Class 2 Flashcards
(20 cards)
Medication Delivery
- _______ dose
- each dose is packaged separately
- dispensed just for this patient
- manufacture’s label versus pharmacy label
- _______ dose
- one container provides ______ doses
- nurse must confirm the drug via the label and then pour or withdraw the right amount of the drug
- UNIT
- MULTI-
- multiple
Nursing Responsibilities with Medication Orders: MULTIPLE CHEKCS
1. Accepting the medication order - is it __________?
2 Confirming the ______ - is it ________ and _______?
3. Checking what pharmacy has supplied - medication label - can this _______/_______ be used for this order?
4. ________ of Medication Administration
5. _______________
- complete
- dose; safe; therapeutic
- form/product
- Rights
- Documentation
- The RN can only accept a ______ order from the MD for a medication
- What is a legal MD order?
- It is a written description from the MD that indicates 7 essential items
1. the ________ the medication is for
2. the ________ that is to be given to the patient
3. the _______ of the medication
4. the ______ or _________ of administration
5. the ______ that the medication should be given
6. the _____/_____ that the order was written
7. the ___________ signature (and ______ # if a ________)
- It is a written description from the MD that indicates 7 essential items
- the order may also include additional ________ items
- legal
1. patient (name)
2. medication
3. dose
4. time or frequency
5. route
6. date/time
7. physician’s (DEA; narcotic) - optional
Examples of Optional Items for Orders
1. Additional ____________, if needed
- example: check BP every 15 min during the infusion and every 30 minutes x2 after completed
- _______ of drug
- this refers to _______ vs ______
- ______ is only required if needed to find the _____ of the order
- instructions
- form
- capsule; tablet
- form; dose
The dose must indicate “_____ _____” to give at each time of administration
- mg, tablets, mL, capsules….
- if given in tablets/capsules/mL, you. must be able to identify the _______ in that concentration
The ______ must be included (and legible; any abbreviations must be acceptable)
how much
- amount (mg)
route
Verify the Dosing Schedule: Frequency and Times to Give the Med
- May be a ________:
- TID, q6hrs
- May be a ______
- Q HS, 30 minutes before surgery, STAT, ASAP, NOW
- May relate to an event:
- ac/pc = _______________
- Are q6hrs and QID the same thing? _______
- frequency
- time
- before/after meals
- Not always… QUID may be 4 doses during waking hours (8am, 12pm, 5pm, 9pm) while Q6hrs is exactly 6 hours apart between doses (8am, 2pm, 8pm, 2am)
Verbal Orders
- An RN may accept an order for a physical by telephone
- BUT this must be in accordance with the hospital’s policy on verbal orders and computer use
- The RN writes (or enters) the order and it must include the 7 critical elements
- a “_____ _____” must be performed: the nurse reads back the entire order for clarification with the MD
- the physician must then _______ (acknowledge) the order at the next visit
- “read back”
- countersign
Nurse Must be Knowledgeable About:
1. The types of _________ of a drug
- how many ways can this drug by administered
- is the one order appropriate?
2. The ______ of a drug:
- ___________ effect: desired effect from the drug
- ____________ effects: not intended effect, but occurs anyway
- __________ effect: if too much is given
- __________ _______: patient cannot tolerate this medication
3. The _______ _______ of a drug
- is the dose ordered within a normal range?
4. The method of administration (______)
- is the ________ ordered a reasonable _________?
- preparations
- actions
- therapeutic
- side
- toxic
- allergic reaction - usual doses
- ROUTE
- route; route
Documentation of medication must reflect what was ______ given and _____ time of administration
ACTUALLY; ACTUAL
If there is an error in ADMINISTRATION of Medication
1. ________________ (ALWAYS comes first)
2. ________________
3. ________________
- check condition of the patient
- notify MD and/or supervisor of the error
- document what was actually given, even though it’s not what the MD ordered (you cannot falsify the record)
General Guidelines for Rounding Doses in SOLID format (mg, kg, in)
- ____ decimal places if the dose is less than 1
- ___ decimal place if the dose in between 1-10
- _______ ________ if the dose is greater than 10
- 2
- 1
- whole number
General Guidelines for Rounding LIQUIDS (mL)
- _____ decimal places if the dose is less than 1
- _____ decimal place if the dose is greater than 1
- 2
- 1
Reconstitution of Medication
- some drugs come in a __________ form or ___________ liquid
- can be an _____ drug or a _______ drug
- pharmacy staff usually reconstitute the drug, but it can also be a nursing responsibility
- reconstitution involves “______” the entire vial/bottle of medication
- powdered; concentrated
- oral; parenteral
- mixing
How to Reconstitute a SINGLE STRENGTH SOLUTION:
- ALWAYS check the ________! if there are none than do NOT attempt to reconstitute
- Determine two items:
1. What _________/_______ is needed to reconstitute the medication= __________ is the generic term for this mixing solution
2. How much _______ is needed
- directions
1. solution/liquid; diluent
2. diluent
The Recommended Dose may be reported as a “Range” of 2 numbers
- the lower number (minimum) is the ___________ value
- the upper number (maximum) is the ________ value
- the prescribed dose should fall within this range
- therapeutic
- safe
Explaining your decisions regarding safe and therapeutic doses: there should be 4 factors
1.
2.
3.
4.
- Ordered dose
- Minimum dose (therapeutic)
- Maximum dose (safe)
- al three must be in the same time frequency - Your conclusion regarding safe/therapeutic
Key Pharmacokinetics Terms
- ____________: movement of drug into a bloodstream
- ____________: movement of a drug throughout the body
- ____________: breakdown and inactivation of drug
- ____________: removal of drug from the body
- Absorption
- Distribution
- Metabolism
- Excretion
Clinical Factors that the MD/NP must take into account when deciding on a medication dose
- _________________ (age, nutrition, gender, ethnicity, genetics, cultures)
- ________________ (route or timing of administration, absorption and excretion of medication)
- _______________
- _____________________
- PO route: what if the patient cannot swallow or what if the patient is vomiting
- IM route: how large is their muscle mass
- ________________ (are they sensitive to the drug or are they allergic to the drug)
You can see that the MD/NP must consider many elements when they write an order for mediation, and thus the reason why, on occasion, doses may appear low or even high!
- Patient’s General Condition
- Medication
- Concurrent Drug Therapy
- Available routes for drug administration
- Individual response to the drug
If a drug is NOT SAFE, it is an _______
- the nurse must _______ administer the dose
- the dose is _____
- it is LEGAL to _____ the dose
overdose
- NOT
- held
- HOLD
If a drug is sub therapeutic, the nurse may ______ legally hold the dose
- certainly it should be discussed with he MD, but if the MD cannot be contacted right away, the dose must be given on time as ordered
- Otherwise, a medication ______ has be committed
- If the MD decides on a higher dose later, ________ can be given
NOT
- ERROR
- more
