Medication Administration Flashcards

Question

Pediatric Drug Claculation

Answer 1

1) Calculate daily dose ordered - The dose for the whole 24hr period - Need to read: is it 24hr or per dose? 2) Calculate low and high parameters of safe range by checking in drug manual/handbook on unit and using client's weight - Is the order within that range? 3) Compare the client's daily dose to see if it falls within this safe range

Answer 2

- Accurate READING - Accurate CONVERTING - Accurate CALCULATING - Using common sense to check your answers and look at the whole picture - If in doubt, check with another nurse or the pharmacist (indepedent double check)

Answer 3

Before meals

Answer 4

As desired

Answer 5

twice a day | cap

Answer 6

community acquired pneumonia

Answer 7

glucose tolerance test

Answer 8

can mean half-strength or bedtime; write out directly

Answer 9

can be od (daily) or OD (right eye)

Answer 10

after meals

Answer 11

single (one time) order

Answer 12

whenever there is a need

Answer 13

meaning "quaque"; every

Answer 14

every morning, every AM

Answer 15

every hour

Answer 16

every 2 hours

Answer 17

four times a day

Answer 18

give immediately

Answer 19

suppository

Answer 20

oral suspension

Answer 21

three times a day

Answer 22

means unit; not best practice

Answer 23

1) Prescriber - Ordering the medication 2) Pharmacist - Dispensing and giving information 3) Nurse - All types of nurses and students

Answer 24

1) Medical directives - Not for a specific client - Nurse uses assessment and doesn't need to wait, they have the directive to do what is necessary - I.e. allergic reactions, pain management 2) Direct order - For a specific client, for a specific condition - Routine, prn, single (one time), STAT, now - Routine orders may indicate a final date or total number of doses 3) Verbal orders - Not ideal, used for codes or remote areas - Prescriber not in the building - Role of nurse; repeat the order back, write it down on the order sheet, get the prescriber signature ASAP (usually a window of 12hr)

Answer 25

- Patient's full name; may include unique identification number in a hospital - Date and time the order is written - Medication name (generic or trade) - Dose - Route of administration - Time and frequency of administration - Signature of prescriber

Answer 26

- Prepares and distributes prescribed medications - Administer medications - Responsible for filling prescriptions accurately and ensuring the prescriptions are valid - Provide information about side effects, toxicity, interactions and incompatibilities - In Ontario, able to prescribe some medications or extend prescriptions for ongoing conditions (in community based practice)

