Nurs1510/Medication Admininstration
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Transcript Nurs1510/Medication Admininstration
U.S. drug legislation
• Sets official drug
standards
• Defines prescription drugs
• Regulates controlled
substances
• Improves safety
• Requires proof of efficacy
Nurse Practice Acts
• Identify nursing
responsibilities for
administration and client
monitoring
Stock Supply:
Bulk quantity
Central location
Not client-specific
Unit Dose:
Individually packaged
Client-specific
drawers
24-hour supply
Automated Dispenser:
Password-accessible locked cart
Computerized tracking
Can combine stock and unit doses
Self-Administration:
Individual containers
Kept at client’s bedside
Pharmacokinetics:
What happens to the drug in the body
Pharmacodynamics:
How the drug affects the body
Four processes:
Absorption
Distribution
Metabolism
Excretion
Movement of drug into the bloodstream
Factors affecting absorption:
• Route of administration
• Drug solubility
• pH/ionization
• Blood flow
Drug transport to tissues and organs
Factors affecting distribution:
• Local blood flow
• Membrane permeability
• Protein-binding capacity
Biotransformation: chemical conversion of
drug
Factors affecting metabolism:
• Liver function
• Health/disease status
• First-pass effect
Elimination of the drug
Factors affecting excretion:
• Organ function, especially the kidneys, liver, and
lungs
Time until onset and peak
Therapeutic range
• Peak level
• Trough level
• Therapeutic level
Half-life
Concentration of active drug
Primary effects:
Therapeutic effects
Predicted
Intended
Desired
Why the drug was prescribed
Secondary effects:
Unintended
Nontherapeutic
Can be:
• Predictable
• Harmless
• Harmful
Types of secondary effects:
Side effects
Adverse reactions
Toxic reactions
Allergic reactions
Idiosyncratic reactions
Cumulative effect
Antagonistic
Synergistic
Incompatibilities
Types of medication orders:
Written order
Automatic “stop” date
STAT order
Standing order
PRN order
Communication of orders:
Handwritten
Preprinted
Orally
Telephone
Client’s full name
Date and time order was written
Name of medication
Dosage size, frequency, number of doses
Route of administration
Signature of prescriber
Three checks:
Before you pour:
• Check the medication label against the MAR
After you pour:
• Verify the label against the MAR
At the bedside:
• Check the medication again
Six Rights:
Right drug
Right client
Right dose
Right time
Right route
Right documentation
Other Rights:
Right reason
Right to know
Right to refuse
Oral medications:
Most commonly used route
Includes:
•
Tablets, pills, capsules
• Liquids(syrups, elixers,
suspensions, emulsions
• Buccal
• Sublingual
• Enteral medications
• Troche
Topical medications:
Applied directly to body surface/body cavities
Local effects:
• Lotions, creams,
ointments
• Transdermal patches
• Eye and ear
• Nasal
• Vaginal
• Rectal
Respiratory inhalations:
Use concept of nebulization
Absorption via alveoli and blood supply
• Atomizers
• Aerosol
• Metered dose inhaler
Parenteral medications:
Intradermal
Subcutaneous
Intramuscular
Intravenous
Equipment Preparation:
Syringe/needle (size, gauge)
Medication Preparation:
Vials and ampules
Reconstituting from powder
Two medications in one syringe
Safety issues:
Use sharps containers
Never recap dirty needle
Use the correct site
• Wrong site could mean wrong route
Be familiar with the technique required for the
medication (e.g., heparin, insulin)
Intravenous medications:
IV push
IV piggyback
Medicated drips
Use the six rights
Calculate doses carefully; double-check with a
second RN
Watch for drugs with similar names
Watch for clients with same last names
Clarify illegible orders
Know and use your resources
Keep up with changes in medication orders