Transcript Medication Administration

Medication Administration
Part 1
Keith Rischer, RN, MA, CEN, CCRN
Today’s Objectives
 State
the primary use and nursing implications
for drugs in each major classification
 Describe the characteristics of any drug that
the nurse is responsible for administering
–Onset, peak, duration and half-life
–Mechanism of action>SE>Nsg Implications
 Calculate fractional dosages of drugs
 Using drug reference text correctly fill out
clinical paperwork related to medication
administration
Nurse’s Responsibility
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How many patients die each year because of
medication errors in US hospitals?
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500
5000
7000
25,000
How many patients are injured as a result of
medication errors annually?
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100,000
500,000
1,000,000
1,500,000
Pharmacological Concepts
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Drug Names
 Chemical
name –
 name
of a drug as the chemist knows it.
 Describes the constituents of the drug
 Ex:
– N-acetyl-para-aminophenol (Tylenol)
– 2-(acetyloxy)benzoic acid. (Aspirin)
Pharmacological Concepts
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Drug names
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Generic names
Name given to a drug before it becomes official.
 Name is often listed in the USP as the official name
 Ex: Furosemide, Acetaminophen, Atorvastatin
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Brand name
Trademark or name given by drug manufacturer.
 More that one manufacturer may make the same drug
 EX: Lasix, Tylenol, Lipitor
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Reading Medication Labels
Nursing implications
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Implications related to administration and
assessment/monitoring
 RN
responsible for
 V/S
 Timing
with meals
 Labs
 I&O
 Dilute?
Crush?
Classifications/Nursing Implications
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Anti-hypertensive
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Beta Blockers
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Calcium channel blockers
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Diltiazem
Nifedipine
ACE Inhibitors
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Atenolol
Metoprolol
Propranolol
Captopril
Enalapril
Lisinopril
Diuretics
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Loop of Henle (Furosemide)
Distal tubule-(Hydrochlorothiazide-HCTZ)
Classifications/Nursing Implications
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Analgesics
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Mild-NSAIDS
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Moderate-Opiod Narcotics po
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Tylenol #3, Vicodin, Percocet
Severe-Opiod Narcotics IV
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Tylenol, Ibuprofen, Aspirin
Morphine, Dilaudid, Fentanyl
Anti-bacterial
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Penicillins
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Cephalosporins
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Amoxicillin
Keflex
Sulfa
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Bactrim DS
Classifications/Nursing Implications
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Anti-inflammatory
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Anti-coagulant
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Heparin
Coumadin
Anti-platelet
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NSAIDS
Prednisone
Aspirin
Plavix
Laxative
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Sennakot, Metamucil
Routes of Administration
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Oral
 Capsules/tablets
 Syrup/solution
Inhalation
Rectal
 suppository
Topical
 Patch
 ointment
Parenteral
 IV (intravenous)
 Sub-q (sub-cutaneous)
 IM (intra-muscular)
 ID (intra-dermal)
Medication Administration
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Oral
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60-100 mL of fluid
Contraindications
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NPO
GI
CVA
Prevent aspiration
(Table 35-16 p.717
P&P)
Medication Administration
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Topical
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Remove old patch before applying new
Date and time new patch
Use gloves
Make sure skin is clean and dry
Examples:
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Fentanyl
Nitroglycerin
Nicoderm
Medication Administration
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Nasal
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Eye
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Ear
Medication Administration
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Inhalers
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Albuterol/Advair
Spacer
Vaginal
Rectal
Types of Medication Action
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Therapeutic/Mechanism
of action
Side effects
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Allergic reactions
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Idiosyncratic reactions
Toxic effects
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Adverse reactions
Amiodarone
Tolerance
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Opiate narcotics
Time/Action Profile
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Onset
Peak
Duration
Trough
Serum Half life
Morphine IV
Vicodin po
Interpreting Drug Orders
Abbreviations - Pickar
 “Do not use” of abbreviations list – Pickar
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 MS
2 mg IV q4 hours p.r.n for pain
 Lantus insulin 20u qd
 Maalox 15cc q6 hours prn
Formula Method
D X Q = X
H
Desired
Have
X Quantity = Amount
Formula Method
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Heparin subq order for 12,000u due. This injection
comes in a vial of 20,000u/cc. What will be the amount
you will administer?
Dilaudid 0.25mg IV for pain. The pharmacy dispenses
a carpuject/vial of Dilaudid 1mg/cc. What is the amount
you will administer?
Solumedrol 25mg IV. It is dispensed as a 40mg/cc vial.
What is the amount you will administer?
Plavix 300mg to be given now. It only comes in 75mg
tablets. How many tabs will you administer to give the
correct dose?
This is your patient…
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MB, 75 yo, admitted to the step down unit with
exacerbation of heart failure. She complained
of SOB, 3+ pitting edema in lower legs and a
weight gain of 8 lbs in 3 days. Her K+ was 3.4
mEq/L in the ED.
Furosemide 40mg IV was given in the ED with
800cc urine out
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P-96 R-32-BP 160/90 initially in ED
P-86-R-24 BP 122/78 after Lasix
 Physician
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has ordered:
KCL 30 mEq po bid
 Pharmacy
has dispensed KCL 20 meq/15cc elixir