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