Chapter 34 medication administration, canadian fundamentals of nursing

Parenteral routes

1. Intradermal (ID) 2. Subcutaneous 3. Intramuscular (IM) 4. Intravenous (IV)

Seven rights of medication administration

1. Right medication 2. The right dose 3. The right clients 4. The right route 5. The right time 6. The right documentation 7. The right reason

Process for medication reconciliation

1. Verify 2. Clarify 3. Reconcile 4. Transmit

Noncompliance

A deliberate misuse of medication. - occurs by drug ineffectiveness - uncomfertable side effects - or the prohibitive cost of the medicine

Medication

A substance used in the prevention, diagnosis, relief, treatment, or cure of health alterations

Solutions

A various concentrations are used for injections, irrigations, and infusions

As needed - PRN - orders

According to this order a medication is to be given only went to client requires it

Buccal administration

Administering a meditation by this route involves placing a solid medication in the mouth and against the mucous membranes of the cheek until the medication dissolves

right dose

After confirming the calculated does, prepare the medication by using standard measurement devices. Use graduated cuts, syringes, and scaled droppers to measure medications accurately

Circulation

After medication enters the bloodstream, it is carried throughout the body's tissues and organs, the speed at which it reaches the site depends on the vascular content of the tissues and organs.

Distribution

After medication is absorbed by the body, it is distributed to the tissues and organs and see what specific site of action

Excretion

After medications are metabolized, the exit the body through the kidneys, liver, bowel, lungs, or exocrine glands.

Safety

All drugs need to be continually evaluated to determine their side effects

Right route

Always consult with the prescriber. When administering injections, take precautions to ensure that the medications are given correctly.

Right client

An important step in administering medication say please in sure the medications are given to the right person check the medication administration record against the client identification bracelet and asked the client to state his or her name to ensure that the clients identification bracelet has the correct information

Intrapleural route

And injection or chest tube is used to administer these medications directly into the plural space - chemotherapeutic agents are the most common medications administered by this method

Medication errors

Any event that could cause or lead to a client either receiving inappropriate to medication therapy or failing to receive appropriate medication therapy

Anaphylactic reactions

Are severe reactions that are life-threatening and are characterized by sudden constriction of bronchial muscles, Edema of the pharynx and larynx, severe wheezing, shortness of breath, and circulatory collapse.

Side effects

Are the unintended, secondary effects that medication predictably will cause. It may be harmless or injurious

Aspirin

Belong to more than one class is an analgesic, an antipyretic, and an anti inflammatory

What is Canada's standard of measurement?

Canada uses the metric system

Nasal instillation

Clients with nasal sinus alterations may recieve medications by spray, drops, or tampons

Efficiancy

Detailed laboratory studies help determine a drugs effectiveness

Toxic effects

Develop after prolonged intake of the medication or after a medication accumulates in the blood because of the impaired metabolism or impaired excretion

Some medications are administered into the body cavities other than the four parenteral administration sites theses are what?

Epidural, intrathecal, intraosseous, intraperitoneal, intrapleural and intra-arterial routes

Membrane permeability

For medication to be distributed it into an Organ it must pass through all the organs tissues and biological membranes.

Before a new drug can be marketed in Canada, and application for approval must be made to this

Health protection branch (HPB)

Lipid solubility of the medication

Highly lipid soluble medications easily cross the cell membrane and I absorbed quickly

Eye instalation

I medications used by clients are eyedrops and ointments, including over-the-counter preparations -ophthalmic medications for our conditions, such as Glo,, and after cataract extraction in older adults

Single - one time - orders

I prescriber will often order a medication to be given only ones at a specific time

Meditation classification

Indicates the effect of the medication on a body system the symptoms the medication relieves, or the medications desired effect

Symptom Rhinitis

Inflammation of mucous membranes lining nose, causing swelling in clear, watery discharge

Intramuscular (IM)

Injection into a muscle

Intravenous (IV)

Injection into a vein

Intradermal (ID)

