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44 Cards in this Set
- Front
- Back
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Drug Preparations
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drugs are manufactured in different forms for oral, parenteral and topical administration
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Oral Route
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by mouth; easiest; most convenient; include tablets, capsules, sublingual, ODT, lozenges, syrups, elixirs, fluid extracts and tinctures, solutions, suspensions, magmas, gels, emulsions, powders
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Tablets
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powdered drug compressed in solid shapes. types: scored, coated, enteric coated, prolonged release or extended release, coded, capsules
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Parenteral route
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by injections; bypasses the GI tract; intradermal, subcutaneous, intramuscular, intravenous
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Topical Route
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aerosol powders or liquids, powders, creams, ointments, pastes, suppositories, transdermal, topical drops (eye,nose,ear)
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Practices to measure liquids accurately
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pour liquids to line; pour liquids at eye level; meniscus should be at line.
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Equipments to measure liquids
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Nurses typically use a medicine cup or syringe
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Types of Syringes
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3mL-marking to nearest tenth; 1mL-marking to nearest hundredth; insulin syringe marking in units
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Gauge
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needle's diameter or width; higher the number the smaller the diameter
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Intradermal needle
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3/8"-5/8" (1 - 1.5cm) long and are 25G.
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subcutaneous needles
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5/8" - 7/8" (1.5 - 2 cm) long; 25G-23G
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intramuscular needles
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1" to 3" (2.5 -7.5cm) long; 23G-18G
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intravenous needles
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1"- 3" long; 25G - 14G
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Needle Choice
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route of administration; size and condition of patient; amount of adipose tissue present at site
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Nursing Process
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ADPIE:
Assessment Diagonsis (nursing) Planning Implementation Evaluation |
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Assessment
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-History
Allergies and Sensitivities Diet History Attitudes About Medication Use Knowledge of Current Medications -Physical Exam Weight/Height Vital Signs Swallowing -Resources |
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Nursing Diagnosis
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-Knowledge deficit regarding medication regimen
-Noncompliance related to drug regimens -Ineffective management of therapeutic regimens -Ineffective health maintenance -Risk for injury |
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Planning
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-Identify desired outcomes
-Why the drug is needed -How the drug will be administered -Common indications of adverse effects -Other nursing measures that will enhance the likelihood of achieving desired outcomes -What response by the client will indicate that a therapeutic response has been achieved |
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Implementation
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Preparing to administer medications:
-Ensure cleanliness of your hands, work area and supplies -Ensure availability of supplies -Ensure adequate lighting -Decrease environmental distractions -Verify order |
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Evaluation
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Always evaluate your client’s response to medication at the appropriate interval
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Focus on Implementation
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-Medication Orders
-The 7 Rights of Medication Administration -Routes of Administration |
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Factors Influencing Dosage & Action
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Route of administration
Time of administration Age Weight Nutritional status Absorption and excretion of the drug Health Status Sex of the client Ethnicity and culture of the client Genetics |
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Medication Orders
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WRITTEN - must be on all orders
-Patient’s Full Name -Date and Time -Drug Name -Dosage -Route -Frequency and Duration -Prescriber Signature |
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Rights of Medication Administration
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Right Drug
Right Dose Right Client Right Time Right Route Right Documentation Right to Refuse |
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Right Drug
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chemical name
generic name brand name Three checks! Look alike/sound alike medications |
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Right Dose
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ml = milliliter
g or Gm = gram kg = kilogram L = liter mcg = microgram mEq = milliequivalent mg = milligram tsp = teaspoon Unit gtt = drop |
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Right Client
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check ID
ask name Two patient identifiers |
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Right Time
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ac = before meals
bid = twice daily h or hr = hour hs = hour of sleep c = with pc = after meals prn = as needed daily = once day qh = every hour q 2 h = every 2 hours qid = 4 times a day stat = immediately tid = three times a day |
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Right Route
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PO = by mouth
IM =intramuscular SQ= subcutaneous PR= per rectum vaginally OS=left eye OD = right eye OU= both eyes IV= intravascular |
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Right Route (con't)
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ET=endotracheal tube
ID=intradermal sl=sublingual NG=nasogastric IVPB=IV piggyback AS=left ear AD=right ear AU=both ears GT=gastric tube JT=jejunal tube |
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Routes of Administration - For Local Effects
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topical
intra-articular intra-cardiac intradermal intrathecal inhalation |
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Routes of Administration - For Systemic Effects
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topical
buccal oral sublingual rectal intramuscular intraosseous intravenous subcutaneous |
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Intramuscular Injection
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90 degree angle; common sites include deltoid, the gluteus medius minimis and maximus in the buttocks and the vastus lateralis in the thigh
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Subcutaneous injections
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45 degree angle; SQ-used more frequently than IM-given into areas with abundant subcutaneous tissue (examples-insulin and heparin)
If someone has more fat than you can go in a 90 degree angle |
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Intradermal Injections
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most commonly used to administer diagnostic antigens-TB test
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Administering Ear Drops
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Adult back and up
Child back and down |
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Right Documentations
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-Medication (drug and dose)
-appropriateness / associated data time -Route (site if needed) -response / outcome -client teaching -refusal ?? (Right to Refuse) |
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Medication Administration Record
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-Can be electronic or paper
-Military time vs Traditional time |
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Clients' Rights
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-Right to be informed of the medication’s name, purpose, action, and potential undesired effects
-Right to refuse a medication -Have qualified nurses and physicians assess a medication history that includes allergies |
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Clients Rights (con't)
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-Be advised of the experimental nature of medication and give written consent
-Receive labeled medications safely -Receive appropriate supportive therapy -Not receive unnecessary medications |
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Teaching and the Nursing Process
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-Assessment-
Learning needs, ability to learn, readiness to learn -Formulate a nursing diagnosis- Knowledge deficit, ineffective management of medication regimen -Planning- Develop a teaching plan -Implementation -Evaluation- Evaluate client’s response and document |
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Important Points to Teach
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-General knowledge of the health problem and treatment
-Name and dosage of the med -Schedule for the med -Importance of taking the med as ordered -Consequences of not taking the med |
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Important Points to Teach (con't)
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-Major adverse effects of the med and what to do if they occur
-How to handle minor side effects -Whom to call and when to call for advice -When and where to get the prescription filled |
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Noncooperation
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-Studies show 17-90% of clients are noncooperative w/ med regimen
-reasons for failure to cooperate -lack of knowledge or understanding -dissatisfaction -cost -adverse side effects -inconvenience -forgetfulness -stigma |
