Review for NCLEX-RN® - PHARMACOLOGY & PARENTERAL THERAPY

Review for NCLEX-RN® - PHARMACOLOGY & PARENTERAL THERAPYLegal aspects of medication administration The Joint Commission requires that two patient identifiers (e.g., name, birthday, account number) be checked prior to administration of any medication. Components of a legal medication order • Date and time • Patient’s name • Patient’s inpatient ID number • Drug Name and strength of dose • Frequency of dose • Physician’s full signature Nurse’s legal responsibility • Interpret each component of the order • Question the order by communicating with the physician if • The nurse cannot read the order • Any component of the order is erroneous or ambiguous • The nurse had any doubt about the appropriateness of the order • Any order which does to make sense, such as large number of tablets or capsule. Or a large volume of solution for injection Controlled Substances All controlled substances must be stored in a locked container requiring a key or computerized access code for entry. An inventory record of all controlled substances used is maintained. If any part of a dose of a controlled substance is discarded, a second nurse witnesses the disposal and the record is signed by both nurses. (Agency policies and procedures are always followed.) Agency policies and procedures are followed with regard to the counting of controlled substances at the end of a shift; any discrepancy in the count is reported immediately. Before Administration Wash your hands. Assess the prescription and compare new medication prescriptions with the current list of medications (reconciliation). Ask the client whether he or she has a history of allergies. Determine the purpose of the medication. Assess the client for existing medical disorders in which the prescribed medication is contraindicated (e.g., many medications are contraindicated in pregnancy and for breastfeeding clients). Check the client’s age (the older client and the neonate are at greater risk for toxicity than is an adult client). Assess the client’s vital signs and significant laboratory results (e.g., the potassium level in a client who has been prescribed a loop diuretic). Assess the client’s understanding of the purpose of the