Injection into the dermis just under the epidermis

Subcutaneous

Injection into tissues just below the dermis

Parenteral administration

Involves injecting a medication into the body tissues. There are the four major site of injection

solution

Is a given mass of solid substance dissolved in a known volume of fluid or a given volume of liquid dissolved in a known volume of another fluid

Medication administration

Is an essential part of nursing practice and requires a sound knowlage base in anatomy, physiology, pathophysiology, pharmacology, psychology, and research

Medic alert bracelet

Is ingraved with the person's emergency medical information, including drug allergies

Oral route

Is the easiest and most commonly used route of administering medication

Therapeutic effect

Is the expected or predictable physiological response that a medication causes

Pharmacokinetics

Is the study of how medications into the body, reach their site of action, metabolize, and exit the body.

Symptom pruritus

Itching of skin, accompanies most rashes

Purity

Manufacturers must meet purity standards for the type and concentration of substances allowed in drug production

household measurements

Measures include drops, teaspoons, tablespoons, cups, pints, and quarts or leaders for volume, and ounces and pounds, or grams and kilograms/4 weight.

Intraosseous route

Medication administration involves the infusion of medication directly into the bone marrow. Commonly used in infants and toddlers because intravascular space is difficult to access, mostly use when an emergency arises an IV access is impossible usually infused to the tibia

Topical administration

Medication applied to the skin and mucous membranes usually result in local effects

Right medication

Medication order is required for every medication you would administer to a client.went to medications our first ordered, compare the medication administration record or computer order with the prescribers written order

Intraperitoneal route

Medications are administered into the paratonia cavity, where they are absorbed into the circulation system -these routes are used to administer chemotherapeutic agents, insulin, and and Antibiotics

The basic units of measurement in the metric system

Meter- Length - Litre- Volume - Gram-weight- * medication calculations, use only the measurements for volume and weight*

Protein binding

Most medications bind to proteins to some extent. The degree to which medications bind to the serum proteins, such as albumin, affect the medications distribution

Orally administered medications

Must pass through the gastrointestinal, G.I., tracked to be absorbed, the overall rate of absorption is usually slow.

Violations of this are punishable by fines, imprisonment, and loss of your nursing license or your nursing registration

Narcotic control act

Right documentation

Nurses and other healthcare professionals use accurate documentation to communicate with each other, this is essential to ensure safe medication administration. Appropriate documentation includes the clients name, the name of the ordered medication written out in full, the time the medication was administered. and the medications dose, route, and frequency

Right reason

Nurses are professionally responsible for obtaining the rationale for prescribed medications. You have the professional responsibility to research the medications by using sources given

idiosyncratic reactions

Occurs when a client overreacts or underreacts to a medication or has a reaction different from the normal reaction

Rational polypharmacy

Occurs when clients need to take several medications to treat their health conditions - common for older adults

Biotransformation

Occurs when enzyme detoxify, degrade or breakdown, and remove the biologically active chemicals

Aspiration

Occurs when food, fluid, or medication intended for GI administration is invertedly administered into the respiratory tract

Irrational polypharmacy

Occurs when the client takes more medications than needed, this results from several causes

Polypharmacy

Occurs when the client takes two or more medications to treat the same illness - divided into 2 types; rational and irrational

Right time

Prescriber often give specific instructions for the timing of administration of the medication. Nurses must know why medication is ordered for certain times of the day and whether the time schedule can be altered

Intravenous, I V injection

Produces the most rapid absorption because this route to provide immediate access to the systemic circulation

Symptom Urticaria

Raised, irregularly shaped skin eruptions with varying sizes and shapes, eruptions have a right into margins and pale center.

Absorption

Refers to the passage of medication molecules into the blood from the medications site of administration.

Adverse effects

Severe, negative responses to medication

Symptom rash

Small, raised vessels that are usually reddened often distributed over the entire body

At least seven different medications are included in this classification

Sulfonylurea classification

Bioavailability

The ability of a drug to be released from its dosage form and to be dissolved, absorbed, and transported by the body to the drugs site of action.

