Medication Administration
Keys to medication administration accuracy
-avoid distractions and follow the same routine -administer only medications you prepare, and never leave prepared medications unattended -Document medications immediately after administration -use clinical judgement in determining the best time to administer PRN medications. -When preparing medications, check the medication container label against the MAR 3 times.
Intramuscular Injections
Assess the muscle before giving the injection Properly identify the site by palpating bony landmarks Be aware of potential complications with each site The site needs to be free of tenderness Minimize discomfort Insertion angle is 90 degrees
What are the 3 types of drug names?
Chemical: provides the exact description of medication's composition. Generic: the manufacturer who first develops the drug assigns the name, and it is then listed in the U.S. Pharmacopeia. Trade: also known as brand or proprietary name. This is the name under which a manufacturer markets the medication.
You are caring for a patient who has diabetes complicated kidney disease. You need to make a detailed assessment when administering medications because this patient may experience problems with a. Absorption, b. Biotransformation, c. Distribution, d. Excretion
D. Excretion
A postoperative patient is receiving morphine sulfate via PCA. The nurse assesses that the patient's respirations are depressed. The effects of the morphine sulfate can be classified as: A. Allergic, B. Idiosyncratic, C. Therapeutic, D. Toxic
D. Toxic
Intramuscular Injections
Faster absorption than subq route Many riskes, so verify the injection is justified Needles -Very obese: 3 inches, use different route -thin: 1/2 to 1 inch Amounts: adults: 2-5ml can be absorded children, older adults, thin patients: up to 2 ml Small children and older infants: up to 1 ml Smaller infants: up to 5 ml
Parenteral administration
Injection into body tissues Invasive procedure that requires aseptic technique Risk of infection Skills needed for each type of injection Effects develop rapidly, depending on the rate of medication absorption Non-leur lock or leur lock syringes. usually 0.5-60 ml Larger syringes used for IV meds and to irrigate wounds or drainage tubes.
Thorough assessment
Medical history, allergies, medications, diet history, patience adherence to therapy, patient's perceptual or coordination problems, patient's current condition, patient's attitude about medication use, patient's understanding of and adherence to medication therapy, and patient's learning needs.
Nurses are legally required to document medications that are administered to patients. The nurse is mandated to document at which time?
Medication after administering it.
Trough
Minimum blood serum concentration before next scheduled dose
Prescribers role in medication orders
Orders can be given hand-written, electronic, verbal, or by telephone. Use caution with abbreviations Each medication order needs to include, patient's name, order date, medication name, dosage, route, time of administration, drug indication and prescribers signature
Absorption of medication
Passage of medication molecules into the blood from the site of administration. Factors that influence absorption: -route of administration -Ability to dissolve -Blood flow to the site of administration -body surface area -lipid solubility of medication
Plateau
Point at which blood serum concentration is reached and maintained
The Seven Rights
Right Medication Right dose Right patient Right time Right route Right documentation Right allergies listed
Implementing health promotion
Teach the patient and family: -medication benefit -how to take meds properly -symptoms of side effects -safe use and storage of meds -a medication routine -refer to community resources for transportation as needed
Types of medication action
Therapeutic effect: expected or predicted physiology response. Side Effect: unavoidable secondary effect Adverse effect : Unintended, undesirable, often unpredictable. Idiosyncratic effect: over-reaction or under-reaction or different reaction than normal Toxic effect: accumulation of medication in the bloodstream. Allergic reaction: unpredictable response to a medication
Medication Interactions
These occur when one medication modifies the action of another. A synergistic effect occurs when the combined effect of two of the medications is greater than the effect of the medications given separately.
Onset dose response
Time it takes for a medication for produce a response
Intradermal injections
Used for skin testing (TB, allergies) Slow absorption from dermis Skin testing requires the nurse to be able to clearly see the injection site for changes Use a tuberculin or small hypodermic syringe for skin testing Angle of insertion is 5-15 degrees with arm up A small bleb will form as you inject; if it does not form, it is likely the medication is in subcutaneous tissue and the results will be invalid
Therapeutic Range
When a medication will start to take effect, the duration, and the time the medication peaks.
Biological Half-life
time for a serum medication concentration to be halved