Answer 27

``` - Described the accountabilities of the nurse when engaging in medication practices Includes: - Administration - Dispensing - Medication storage - Inventory - Management - Disposal ``` Based on 3 principles: - Authority - Competence - Safety

Answer 28

- You are accountable and responsible for your actions | - The nurses (if working with you) do have responsibility to make sure you are able to practice safely

Answer 29

RNs and RPNs require an order for a medication practice when: - A controlled act is involved - Administering a prescription medication - It is required by legislation that applies to a practice setting - Hospital Act; states we need an order for everything, even thing available over the counter

Answer 30

Knowledge, skill, and judgement - Evidence informed practice - Appropriateness of medication practice - Know limits on own knowledge and ask for help - Do not perform medication practice if not competent to perform

Answer 31

- Drug classification - Why it is being given - Normal dosage range - Usual routes of administration - Usual action of the medication - Expected side effects - Potential harmful side effects and what to do if they happen - Peak action and duration - Time of onset of action depending on route - Is it necessary to do pre-assessment and evaluation afterwards? YES

Answer 32

Promote safe care and contribute to a culture of safety - Seek information from client - Provide education to client - Collaborate with client - Promote and/or implement secure storage, transportation and disposal - Promote or implement strategies to minimize drug diversion and misuse - Take appropriate action to help client if medication error or adverse reaction occurs - Report errors, near misses or adverse reactions in a timely manner - Collaborate in approaches that support safe medication practices

Answer 33

- Assessment - Problem/Diagnosis - Goals/Planning (i.e. organizing care and decrease distractions_ - Implementation - Evaluation (i.e. response and/or effectiveness of medication)

Answer 34

- Medical History - History of allergies - Medication information - Diet history - Client's perceptual or coordination problems - Client's current condition - Client's attitude towards medication use - Client's knowledge and understanding of medication therapy - Client and family's learning needs

Answer 35

- Created from assessment data - May be a condition or symptom that is being treated (i.e. Anxiety, pain) - May be a considerations for giving the medication (i.e. impaired swallowing) - May be related to medication regimen management

Answer 36

- What are the goals or outcomes? - What are the priorities? - How does the nurse need to collaborate with others?

Answer 37

Guidelines for giving meds: - Prepare the medications alone; no distractions - Don't leave medications unattended - Check client ID band; have client state their name (2 unique identifiers) - Know generic and trade names - Administer only what YOU prepare - Watch the patient take the medication - If a client refuses a medication, discard it rather than returning it to the original container - Unwrap mediation at POC (bedside) - Return to original prescriber's order if questions arise - Call pharmacist if you have questions

Answer 38

1) Right patient 2) Right medication (3 checks) 3) Right reason 4) Right dose 5) Right time and frequency 6) Right route 7) Right documentation 8) Right to refuse 9) Right patient education 10) Right evaluation

Answer 39

- Check MAR against identification band (&DOB) - Ask patient to state their full name - Use two unique identifiers - Explain what you are giving and why - Check allergies - Listen to your patient

Answer 40

3 checks | - Check labelling against MAR

Answer 41

- Unit dose system designed to minimize errors - Calculated doses or "high alert medications" should be checked with another RN; independent double check - Know customary doses and appropriateness for age and size - Use table cutters when necessary; only break scored tablets

Answer 42

- How often should this medication be given? (hospitals usually have 30min window) - When was the last dose? - Why is this medication ordered at this particular time?

Answer 43

- po, S/L, topically, ID, subcut, IM, IV, rectally, vaginally, etc. - Check order carefully; consult prescriber id route not designated - Prepare injections only right before administration

Answer 44

- Chart time and site - Complete signature - Do not pre-sign MAR - Chart pre-administration assessment data - Chart the effectiveness

Answer 45

- Patients should be informed of this right - Patient also need to be fully informed about benefits and risks of medications - Who doesn't have the right to refuse? Ask them why they are refusing

Answer 46

- Clients should be fully informed - Education may also involve family members in some situations - Education includes reason for taking drug, action and possible side effects - Should also include how to take medication

Answer 47

- Evaluate order; is it correct? is the medication available and accessible to the patient? - Are there special assessments necessary? - What monitoring is needed before and after medication?

Answer 48

- Err on the side of safety; check the original prescriber's order if in doubt - Listen to your patient - Stay at the beside until medication is taken - Bring MAR to bedside - Do not sign MAR before giving med - Separate drugs that need vital signs prior top administration

Answer 49

- Variations in size, weight, body surface area - Ask child's parent or guardian about how to best administer the medication - Use simple language - Try different forms of medication - Use a disposable syringe for accuracy

Answer 50

- Physiological changes associated with aging - Simplify the medication plan - Older adults may be more sensitive to medications - Encourage fluids if not contraindicated - By mindful of polypharamcy

Answer 51

- Any event that may cause or lead to a patient either receiving inappropriate medication therapy or failing to receive medication - Errors may result in ADE (adverse drug event), near miss or near/actual death - Errors of commission; we give the wrong medication - Errors of omission; we don't give the medication

Answer 52

- Lack of verification of 10 rights - Miscommunication among HCPs (written and verbal) - Lack of drug knowledge and drug miscalculations - Ambiguities; product names and appearance - Interruptions and distractions

Answer 53

- Drugs that bear a heightened risk of causing significant harm when they are used in error - Drug classes: opiates antiarrhythmics antothrombotic agents dextrose dialysis solutions oral hypoglycemics total parenteral nutrition solutions - ISMP list of high-alert medications in acute care setting

Answer 54

Used to distinguish between medications with similar names

Answer 55

- Medication carts - Bar codes - Blister packs - Informatics and medication safety - Network computers - Prescriber entered orders - Intranet resources - Automated dispensing systems

Answer 56

- Preparing medications for multiple patients - Nonstandard times - Documentation - MAR unavailable - Partial drug administration - Held or discontinued medications - Monitoring issues - Nonspecific doses dispensed - Oral liquids in parenteral syringes

Answer 57

Formal process of: 1) Obtaining a complete and accurate list of each current medications; including name, dosage, frequency and route 2) Using list when writing admission, transfer and/or discharge medication orders, and 3) Comparing the list against the admission, transfer and/or discharge orders, identifying and bringing any discrepancies to the attention of the prescriber and, if appropriate, making changes to the order. This list should accompany the patient to the next care site

Answer 58

- Notify prescriber - Determine how long client must be monitored and if treatment is needed - Treat and/or monitor adverse reaction and document in chart - Report error (incident report) - Corrective actions - Advocate for systems that reduce risk of error - Check hospital policy re disclosure to client

Answer 59

Includes: - Patient identification information - Location and time of the incident - An accurate, factual description of the incident and - Measure taken to address the error Most organizations have procedures in place for disclosing incidences to patients and families

Answer 60

- Know disclosure policy and procedure of institution - Disclose as soon as possible to patient or family - Choose an appropriate setting - Describe the course of events; nature of mistake, consequences and corrective actions - Express regret and apologize; if appropriate - Elicit concerns and questions and commit to addressing them - Provide follow up - Provide personal and professional support and guidance to staff if necessary - Learn what happened using an open approach - Communication incident to ISMP (Institute for Safe Medication Practices)

Medication Administration Flashcards

(89 cards)