Synergistic effect

The combined effect of the two medications is greater than the effect of the medication when given separately

Medication forms

The composition of the medication is designed to enhance its absorption and metabolism. Many medications are made in several forms, such as tablets, capsules, elixirs, and suppositories.

Potency

The concentration of the active drug in the preparation affects its strength, or potency

Peak concentration

The highest serum concentration of the medication usually occurs just before the body absorbs the last of the medication

Sublingual administration

The medication given by this route should not be swallowed because the medication will not have a desired effect. Some medications are designed to be readily absorbed after being placed under the tongue to dissolve

Pharmacokinetics

The study of how medications enter, affect, and exit the body

Medicalert bracelets

These alert health care workers to the clients medical information, including allergies, if the client is unable to communicate this information when receiving medical care

Intrathecal route

These are administered through a catheter that has been placed into the subarachnoid space or into one of the ventricles of the brain. This is often associated with long-term medication administration through surgically implanted catheters

Intra-arterial route

These medications are administered directly into the arteries and are often are commonly used to deliver tissue plasminogen activator's in clients who have arterial clots

Epidural route

These medications are administered in the epidural space via catheter, which is put in place by an anaesthesiologist

Intraocular administration

These medications resemble a contact lens. Place the medication into a conjunctival sac where remains in place for up to one week

Intraocular route

This medication delivery a medication in a form similar to a contact lens is inserted directly into the clients eye

Routine medication orders

This order is carried out until the prescriber cancels it by writing a new order or until a prescribed number of days have elapsed

STAT orders

This order signifies that a single dose of medication is to be given immediately and only once

Inhalation

This roots are readily absorbed and work rapidly because of the rich vascular Alveolar-capillary network present in the pulmonary tissue. Inhaled medications may have either local or systemic effects

Allergic reaction

Unpredictable responses to a medication. Some clients become immunologically sensitized to the initial dose of the medication

Body surface area

When a medication is in contact with a large surface area, the medication will be absorbed at a faster rate

Medication interaction

When one medication modifies the action of another medication

Serum half life

Which is the time it takes for the excretion process to lower the Serum medication concentration by half

Ability of the medication to dissolve

depends on its form of preparation

Tradename, brand-name, or proprietary name

is the name under which a manufacturer markets a medication

Blood flow to the site of administration

when the site of administration contains a rich blood supply, the body absorbs medications more rapidly

Intracardiac routes

*limited to administrated by a physician* -in which medication is injected directly into cardiac tissue

Intra-articular routes

*limited to administrated by a physician* -in which medication is injected into a joint

Are the other measurements used in medication therapy?

- The metric system - the apothecary system - and household systems

3 different names of medications

- chemical name - given name - trade name

Protecting the client from aspiration

- determine the clients ability to swallow - assess the clients cough - determine the presence of a gag reflex - prepare oral medications in the form that is easiest for the client to swallow - allow the client to self administer medications if possible - if the client has unilateral weakness, place the medication in the stronger side of the mouth - administer pills one at a time, ensuring that each pill is properly swallowed before the next one is introduced - thicken regular liquids or offer fruit nectars if the client cannot tolerate thin liquids - have the client hold and drink from a cup if possible - when possible, medications should be timed to coincide with meal times or when the client is well rested and awake - administer medications through another route if risk of aspiration is severe

Elements that should be included in a verbal order include

- name of clients - age and weight of client, when appropriate - drug name - dosage form - exact strength or concentration - dose, frequency, and route - quantity and duration - purpose or indication - specific instructions for use - name of the prescriber end, when appropriate, the telephone number -name of individual transmitting the order, it's different from the prescriber

What does the recording of the medication include?

- writing the name of the medication -The dose - The route - and the exact time of administration

The variety of ways medications can be applied to the mucous membranes

1) By directly applying a liquid or ointment 2) by inserting a medication into a body cavity 3) by instilling fluid into a body cavity 4) By irrigating a body cavity 5) by spraying