Nursing 120- Test 3 - Medications - Olol

Front 1

Medications: powerpoints
Objectives

Back 1

Safety before admin
6 rights
routes of admin

Front 2

Medication Safety

Back 2

admin of meds if one major responsibility for nurses.

Front 3

Checks and Balances of Medication

Back 3

while there are several it is the nurse who is ultimately responsible

Front 4

Medication errors can lead to?

Back 4

death
lawsuits
patient injuries

Front 5

Six rights of drug admin

Back 5

MD,PR,TD
right medication
right dose
right patient
right route
right time
documentation

Front 6

General Principles that can stop med. errors:

Back 6

follow the 6 rights
learn the drug info
question orders that are incorrect

Front 7

The nurse is ________ ________
for safe and accurate administration

Back 7

legally responsible

Front 8

What is the definition of delegation according to Webster?

Back 8

delegation is to entrust authority, power, etc

Front 9

According to the Institute of Medicine, _______ to ________
deaths occur each YEAR in the US because of med. errors

Back 9

44,000 to 98,000

Front 10

What should Medication Orders include?

Back 10

client's full name
name of the generic or trade name of the med
proper route, dose, frequency, date, time and signature of the prescriber

Front 11

Can a nurse accept a verbal order?

Back 11

if signed within 24 hours.

Front 12

What is the name of the paper that Medication orders are written on?

Back 12

Physician order sheet

Front 13

What paper is produced by the Pharmacy from Physician orders?

Back 13

MAR- Medicaiton Administration Record

Front 14

Name the routes of admin.

Back 14

oral
via tubes
topical
inhalation
drops
suppository
intradermal
injections
-SQ
-IM

Front 15

Which route is the most common?
What supplies are needed?

Back 15

Oral

disposable cup, meds, syringe (peds, via tubes), liquid, MAR

Front 16

What ACTIONS should a nurse perform when giving oral meds?

Back 16

1.perform chart check
2.check for allergies
3.gather equipment
4.hand hygiene
5. know special considerations for meds
6.know safe dosages, reason for giving, and side effects
7. handle meds for one client at a time
8. when the med cart is not in use always lock it
9. Verify calculations with another nurse if necessary

Front 17

Actions of nurse giving meds continued...

Back 17

10. do not open wrapper until at the bedside
11. do not touch pills with hands
12. break only scored pills
13. know policy for administration
14. check identity of patient
15. remain with pt until meds are taken
16. never leave any meds at the bedside

Front 18

What is the golden rule of documentation?

Back 18

IF IT WAS NOT CHARTED IT WAS NOT DONE!

Front 19

How to give meds via tubes, nasogastric, pegtubes, gastric tubes, etc.?

Back 19

1. use a liquid prep, may need to crush tab or empty cap. into 30 mil of water. mix well
2. do not crush enteric coated or sustained release products
3. use a clean bulb or catheter syringe
4. b4 using tube aspirate contents. Verify placement

Front 20

What are some Topicals?

Back 20

creams
gels
lotions
ointments
paste
powders
sprays and aerosols
topical vaginal meds
anorectal meds

Front 21

What is a MDI?

What is a DPI?

Back 21

Metered Dose Inhalers

Powdered inhalers

Front 22

What are MDI's and DPI's used for?

Back 22

to produce local effects such as bronchodilation

Front 23

What are eyedrops used for?

Back 23

eye exams, client's with infection or conditions such as glaucoma. Eye drops are used for their local effects to dilate or constrict

Front 24

What equipment is needed for completing eyedrop meds admin?

Back 24

Gloves
meds
tissues
washcloth
MAR

Front 25

What assessments must be made for giving eyedrop meds?

Back 25

1.allergies
2.assessment of any redness, 3.drainage or swelling
4.need for patient teaching

Front 26

What are the steps for Implementation of eyedrop meds?

Back 26

1.assemble equip. @bedside
2.double check med order
3.id patient
4.perform hand hygiene
5.cleanse eyelids and lashes inner to outer canthus
6. tilt pt's head slightly
7.never touch inside lid of med
8. have pt look up and at something
9. place thumb or fingers near margin of the lower level & exert pressure downward toward the cheek
10. avoid touching eye or eyelid
11. release lower lid, ask pt to close eyes
12. apply slight pressure to the inner canthus

Front 27

What are some infant, child considerations for eyedrops?

Back 27

two or more must restrain the child to reduce the risk of injury

Front 28

What are the hoped for Outcomes for eyedrop meds?

Back 28

client has no allergic responses
- client understands reasons for taking meds

Front 29

Instilation of Eardrops:

Back 29

-loosen wax
-relieve pain
-to destroy foreign objects

Front 30

Equipment needed for eardrop admin:

Back 30

1.meds (warm to 98.6)

Front 31

What are some assessments for eardrop admin?

Back 31

1. drainage or tenderness
2.swelling
3.need for pt teaching

Front 32

What are the steps in implementing eardrop admin?

Back 32

1.verify orders
2.id pt
3.explain procedure
4.hand hygiene
5.cleanse external ear of drainage
6.ask pt to turn to the unaffected side
7. draw up amt of solution needed
8. pull ear up and back in adult, 3 yrs or younger down and back
9. hold dropper in ear with its tip above the auditory canal allowing drops to fall on side of canal
10. press on ear a few times
11. place cotton ball only if ordered
12. document

Front 33

What are nosedrops used for?

Back 33

treat allergies,
infections
congestion

Front 34

Equipment needed for nose drop admin:

Back 34

meds
MAR
Gloves
Tissue

Front 35

What assessment must be made with nose drop admin?

