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75 Cards in this Set
- Front
- Back
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What are the safe administration practices |
Safety is 1st Follow standard procedure Know drugs your administering Safe environment Positively ID pt Proper documentation
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What are the common routes of administration? |
Oral Pulmonary Topical Parenteral |
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An oral route includes ..... |
Enteral tubes (PEG or NG) Buccal Sublingual |
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What does topical rts include? |
Vaginal Rectal Skin Inunction Instillation |
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What does "on call" mean? |
Usually med is given right before surgery |
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What are the keys to error prevention? |
Don't document before drug is given
Don't document at random
Don't document for someone else |
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What are you looking for on a MAR? |
Rt Pt Rt drug Rt time Signed or initial |
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A TAR can only be done by a ______ |
Nurse |
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A MAR can be carried out by a nurse or a _______ |
CMS |
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When administering a new drug, we are going to document _________ |
Effects of drug |
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Knowing all the drugs you give is one way to prevent ______ |
Med errors |
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Document the effects of PRN med given in ______ and/or _____ |
Nurses notes
MAR |
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When a pt refuses a med, what do you do? |
Determine a reason
Educate and retry
Report it
Document it |
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Any event that may cause or lead to inappropriate medication use or pt harm while the medication is in control of the health care professional pt |
Medication error |
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Reasons to question an order? |
Reason Pt is allergic Drug interaction Nurses have right to refuse Notify the prescriber and DOCUMENT |
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Nurses are ____responsible for medications given to pt |
Legally |
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If pt. comments about it not being their pill? |
Stop and double check |
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Common causes of erros |
Distractions / interruptions Inadequate staffing Illegible orders Incorrect dosage calculations Incorrect rte Similar drug names/ packaging Verbal orders (emergency only) Inappropriate drug Incorrect preparation of drug Drug expiration |
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Keep your pt's _____ |
Allergies |
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Read back and verify all ________ and ______ orders |
Verbal and telephone |
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Drugs may be omitted ____ or inadvertently |
Intentionally |
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Reasons that drugs may be intentionally omitted |
Pt has diagnostic test and has to fast
Problem for which med is given no longer exists
Pt has allergy |
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What are some system safeguards for dosing? |
Computer systems
Unit dosing
Dosage calculations
Shift counts (narcotics) |
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Steps to follow when a medication error is made: |
Check pt condition Notify charge nurse and pcm Follow facility policy ( incident report) Complete med error report |
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Medication errors often occur at points of ______ |
Transition |
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In an incident report you should include |
Med error
Adverse reaction to meds given |
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What do you include in an med error report |
PCM and was notified Pt's name and any witnesses Objective, description of situation |
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Do not include what in incident report: |
Second hand info
Suggestions to prevent going forward |
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Medication error report is ___ part of pt record |
NOT |
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__________ is part of discharge planning |
Education |
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How do we teach pt about meds? |
Side effects Include family Ensure complete by evaluating ( ex : demonstration for insulin) |
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Remind pt to take meds as long as _____ |
Perscribed |
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Remind pt to take meds as long as _____ |
Perscribed |
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Instruct pt to not _______ dosage with contacting PCM |
Alter |
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Remind pt to take meds as long as _____ |
Perscribed |
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Instruct pt to not _______ dosage with contacting PCM |
Alter |
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how do you document in the teaching? |
Who and what
Responses or skill to demonstration
Verbalized understanding |
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You need to follow facility policy when meds are _____, PRN meds, and errors |
Refused |
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A medication error can be a _____ in any step of the medication management process or system. |
Mistake |
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What are a nurses 2 primary roles in medication error prevention? |
Must use all standards of meds
Must ensure that they themselves are not making med error |
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Documentation needed for a MAR
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Blood glucose for insulin Site of injection Pain scale report for pain meds |
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This may of may no include medications. It will contain "treatments" or nursing interventions for pt and is documented according to facility policy
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TAR (Treatment Administration Record) |
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For this type of documentation, you need a unique username and password, medication, dosage, route, time, and Name of pt.
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CMAR (Computerized medication administration record)
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When using a CMAR, you cannot ______ username and password with anyone
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share |
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What 4 things do you do when a pt. refuses meds?
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Educate and retry Report it Document it |
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More than ______ _____ Americans injured evert year from medication errors
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1.5 million |
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The institute of Medicine estimates that _______ pt's are subject to at least ______ medication error every day
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one |
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_______ americans die annually due to Preventable med erros |
7000 |
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Using all standards of med administration and their checks, and ensuring you do not make a medication error yourself are the 2 _________
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Primary nursing roles for med error
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What do you do when you are unsure why a medication is being given?
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question the physician
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What do you do if you realize a pt is allergic to a prescribed medication?
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question the MD |
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What do you do if you know that the drug prescribed will interact with current medications?
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ask the MD |
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Nurses have the _____ to refuse drug administration under the right circumstances
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refuse |
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What do you do if you need to refuse to administer a drug? |
Document |
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How can you tell if a drug has deteriorated?
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Passed the expiration date |
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What are your 3 checks of medication are:
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2. After retrieving from drawer to compare order with MAR 3. Before administering to pt./or when replacing a container |
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Do not give a medication that you do not ____
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know |
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Be aware of all medications that need to be ____ at or around ______ change
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shift |
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Work as a ______ with other health care providers (pharmacists and physicians) |
team |
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When verifying over the phone, you need:
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write down order read back order to confirm unfamiliar drug (have spell and what kind of name: generic or trade) Ask what drug is used for |
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A medication error report is ______ part of pt record. It is used for risk management, remedial education, and improvement in quality care practices
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NOT
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What are important steps for the nurse to do prior to beginning to teach the pt?
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Readiness for teaching Pt. baseline knowledge Printed copy of pt. med list to give to them time to meet with pt and family set mutual goals for medicine admin at home |
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What important safety content should be included in pt. medication education? |
Do not share Do not used if expired no haording adverse reactions possible precautions (driving, alcohol, etc) Proper storage |
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Types of oral meds:
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Solid and Liquid
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Solid meds are:
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tablets, capsules and pills |
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Liquids are : |
elixirs, spirits, suspensions, syrups |
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____ route is the most commonly used route of administration
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Oral
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If a tablet is not _____ do not break it because it could lead to inaccurate dosing
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scored
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Enteric-coated tablets are covered with a hard surface that impeded _______ until it has left the stomach
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absorption |
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______ coated tablets are used when the active ingredient of the drug is irritating to the stomach mucosa |
Enteric
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Enteric-coated tablets should not be chewed or crushed w/o checking with prescriber for_______release forms
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extended
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Sublingual meds are placed under the _______ and meant to dissolve
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tongue |
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The buccal method for administering oral meds is between the ____ and the ____
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cheek and the gum |
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The ________ injection route has the longest absorption time of all the parental routes
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intradermal |
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And LPN can monitor established _________ IV infusions and sites
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peripheral |
