Medication Administration

Front 1

Nursing assessment prior to administration

Back 1

1. Age
2. Body weight
3. Genetic Factors
4. Existing Diseases
5. Drug history

Front 2

opiate naive

Back 2

a patient who has not taken opioids is considered naive about them

Front 3

The MD order must contain:

Back 3

-client's name
- stop date
-dosage route
- frequency
-signatures of who ordered med
-date ordered

Front 4

Routine schedule order

Back 4

example: 200mg TID PO X7

regularly take for as long as ordered

Front 5

PRN order

Back 5

example: 50mg IM q4h prn pain

only as necessary

Front 6

1 time order

Back 6

example: 5mg IM x 1

only give 1 dose

Front 7

STAT order

Back 7

example: 5mg IV STAT

1 dose ASAP

Front 8

Types of orders

Back 8

-standing order
- prn order
-one-time order
- STAT order
- phone order/verbal order (P.O./V.O.)

Front 9

6 rights of administration

Back 9

-right drug
- right dose
-right client
-right route
-right time
-right documentation

Front 10

Right client

Back 10

-watch for same client names on the unit
-check ID bracelet with med kardex or computer scan
-ask client to state their name
-check client's bed tag/med cart tag
-ask another nurse to identify client (least acceptable route, use as a double check)

Front 11

Consult the person who ordered the med if:

Back 11

-route was not specefied
- med isn't available via ordered route
- unable to access specefied route (ex. no IV)

Front 12

What should you document when giving med?

Back 12

-time, date, dosage, name of med.
-record details regarding administration of medications
-record pertinent information associated with the drug such as heart rate, BP, etc.
-sign the administration record
-If the med is a prn med, always do a followup assessment indicating successful or failure of drugs effects after 30 minutes

Front 13

The nurse should question the order if:

Back 13

1. unclear or illegible writing
2. nontherapeutic dose
3. incorrect or improbable route
4. drug might harm client
5. cleint/family questions medication

Front 14

What should be done if a medication error is made?

Back 14

1. monitor client
2. notify: MD, team leader/charge nurse, while in school notify instructor
3. give anecdote if ordered
4. quality assurance report (AKA me error report)

Front 15

Administration of oral medications

Back 15

1. wash hands
2. prepare meds for 1 client at a time in an area free from distractions
3. check medication order 3 times
4. pour tablets from container into medicine cup. DO NOT touch tablets with fingers. Return extra tablets to container
5. Do not leave meds unattended
6. Do not give meds that you did not prepare
7. identify client before administering medications (6 rights)

Front 16

how many times do you check a medication order? when?

Back 16

3 times

a) before removing from the drawer
b)when removing from the container
c) before giving to the patient

Front 17

Administration of liquid medications

Back 17

-remove cap and place it upside-down on counter surface to keep it sterile
-hold bottle with label against palm of hand when pouring so med doesn't drip and mess up label
-squat down to view medication cup at eye level. Read fluid level at bottom of meniscus.

Front 18

For drugs causing GI Distress, administer

Back 18

ac or pc

Front 19

for oral liquids given for effect on oral mucus membranes, administer:

Back 19

do not follow with a "chaser". Explain that med won't work if you "get the taste out" by washing it off of mucus membranes

Front 20

For oral liquids with an unpleasant taste:

Back 20

give cold or at room temp. Flavoring may be added

Front 21

For a medication that will discolor teeth:

Back 21

-give via straw

Front 22

Positioning for oral meds

Back 22

upright

Front 23

what position do you place client in for otoscopic meds? how is ear placed?

Back 23

lateral head-tilt

up and back (adults) or down (children)

Front 24

for otoscopic meds, what temperature should they be at?why?

Back 24

room temperature, becuase if it is too cold it can cause nausea or vertigo

Front 25

after administration of otoscopic med, what should you do?

Back 25

gently apply pressure to the tragus with fingers

Front 26

Why should you apply topical medications to intact skin?

Back 26

-because absorption will occur too fast if skin is broken.

Front 27

What can you do to make atopicalmedication more potent?

Back 27

put an occlusion dressing (only used if MD orders it)

Front 28

What equipment should you use for enteral medications?

Back 28

60ml catheter-tip syringe

Front 29

Tubex/carpuject

Back 29

-reusable syringe which holds prepackaged cartridges of certain meds
-may need to draw meds out of cartridges using asceptic technique. DO NOT INJECT AIR
- DO NOT throw these into needle box. Reuse and recycle

Front 30

Syringe size for intradermal

Back 30

tuberculin, 1 mL

Front 31

needle size for intradermal

Back 31

26-27 guage

1/2-5/8 inch long

Front 32

amount of medication for intradermal site

Back 32

0.1 mL

Front 33

angle of needle insertion for intradermal

Back 33

5-15 degrees go in 3 mm

Front 34

Sub Q medication syringe size

Back 34

1-3 mL

1 mL tuberculin

100 units/mL insulin syringe

Front 35

Needle size for SubQ

Back 35

25-27 guage

look at skin fold to go for needle length: 1/2-5/8 inch

Front 36

Max. amount of med for subQ site

Back 36

1mL

Front 37

Angle of needle insertion for Sub Q

Back 37

45-90 degrees

Front 38

Comon subQ meds

Back 38

-insulin
-heparin
-protamine zinc (common anecdote)

Front 39

What's the rule for mixing insulins?

Back 39

-draw the fastest into the syringe first

*mixing fast acting with slower acting will slow the fast acting but not effect the slow acting

Front 40

syringe size for IM meds

Back 40

1-3 mL

Front 41

IM Needle size

Back 41

21-25 guage (21-22 most common)

1-1 1/2 inches
*1 inch max deltoid

Front 42

Amount of medication (max) for IM site

Back 42

3 mL

*1mL max for deltoid & for children

Front 43

Angle of needle insertion for IM

Back 43

90 degrees

Front 44

Deltoid muscle positive points

Back 44

-easy toaccess
-site preferred by most patients

Front 45

Deltoid muscle negativepoints

Back 45

-small muscle, will only absorb a small amount
-brachial artery near site
- could damage nerves

Front 46

Vastus lateralis positive points

Back 46

-easy access
-no major nerves or arteries- safe!

Front 47

Vastus lateralis negative points

Back 47

-muscle long but NOT wide

Front 48

Ventrogluteal positive points

Back 48

no major nerves or arteries- safe!!!

Front 49

ventrogluteal negative points

Back 49

-muscle deep but not wide
-difficult to locate on some patients