Back 35

allergies
need for pt teaching
assess for drainage or broken skin

Front 36

What are the steps for implementing nose drop admin?

Back 36

1.check MD orders
2. id pt
3.explain procedure
4.hand hygiene
5.ask pt to blow nose
6.have pt tilt head back
7. hold tip of nose, place dropper inside narls, 1/3" - instill prescribed number of drops

Front 37

What are the expected outcomes for nose drop admin?

Back 37

1.admin is successful
2.no allergic reactions
3.minimal or no pain
4.document

Front 38

What are intradermal injections used for?

Back 38

for diagnostic purposes
-TB test PPD
-test used to test sensitivity to various substances
-placement just below the dermis

Front 39

What are the steps to implement intradermal injections?

Back 39

1. explain procedure
2.hand hygiene
3.withdraw meds
4. select area (inner forarm)
- alternate sites: upper chest, upper back beneath scapulae
5. cleanse area w/antimicrobial
6. hold the skin taut
7.place the needle bevel up, @ a 15 degree angle -insert needle under the dermis, where the needle can be seen at about 1/8" in. inject meds slowly, creating a wheal
8. withdrw needle quickly w/non-dominant hand
9. do not massage instruct pt not to scratch or rub
10. discard needle
11. remove gloves
12 document

Front 40

What equipment is needed for Intradermal injections?

Back 40

1.meds
2.sterile syringe needle 25 to 27 gauge 1/4 to 5/8" long)
3. antimicrobial swab
4.gloves
5.alcohol and 2x2
6. MAR

Front 41

What are some assessments as to intradermal inj.?

Back 41

allergies
assessment of site
need for pt teaching

Front 42

What are the outcomes expected for intradermal inj?

Back 42

1. nurse notes a blister or wheal after the injection
2. pt has no allergic response
3. pt does not scratch or massage area

Front 43

What are the uses of SQ injections?

Back 43

used for insulin, heparin, certain immunizations, etc

Front 44

What are the sites for SQ injection?

Back 44

Anterior thigh
Upper back
Upper ventral or dorsogluteal area
outer arms
abdomen

Front 45

What is the equip. for giving a SQ inj?

Back 45

1.meds
2. sterile syringe
3.antimicrobial
4.gloves
5.MAR
6. 2x2 gauze

Front 46

What are the assessments for SQ inj?

Back 46

1.allergies
2.pt teaching
3.assess inj. site
4.never give in areas of broken skin

Front 47

What are the steps in implementing SQ inj?

Back 47

1. check Physician's order
2. explain the procedure to pt
3.prepare meds
4. id pt
5. assure privacy
6.select site
7. ensure there are no lumps or nodules in area
8. cleanse area
9.remove needle cap w/dominant hand
10. pinch the area surrounding the inf site
11. hold the syringe w/dominant hand
12. inject the needle at 45-90 degrees
13. aspirate if recommended
14. if bl. start over in another site

Front 48

What are the steps in implementing SQ inj? con't

Back 48

15. NEVER ASPIRATE INSULIN OR HEPARIN
16. if no blood, inject med slowly
17. withdraw needle quickly
18. massage area w/gauze, unless contraindicated as in heparin and insulin
19. never recap, discard
20. dispose of gloves
21. document
22. reassess pt reaction to meds given parenterally may occur within 15-30 min

Front 49

Facts about Intramuscular injections:

Back 49

1. max amt of meds given only in well developed muscle-use nursing judgement
2. avoid nodules and lumps
3. it is very imp. to selct correct site, injury can occur to large nerves, bones, bl. vessels
4. always palpate the muscle b4 inj.

Front 50

What is the equipment needed for IM inj?

Back 50

1.disposable gloves
2.meds
3.sterile syringe and needle (size depends on meds being admin.)
4. antimicrobial swab
5. MAR

Front 51

What are some assessments to be made in IM inj?

Back 51

1.allergies
2.pt ed
3.assess inj site
4. never inject into broken skin
5. assess nursing indications/considerations (lab results; vital signs)
6. assess pain level if med is for pain

Front 52

What are the IM injection sites?

Back 52

1. ventrogluteal
2.Vastus lateralis
3. Deltoid
4. dorsogluteal

Front 53

What are the steps in implementing IM injections?

Back 53

1.ck physicians order
2.id pt
3. explain procedure
4. hand hygiene
5. double chk meds
6. do not add air to the syringe
7. provide privacy
8. locate site
9. cleanse area appropriately
10. remove needle
11. displace skin Z tract or by spreading the skin
12. Quickly dart the needle @ 90 degree angle

Front 54

What are the steps in implementing IM injections? con't

Back 54

13. aspirate slowly (5 sec)
14. if bl returns discard needle -start over selecting another site and needle
15. if no bl inject meds slowly
16. remove needle slowly
17. apply gentle pressure w/gauze
18. never recap, discard
19. dispose gloves
20. hand hygiene
21. document
22. reassess pt 15 min, reassess in 2-4 hrs

Front 55

Essential components of a med order are?

Back 55

name of med, dose, route, frequency

Front 56

If a physician orders a high regular insulin dosage of 20 units of U-500 insulin and there is only a U-100 dosage syringe, how many units will be given?

Back 56

4 units U-500 is 5 times as strong as U-100 so divide 20 by 5 = 4

Front 57

What is the basic formula to give oral, SQ, & IM meds

Back 57

D/H x Q = X
dose ordered/dose on hand times the quatity on hand = amt. administered