Medication Administration (Exam 1) Questions and Answers complete solutions

Medication Administration (Exam 1) Questions and Answers complete solutions Administration of medication is a shared responsibility between _______________ - ANS- the prescriber the pharmacist the nurse Written Orders - ANS- are a permanent legal record Who is accountable for mistakes? - ANS- It is a shared legal responsibility. Nurses still need to check before administering medications. Prescriber's Role - ANS- order medications Orders may be given - ANS- written verbal standing MD protocols Verbal orders need to be - ANS- repeated back to the physician Standing MD protocols - ANS- are standing orders that are given if a certain thing takes place. i.e. If K+ drops, do ___________. If K+ rises, do _____________. Ambiguous Orders - ANS- must be clarified Essential components of a medication order - ANS- Must be a part of every medication order patient name date and time order is written name of drug dosage of drug route of administration frequency of administration signature of person writing the order Please Do Not Drown Really Fresh Shrimp If any part of the essential components is missing - ANS- drug should not be administered Types of medication orders - ANS- standing order PRN order single order stat order Standing Order - ANS- Everyday Give within 2 hours i.e. Lasix 40 mg every day PRN Order - ANS- as needed i.e. Demerol 50 mg IM q 4 hr PRN for pain Single Order - ANS- given one time at a specific time i.e. Atropine 1 mg IVP stat What does stat mean? - ANS- Medication needs to be given within 5 minutes What does ASAP mean? - ANS- Medication needs to be given within 30 minutes Pharmacist's Role - ANS- Maintain medication supply (pyxis & unit dose) Act as resource Unit Dose - ANS- 24 hour supply for each patient Pyxis - ANS- computer system that dispenses, tracks, bills, etc. Pharmacists as a resource - ANS- can ask about interactions or reactions Nurse's role in administering medications - ANS- *correct transcription and communication of orders *accurate calculation, measurement, and administration techniques *recording drug administration *patient and family teaching How to handle incorrect/incomplete orders - ANS- *clarify *withold harmful medication *notify the physician (if you withheld drug) *refuse to administer harmful drugs (some drugs require vital signs and certain ranges) What to clarify - ANS- dose, route, frequency, why the medication is ordered Clarifying with patient - ANS- say to patient "I'm here to give you your 44 units of insulin" and they may be like "NO I take 4 units of insulin" Initial assessment includes - ANS- medical history (drug data and diet history) allergies (food and drug) perceptual or coordination problems patient's attitude level of knowledge learning needs 3 Check System - ANS- read medication label compare med label to MAR (in electronic record) reread label during med preparation do this before, during, and after administration Medication Error - ANS- any preventable event that may lead to patient harm or incorrect administration The Six Rights - ANS- Right Drug - ambiguous drug names Right Dose - dosage calculation Right Patient - identification bands Right Route Right Time - 30 min hedge factor allowed Right Documentation Do Dragons Play Ring Toss Diligently? Right Drug - ANS- a challenge when there are ambiguous drug names. In order to administer the right drug the nurse must use the 3 check system, closely examine spelling, be knowledgeable about drugs administered, and examine the relationship between the drug ordered and the patient's condition. When in doubt, the nurse must consult drug resources such as textbooks, pharmacist, and the physician. Right Dose - ANS- Check product literature to make sure the drug dosage is ordered as indicated by the manufacturer. Evaluate serum drug levels and notify the physician when these may affect the patient's current condition. Drug calculations must be correct and when in doubt have another nurse recheck calculations. Right Patient - ANS- always check identification bands Right Route - ANS- Check product literature to make sure the drug may be given by the ordered route. If the route is ordered incorrectly hold the medication and notify the physician. Nurses must be knowledgeable of each medication they administer. Right Time - ANS- give medications on time and assess that the schedule for the drug is consistent with maintaining therapeutic levels for the drug. There is a 30-minute hedge factor that is allowed before or after the time frame ordered. Right Documentation - ANS- chart each medication thoroughly and correctly Primary focus of administering medications - ANS- SAFETY 2 times per day and 3 times per day - ANS- hospitals have set time frames for these medications Guidelines for administering medications - ANS- concentrate use appropriate measuring devices maintain asepsis avoid waste NEVER administer medication prepared by another NEVER leave medications unattended NEVER chart a med as given until given check for allergies on bracelet be aware of situations that contraindicate admin of meds listen to the patient If a patient vomits, - ANS- do not repeat medication as some begin absorption in the mouth. Notify the MD. Situations that contraindicate administration - ANS- condition change, allergy, diagnostic tests Most errors are from - ANS- distractions Asepsis - ANS- free from contaminates/bacteria enteral medications = clean/medical asepsis parenteral medications = surgical asepsis Medication Errors - ANS- wrong patient wrong dose poor penmanship wrong route record keeping errors When error occurs - ANS- assess the patient notify the MD incident report Incident Report - ANS- mandatory used for risk management helps identify the reason for mistake Patients have the right to - ANS- *be informed of the purpose, action, and side effects of the drug *refuse a medication (document why done so) *have health hx and allergies assessed *be advised of experimentation *receive medication correctly and safely *not receive unnecessary meds Goals of client teaching - ANS- partnership in health improved health decreased healthcare costs (meds prevent future visits) Partnership in Health - ANS- this is achieved when the patient understands the need for their medication therapy and accepts responsibility for learning and correctly managing their medication regimen What to teach - ANS- *medication action - why they are on the drug *side effects *how to administer *when to notify the MD *take as prescribed *keep current list of medications *OTC interactions Tips on teaching - ANS- be as specific and simple as possible ask patient to review the steps in their words do verbal teaching and provide reading sheets have family present How to teach - ANS- assess learning need be brief sensory perceptual problems include family and significant others