week 2 - oral medications

Ways to supply drugs

Individual supply Unit dose supply Stock supply

3 checks to do before administering drug

name (ask client), dob (arm band), allergies check that the order form matches the med check that the med is not expired

t.i.d. stands for

three times a day

flush tube with _____ after each medication administration

water

is a medical order written on a client's medical record?

yes

The nurse is teaching a client about metformin SA. When the client asks, "What does the SA mean?" what is the appropriate nursing response? -"extended release" -"continuous release" -"sustained release" -"sustained action"

"sustained action"

The nurse is teaching a client about indomethacin SR. When the client asks, "What does the SR mean?" what is the appropriate nursing response? -"sustained action" -"sustained release" -"continuous release" -"extended release"

"sustained release"

The client refuses a medication. Which is the best response from the nurse? -"Your physician prescribed this medication to help you." -"What is the reason you do not want to take this medication?" -"You won't get better if you do not take this medication." -"I will have to inform your physician of your refusal."

-"What is the reason you do not want to take this medication?"

A hospital nurse is coming on shift for a night shift and is receiving a change-of-shift report from a colleague. The colleague states that one client refused a prepared medication that was scheduled for 1800. The colleague has left the medication in a paper cup in the client's drawer on the medication cart and asks the nurse to administer the medication when the client goes to bed for the night. How should the nurse respond to this scenario? -Check the five rights prior to administration and then give the client the medication at bedtime. -Ask a pharmacist or pharmacy technician to confirm that the medication is correct before administering it. -Discard the medication and administer a dose of the correct drug from a labeled container. -Ask the client if he recognizes the tablet and then administer it at bedtime.

-Discard the medication and administer a dose of the correct drug from a labeled container.

Components of medication orders

-Drug name -Drug dose -Route of administration -Frequency of administration -Signature of prescribing agent - DEA #

A nurse is caring for a client who has been prescribed codeine, an opioid medication to relieve severe postoperative pain. Which responsibility does the nurse have to complete when handling opioid medications? Select all that apply. -Place the medication in the container with other prescribed medications. -Maintain an accurate account of the use of the medication. -Count each opioid medication at the change of each shift. -Place the medication with other medications on the nursing unit. -Record each medication used from the stock supply.

-Maintain an accurate account of the use of the medication. -Count each opioid medication at the change of each shift. -Record each medication used from the stock supply.

The nurse is assessing a client who was seen 7 days ago with strep throat. The client states, "I felt better after 2 days of the antibiotic the provider prescribed, so I quit taking it." What would the nurse do to address this situation? -Provide education on taking all antibiotics for effective treatment -Instruct the client to return to taking the current prescribed medication until it is all gone -Instruct the client to take both the current antibiotic along with a new prescribed antibiotic to avoid antibiotic resistance -Offer to speak to the provider for different treatment options

-Provide education on taking all antibiotics for effective treatment

The nurse has confirmed the client's identity and provided a client with oral medications to take. What is the next appropriate nursing intervention? -Assess for therapeutic effect of medications. -Stay with the client while medications are taken. -Leave the room. -Document medication administration.

-Stay with the client while medications are taken.

The nurse has prepared a syringe containing morphine to give to a client. The client refuses the drug, stating that pain is under control. What procedure does the nurse follow to properly dispose of the medication? -Two nurses must physically return the medication to the pharmacy for disposal, and both nurses are required to sign the controlled substance return log. -Waste the medication with a nurse witness present, and the nurse witness must countersign the control record. -Discard the controlled medication and document the amount, date, and time on the control record, then sign it. -A second and third nurse must witness the discarding of the controlled medication, and all three nurses must sign the control record.

-Waste the medication with a nurse witness present, and the nurse witness must countersign the control record.

The nurse is to administer an opioid. The prescribed dose is one half of a scored tablet. The nurse cuts the tablet in half and then: -drops the half tablet in the sharps container. -disposes of the half tablet in the sink. -places the half tablet in the client's drawer to administer later. -has a second nurse witness the waste.

-has a second nurse witness the waste.

What is an example of drug diversion? The nurse: -takes a medication from one client's container to use for another person. -maintains an accurate count of opioids every shift. -uses stock supply for administering a medication ordered stat. -obtains medication for the client from the automated medication-dispensing system.

-takes a medication from one client's container to use for another person.

forms of medication orders

-verbal -telephone -documented in med admin record

A nurse is caring for a client in the nursing unit when the physician, during the rounds, prescribes a medication for the client. What appropriate action should the nurse take to ensure the accuracy of the verbal medication order? -Ask the physician to write out the order. -Ask the physician to spell out the medication name. -Ask a second nurse to listen for accuracy. -Ask the physician to repeat the dosage.

Ask the physician to write out the order.

________ the time of administration and initial for any missed doses

circle

medication orders are written by ...

medical personnel, physician's assistant, or advanced practice nurse

do not mic enteral feeds with ______

medication

The nurse is preparing to give medications to a client with anxiety. The order indicates that the client is to have bupropion, 7.5 mg by mouth twice daily. What is the appropriate nursing action? -Contact the health care provider for order clarification. -Assume that the provider meant to order buspirone. -Ask another nurse to verify the order. -Administer the drug as ordered.

Contact the health care provider for order clarification.

The nurse is preparing to administer the second dose of ordered antibiotics to a client and notes that the first dose of medication is still in the automated medication-dispensing system. The medication administration record (MAR) does not show that the initial dose was given. What is the appropriate nursing action? -Give the first and second doses of antibiotics. -Notify the health care provider. -Call the pharmacy before notifying anyone else. -Proceed with the administration of the second dose.

Notify the health care provider.

The client has continuous enteral feedings through a nasointestinal tube. The client has a thyroid medication that is to be taken on an empty stomach. What action does the nurse perform? -Withhold the thyroid medication. -Mix the medication in the tube feeding and administer the tube feeding and medication together. -Ask the health care provider to prescribe bolus feedings. -Stop the infusion for 30 minutes before and after administration of the thyroid medication.

Stop the infusion for 30 minutes before and after administration of the thyroid medication.

The nurse enters a client's room to administer preoperative antibiotics. Which rights of medication administration must the nurse follow? -Blood type -Heart rate -Room -Time

Time

The nurse is caring for a client with pneumonia who requires administration of medications. When does the nurse document administration in the medication administration record (MAR)? -at the end of the nurse's shift -during administration at the bedside -when preparing medications for administration -after completion of administration of each drug

after completion of administration of each drug

PRN stands for

as needed

The "rights" of medication administration help to ensure accuracy when administering medications. What are some of these rights? Select all that apply. -dosage -client -medication -route -pharmacy -prescribing physician

dosage client medication route

a medication order lists the _____ ______and ______ for its administration

drug name and directions

Oral medications are administered by _______ ______if client cannot swallow them

enteral tube

q4h stands for

every 4 hours

q.o.d. stands for...

every other day

q.d. stands for...

everyday

Action taken when medication error occurs

inform supervisor

5 rights of medication administration

right patient, right drug, right dose, right route, right time sometimes right documentation and right to refuse