Med Administration

Question 1

What can med errors cause?

Answer 1

Death
Life threatening situations
Hospitalization
Disabilities
Birth defects

Question 2

What are most med errors?

Answer 2

Wrong dosages

Question 3

What are nurses considered for pt safety and why?

Answer 3

Last line of defense, we are the last people who can catch any errors made by: pharmacies, doctors, or even other nurses

Question 4

When are likely times that there can be a med error?

Answer 4

• Ordering/Prescribing
• Transcribing
• Dispensing
• Administering
• Monitoring

Question 5

What are 10 types of med errors?

Answer 5

Wrong pt
wrong drug
wrong route
wrong time
wrong dose
wrong dose form
wrong technique
deteriorated drug error
compliance
wrong documentation

Question 6

Factors of med errors and what can cause them?

Answer 6

Provider/Pharm/Nurse
- Distraction
- Comm.
- Lack of training
- Inadequate knowledge on pt or drug
- Too tired
- Health issues or stress

Patients
- Personality
- Literact
- Language
- Health condition
- Polypharmacy
- Inconsistent method

Communication
- Names
- Handwriting
- Verbal order
- Labeling

Question 7

How can we reduce med errors?

Answer 7

• Pt and family must be knowledgeable and well informed through nurse education
• Pt must be present and always willing to improve and work

Question 8

What is there no place for in nursing?

Answer 8

Complacency
- You may forget or take shortcuts that can cause harm

Question 9

What causes high alert for med errors?

Answer 9

Name similarities

Question 10

WHEN an error occurs, what’s the priority?

Answer 10

Assess/monitor pt for adverse reaction
Notify the charge nurse
Contact physician
Complete incident report

Question 11

What are 6 things nurses MUST know?

Answer 11

Med pros and cons
PT allergies
How to calc med doses
Factors of pt response
Nursing Process
NPA

Question 12

If you don’t know who is going to be held responsible during a med error, who can you safely assume?

Answer 12

You

Question 13

What are some responsabilities of pt’s?

Answer 13

• Understand treatment and ask questions
• Stick to the regiment
• Avoid to misuse
• Report adverse reactions
• Store meds safely

Question 14

What does the pt have the right to be informed of?

Answer 14

Drug name
Dosage
Reason for drug
Frequency
Route
Potential Adverse Reaction

Question 15

What does the pt have the right for?

Answer 15

Receive labeled meds
Receive meds properly
Not to receive unnecessary meds
Refuse meds

Question 16

Components of a good med orders?

Answer 16

Pt name
Date and time
Name of med
Dosage
Route
Time and frequency
Signature

Question 17

Some musts when taking verbal/phone orders?

Answer 17

Avoid abbreviations as much as possible
Read and spell back
Provider must approve in 24h

Question 18

What are the 7 rights?

Answer 18

Right:
pt: 2 identifiers
med: check label
dose
time
route
reason
documentation: eMAR

Question 19

What is diversion?

Answer 19

Use of drugs for reasons other than their original purpose

Question 20

How to properly dispose of a narcotic?

Answer 20

ALWAYS have a witnessing other RN

Question 21

Consequences of Med diversion

Answer 21

3 day suspension
Termination if necessary
Peer review
BNE report
Loss of RN license
TPAPN

Question 22

3 main pharm concepts?

Answer 22

Med names
Classification
Med forms

Question 23

Adverse drug reaction

Answer 23

Unintended and undesired effects at normal drug dose

Question 24

Difference between Toxicity and Allergic reactions

Answer 24

Toxicity: Excessive drug dosing
Allergic: Immune response based

Question 25

Types of adverse reactions

Answer 25

Idiosyncratic: Due to genetics Paradoxical: Opposite effect of intended Iatrogenic: Disease caused by drug Teratogenic: Caused birth defects Physical Dependence: Body adapted to drug exposure (Addiction)

Question 26

How to identify ADR?

Answer 26

Symptoms start shortly after drug use? Symptoms leave after drug discontinued? Symptoms reappear after drug given again?

Question 27

Ways to minimize ADR

Answer 27

Education Early ID'ing Monitoring Black Box Warning

Question 28

Types of modified releasing of drugs?

Answer 28

Delayed Extended: Controlled to work over long periods of time Oral

Question 29

When should you avoid PO meds?

Answer 29

Change in LOC NPO status Altered GI function(NG Tube or N&V) Dysphagia

Question 30

What 6 types meds to you NOT crush split or chew?

Answer 30

Enteric coated Sustained Release Time Release Controlled delivery Sublingual Buccal

Question 31

Where can you apply topical meds?

Answer 31

Skin Eye Ear Vagina Rectum

Question 32

Types of topical meds

Answer 32

Powders Creams/paste/gel/ointment Grops Sprays Patches Suppositories

Question 33

What should you do before applying topical meds?

Answer 33

Clean area and present it well

Question 34

What can you NOT do to MOST transdermal patches?

Answer 34

DONT CUT them

Question 34

When do you need to remove transdermal patches?

Answer 34

MRI's and AED's

Question 35

When giving rectal meds, what position is needed, and what do you need to use and do?

Answer 35

Lay them sideways(SIMS) Use lubricant Relax pt to make insertion easier

Question 36

What position is needed for giving vaginal meds?

Answer 36

Lithoyomy

Question 37

If you want to clean ear out before administering meds, what must you do?

Answer 37

Ask physician and make sure they allow it

Question 38

2 common types of inhalants?

Answer 38

Metered dose(MDI) or Dry Powder (DPI)

Question 39

Who are spacer inhalants mostly for? And what do they do?

Answer 39

Children Reduce med effects

Question 40

How many times do you shake an MDI?

Answer 40

5-6

Question 41

How do you properly use a MDI?

Answer 41

Deep breath then exhale Tilt head back slightly Puff one time Breath slowly Hold breath for 5-10 secs Wait 1 min Rinse mouth

Question 42

How does a DPI differ from MDI?

Answer 42

Don't tilt it quickly inhale and hold Mostly for at home use, rare in hospitals

Question 43

Components of a Drug label (7)

Answer 43

Exp date Lot number Drug form Manufacturer Generic Name Brand Name Dosage

Question 44

What do you need to teach for meds

Answer 44

Name Dosage Route Frequency Reason Possible side effects