Transcript Power Point Notes - Delmar Cengage Learning

Fundamentals of Nursing:
Standards & Practices, 2E
Chapter 29
Medication
Administration
Drug Standards and Legislation
Standards
• Standards have been developed to
ensure drug uniformity so that effects
are predictable.
• The United States Pharmacopeia and
National Formulary (USP and NF) are
books of drug standards for usage in
the United States.
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Federal Legislation
• The Pure Food and Drug Act of 1906
designated the USP and the NF as
official bodies to establish drug
standards.
• State and Local Legislation
• Health Care Institution Regulations
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Drug Nomenclature
Drugs may be used as an aid in the
diagnosis, treatment, or prevention
of disease, in other abnormal
conditions for the relief of pain or
suffering, or to improve any
physiological or pathologic condition.
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Drug Action
Pharmacology
• Medication Management
• Classification
• Preparation and Route
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Pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
Drug Interaction
Side Effects and Adverse Reactions
Food and Drug Interactions
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Factors Influencing Drug
Action
Individual client characteristics, such
as genetic factors, age, height and
weight, and physical and mental
conditions can influence the action
of drugs on the body.
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Professional Roles in Medication
Administration
Health Care Providers
Types of Medication Orders
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•
•
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Stat Orders
Single-Dose Orders
Standing Orders
PRN Orders
Parts of the Drug Order
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System of Weight and Measure
Metric System
Apothecary System
Household System
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Approximate Dose Equivalents
Converting Units of Weight and
Volume
• Measurement Conversions within the
Metric System
• Measurement Conversions between
Systems
Drug Dose Calculations
• Pediatric Dosages
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Safe Drug Administration
Guidelines for Medication
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•
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Right Drug
Right Dose
Right Client
Right Route
Right Time
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Documentation of Drug
Administration
• Documentation is a critical element of
drug administration.
• Nurse should document that a drug
has been given after the client has
taken the drug.
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Drug Supply and Storage
• Unit dose form is used to dispense
scheduled drugs for each client.
• Stock supplied drugs (dispensed and
labeled in large quantities) are stored
in the medication room or other area
on the nursing unit.
• Narcotics and Controlled Substances
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Drug Abuse
• Addiction is a physiological or
psychological dependence on a
substance.
• Dependence is the reliance on, or
need to take a drug.
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Medication Compliance
Compliance can be associated with the
client’s understanding of why medication
was ordered, and how medication can
decrease the likelihood of getting a
disease or how it can lessen the effects
of an existing disease.
Noncompliance is when clients do not
consistently take prescribed medications,
or when they adjust the scheduling or
dose of the medication.
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Legal Aspects of Administering
Medications
Negligence exists any time the nurse
fails to do something that a reasonable
nurse would do under similar
circumstances or does something that a
reasonable nurse would not do.
Malpractice is any professional
misconduct or unreasonable lack of skill
in professional duties.
Questioning the Medication Order
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Assessment
Drug History
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Allergies
Prescription Drugs
Over-the-Counter Drugs
Biographical Data
Lifestyle and Beliefs
Sensory and Cognitive Status
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Physical Examination
Diagnostic and Laboratory Data
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Nursing Diagnosis
Nursing Diagnoses related to
medication administration are
• Deficient Knowledge
• Ineffective Therapeutic Regimen
Management
• Ineffective Health Maintenance
• Impaired Physical Mobility
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Nursing Diagnosis
• Disturbed Sensory Perception
• Impaired Swallowing
Nursing Diagnoses related to the
addicted client are
• Imbalanced Nutrition
• Impaired Verbal Communication
• Interrupted Family Processes
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•
•
•
•
Impaired Social Interaction
Social Isolation
Spiritual Distress
Readiness for Enhanced Spiritual WellBeing
• Ineffective Coping
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Outcome Identification
Nurse develops goals and plans care on
the basis of nursing diagnosis.
Client teaching based on medications
prescribed is inherent in the plan of care.
Nursing interventions are identified and
incorporated into the plan of care to
promote the attainment of goals and to
assist the client in achieving expected
outcomes.
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Planning
The nurse needs to carefully plan
nursing care activities to ensure safe
administration of medications.
Adequate planning provides for
questions and discussion by the
client and demonstration of skills
learned.
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Implementation
Administer Oral Drugs
• Sublingual and Buccal Drug
Administration
• Review Procedure 29-1 on
administering an oral medication.
• Enteral Instillation of Drugs
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Administer Parenteral Drugs
• Equipment
• Review Procedure 29-2 on withdrawing
medication from an ampule.
• Review Procedure 29-3 on withdrawing
medication from a vial.
• Intradermal Injection
• Subcutaneous Injection
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• Review Procedure 29-4 on mixing
insulins in one syringe.
• Review Procedure 29-5 on
administering an intradermal injection.
• Review Procedure 29-6 on
administering a subcutaneous
injection.
• Intramuscular Injection
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• Review Procedure 29-7 on
administering an intramuscular
injection.
• Intravenous Injections
• Review Procedure 29-8 on
administering medications by IV
Piggyback to an existing IV.
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Administer Topical Medications
• Eye Medications
• Review Procedure 29-9 on
administering an eye medication.
• Ear Medications
• Review Procedure 29-10 on instilling
an ear medication.
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• Nasal Instillations
• Review Procedure 29-11 on instilling
nose drops.
• Respiratory Inhalants
• Review Procedure 29-12 on teaching
self-administration with a metereddose.
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• Rectal Instillations
• Review Procedure 29-13 on
administering a rectal suppository.
• Vaginal Instillations
• Review Procedure 29-14 on
administering a vaginal suppository.
Complementary Therapy
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Evaluation
The nurse is responsible for ongoing
evaluation of client’s response to
medication.
Nurses in the community setting
need to evaluate the client’s ongoing
ability to manage his or her
medication regime.
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