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57 Cards in this Set

  • Front
  • Back
Medications: powerpoints
Objectives
Safety before admin
6 rights
routes of admin
Medication Safety
admin of meds if one major responsibility for nurses.
Checks and Balances of Medication
while there are several it is the nurse who is ultimately responsible
Medication errors can lead to?
death
lawsuits
patient injuries
Six rights of drug admin
MD,PR,TD
right medication
right dose
right patient
right route
right time
documentation
General Principles that can stop med. errors:
follow the 6 rights
learn the drug info
question orders that are incorrect
The nurse is ________ ________
for safe and accurate administration
legally responsible
What is the definition of delegation according to Webster?
delegation is to entrust authority, power, etc
According to the Institute of Medicine, _______ to ________
deaths occur each YEAR in the US because of med. errors
44,000 to 98,000
What should Medication Orders include?
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
Can a nurse accept a verbal order?
if signed within 24 hours.
What is the name of the paper that Medication orders are written on?
Physician order sheet
What paper is produced by the Pharmacy from Physician orders?
MAR- Medicaiton Administration Record
Name the routes of admin.
oral
via tubes
topical
inhalation
drops
suppository
intradermal
injections
-SQ
-IM
Which route is the most common?
What supplies are needed?
Oral

disposable cup, meds, syringe (peds, via tubes), liquid, MAR
What ACTIONS should a nurse perform when giving oral meds?
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
Actions of nurse giving meds continued...
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
What is the golden rule of documentation?
IF IT WAS NOT CHARTED IT WAS NOT DONE!
How to give meds via tubes, nasogastric, pegtubes, gastric tubes, etc.?
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
What are some Topicals?
creams
gels
lotions
ointments
paste
powders
sprays and aerosols
topical vaginal meds
anorectal meds
What is a MDI?

What is a DPI?
Metered Dose Inhalers

Powdered inhalers
What are MDI's and DPI's used for?
to produce local effects such as bronchodilation
What are eyedrops used for?
eye exams, client's with infection or conditions such as glaucoma. Eye drops are used for their local effects to dilate or constrict
What equipment is needed for completing eyedrop meds admin?
Gloves
meds
tissues
washcloth
MAR
What assessments must be made for giving eyedrop meds?
1.allergies
2.assessment of any redness, 3.drainage or swelling
4.need for patient teaching
What are the steps for Implementation of eyedrop meds?
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
What are some infant, child considerations for eyedrops?
two or more must restrain the child to reduce the risk of injury
What are the hoped for Outcomes for eyedrop meds?
client has no allergic responses
- client understands reasons for taking meds
Instilation of Eardrops:
-loosen wax
-relieve pain
-to destroy foreign objects
Equipment needed for eardrop admin:
1.meds (warm to 98.6)
What are some assessments for eardrop admin?
1. drainage or tenderness
2.swelling
3.need for pt teaching
What are the steps in implementing eardrop admin?
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
What are nosedrops used for?
treat allergies,
infections
congestion
Equipment needed for nose drop admin:
meds
MAR
Gloves
Tissue
What assessment must be made with nose drop admin?
allergies
need for pt teaching
assess for drainage or broken skin
What are the steps for implementing nose drop admin?
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
What are the expected outcomes for nose drop admin?
1.admin is successful
2.no allergic reactions
3.minimal or no pain
4.document
What are intradermal injections used for?
for diagnostic purposes
-TB test PPD
-test used to test sensitivity to various substances
-placement just below the dermis
What are the steps to implement intradermal injections?
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
What equipment is needed for Intradermal injections?
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
What are some assessments as to intradermal inj.?
allergies
assessment of site
need for pt teaching
What are the outcomes expected for intradermal inj?
1. nurse notes a blister or wheal after the injection
2. pt has no allergic response
3. pt does not scratch or massage area
What are the uses of SQ injections?
used for insulin, heparin, certain immunizations, etc
What are the sites for SQ injection?
Anterior thigh
Upper back
Upper ventral or dorsogluteal area
outer arms
abdomen
What is the equip. for giving a SQ inj?
1.meds
2. sterile syringe
3.antimicrobial
4.gloves
5.MAR
6. 2x2 gauze
What are the assessments for SQ inj?
1.allergies
2.pt teaching
3.assess inj. site
4.never give in areas of broken skin
What are the steps in implementing SQ inj?
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
What are the steps in implementing SQ inj? con't
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
Facts about Intramuscular injections:
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.
What is the equipment needed for IM inj?
1.disposable gloves
2.meds
3.sterile syringe and needle (size depends on meds being admin.)
4. antimicrobial swab
5. MAR
What are some assessments to be made in IM inj?
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
What are the IM injection sites?
1. ventrogluteal
2.Vastus lateralis
3. Deltoid
4. dorsogluteal
What are the steps in implementing IM injections?
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
What are the steps in implementing IM injections? con't
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
Essential components of a med order are?
name of med, dose, route, frequency
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?
4 units U-500 is 5 times as strong as U-100 so divide 20 by 5 = 4
What is the basic formula to give oral, SQ, & IM meds
D/H x Q = X
dose ordered/dose on hand times the quatity on hand = amt. administered