= scan barcode!!
Never use med dispensing overrides unless in case of true emergency
Always follow rights of medication administration and three checks
DONT GIVE WHAT YOU DIDNT DRAW UP!!! DONT GIVE WHAT YOU DONT KNOW!!!
Red flag alert: special populations correct answers Ends of age spectrum= infants, children and
older adults
Pregnancy and breast feeding
Poly pharmacy= taking more than 2 medications
In med administration you should never... correct answers Never give what you have not
prepared or never give with which you are not familiar with!
CHECK AND EDUCATE!!!!
Medication management: order types ENTRY TYPE correct answers Computerized is the best=
it is typed and can be ordered or placed from anywhere
Written= CPOE or hand written
Verbal
Telephone
Remember to use closed loop communication!!! Restate what is being asked
Medication management: circumstance and NEED correct answers Standing orders/ routine
orders= orders in place for certain incidences such as chest pain= angina, knee surgery and DVT
PRN= need circumstances to give certain medication
Single/ one time use
STAT= immediately within 5-10mins
NOW within 30 minutes
Prescriptions
For drugs that are NTI correct answers Above= toxicity
Below= sub therapeutic
,Be aware of labs and monitor!
As nursing we want to be correct answers Proactive not reactive
Look at the patient situation and pick the priorities
Is oxygen a medication that needs an order? correct answers Yes!
O2 is a medication
Emergency use O2 and then get a order to follow if needed!
ABCS ARE A PRIORITY
components of a medication order correct answers (1) client's full name
2) date & time order was written
(3) name of medication
4) dosage of medication, freq and number of doses- length of time such as 20 tablets total
(5) route of administration PO, parenteral
6) indication for use= why is the medication, for PRN what are the circumstances
7) signature of the person writing the order
Medication management: nurses role correct answers Determine accuracy= appropriate med?
Dose? Route? Indication? Does it fit the patient?
Applies up to date knowledge on medication such as MOA/SES/ INDICATIONS/
PRECAUTIONS/CONTRAINDICATIONS such as is the antib bacteriostatic or bacteriocidal
Assesses and monitors patient= timing of med onset and post administration assessment
Determines medication timing
Ensures rights of medication admin are followed
Evaluates patient response and trends= expected effects, adverse reactions and toxicity
Provides patient teaching
DOCUMENTATION= MED, DOSE, TIME, ROUTE, INJECTION SITE AND RESPONSE
If a med administration isnt documented... correct answers IT DIDNT HAPPEN
COVER YOUR ASS
Standardized times of admin: once daily correct answers Once daily
0900
Very long 1/2 drugs
Standardized times of admin: twice daily correct answers 0900 and 2100
0800 and 1700
These are for longer half life drugs
Standardized times of admin: three times daily correct answers 0900
1400
2100
Shorter 1/2
Standardized times of admin: four times daily correct answers 0900
, 1300
1700
2100
Shorter half life medication
Rights of medication administration correct answers Right medication= generic or brand
Right dose
Right patient
Right route
Right time
Right documentation
Right indication= especially for PRN medication
IF YOU NEED ANY HELP= ASK= if you don't understand ask!
Three checks prior to med administration correct answers Before you pour= check medication
label against the MAR
After you pour= verify medication label against MAR
At the bedside with the patient= verify the medication with the MAR, with the patient armband
FULL NAME/ DOB
Ensure priority order of medication
Thus the three checks consists of correct answers Checking the med while in the package
Checking the med in the med cup
Checking the med to the patient
Specific factors affecting medication response: age correct answers Immature liver in infants and
children
Aging process affects liver and kidney function
Slowed GI motility
Circulation changes
Specific factors affecting medication response: gender and body Habitus correct answers
Distribution of fat, water, lean body mass
Specific factors affecting medication response: chronic disease correct answers Renal, liver,
circulation and perfusion, malnutrition, obesity= altered pharmacokinetics
Specific factors affecting medication response: first pass affect correct answers Meds taken
orally can be inactivated when passed through the liver= must given another way such as IV or
SL
Specific factors affecting medication response: nutritional status correct answers Presence or
absence of food in the GI tract, malnutrition can affect presence of enzymes and protein levels
Hypoalnumenia= increase free drug levels