Medication management

Question 1

What are the 6 rights?

Answer 1

• Right patient
• Right drug
• Right dose
• Right time
• Right route
• Right documentation

Question 2

What information needs to be present on a drug chart before you can administer a medication?

Answer 2

• Patient’s name
• Patient’s date of birth
• Name of the drug
• Dose of the drug
• Time/frequency given
• Route
• Prescriber’s signature

Question 3

What is meant by the term ‘beneficence?’ Give an example of how it is applied in practice.

Answer 3

Beneficence is an ethical principle that addresses the idea that a nurse’s action should promote good.

An example in practice might be carrying out an intervention, e.g. administrating a medication or dressing a wound for the good of the patient’s health.

Question 4

What should you do when reporting a drug error?

Answer 4

• Notify the patient/remedy the harm
• Report to the line manager
• Record in patient notes
• Require a thorough and careful investigation at a local level
• Record on to medication error form

Question 5

What does the NMC mean by ‘open and honest reporting? Why is it important?

Answer 5

The NMC encourages an ‘open culture’ to avoid people not coming forward and reporting drug errors. Historically, local disciplinary actions have often deterred open and honest reporting. It means common mistakes can be identified quickly, and measures can be implemented to minimise them in the future through training, process and policy review.

Question 6

What type of drug interaction occurs when 2 drugs that normally produce the same effect are taken, resulting in an enhanced effect?

Answer 6

Potentiation

Question 7

Protein binding (attachment of the drug to blood proteins) is an important consideration influencing ____________________

Answer 7

Distribution

Question 8

Where should controlled drugs be stored?

Answer 8

In a dedicated locked cupboard

Question 9

Which ethical principle does the concept of ‘consent’ go to the core of?

Answer 9

Autonomy

Question 10

What is meant by the term ‘autonomy? Give an example of how it is applied in practice.

Question 11

What is meant by the term ‘non-maleficence? Give an example of how it is applied in practice.

Question 12

What is meant by the term ‘justice? Give an example of how it is applied in practice.

Question 13

Examples of enteral routes?

Answer 13

• Oral
• Sublingual/buccal
• Rectal

Question 14

What is oral administration?

Answer 14

Route of administration where a substance is taken through the mouth.

Question 15

What is sublingual administration?

Answer 15

Sublingual administration is when medication is placed under the tongue to be absorbed by the body.

Question 16

What is buccal administration?

Answer 16

Buccal administration involves the placement of the drug between the gums and the cheek

Question 17

Examples of parenteral routes?

Answer 17

• Intravenous (IV)
• Intramuscular (IM)
• Subcutaneous (SC)
• Inhaled (Lungs)

Question 18

Name 6 reliable sources for medication information.

Answer 18

• BNF
• NICE Guidance
• Trust Formulary
• Trust Medication Information Service
• Pharmacy Service
• National Library of Medicine

Question 19

What should be your course of action as a qualified nurse if, during the administration of an IM injection, the syringe pops off the needle? You are left unsure of how much of the dose the patient actually received.

Answer 19

This would need to be reported as a drug error as you will not know how much of the medication made it into the muscle. You would need to wait until the next dose is due before attempting to administer again unless otherwise directed by the prescriber.

Question 20

What does it mean to inject subcutaneously?

Answer 20

Injected into the subcutaneous fat tissue at a 45-degree angle.

Question 21

What should you know about the drugs you provide? (5)

Answer 21

Indications
Contraindications
Dosage
Side effects
Rate of administration

Question 22

What are the 4 routes of drug administration?

Answer 22

Percutaneous (bypasses digestive tract)
Pulmonary
Enteral
Parenteral

Question 23

What should you do if a patch is given and BP drastically decreases?

Answer 23

Take the patch off.

Question 24

How should you instruct the patient to take the pill when given buccally or sublingually?

Answer 24

Instruct patient to let the pill dissolve, do not swallow

Question 25

What kind of patient typically uses a metered dose inhaler? (MDH)

Answer 25

Someone with asthma or COPD

Question 26

Why do elderly people and young children often have spacers in their inhalers?

Answer 26

Because they have a hard time operating their inhalers

Question 27

How long should one gently shake their metered dose inhaler for?

Answer 27

2-5 seconds

Question 28

Who are nebulizer medications infective to?

Answer 28

Patients with poor tidal and minute volume because drugs cannot reach the site of action

Question 29

What part of the body can alter the medications effectiveness?

Answer 29

The liver. A dysfunctional liver can alter drug distribution and in extreme cases, metabolize therapeutic medications into harmful substances

Question 30

How should the medication in a medicine cup be measured? Why?

Answer 30

It should be measured towards the centre, at its lowest level because the sides of the cup are higher, which form the liquid into a meniscus

Question 31

What is an important step when administering medicine orally? How much liquid should follow?

Answer 31

Check the label to see if the medication should be administered with or without food. 100-250mL of water should be used to wash down the medicine

Question 32

Indications to use a gastric tube? (5)

Answer 32

Difficulty swallowing
Nutritional status is poor
Drug overdose
Trauma
Upper GI bleeding

Question 33

What is the insulin procedure? (4 Steps)

Answer 33

1. Right patient, review their current health. Have they had their insulin dose today?
2. CHECK THEIR BLOOD GLUCOSE LEVEL BEFORE!!
3. Records check a) Check DSN1 for insulin type (units written in full; if not, ask prescriber to write again) and in date. (reviewed within 12 months). b) check if the patient has recently been discharged & if the insulin has been changed. c) check the time of the last insulin d) check the time of the last meal, if appropriate for insulin type e) Right Dose at the right time? Written on DNS1
4. Safety check = If you think insulin has already been given, get further advice.