Medication Administration DEFINITIONS Drug: anything that causes a physiological response, positive or negative Medication: Chemical compound used to treat or cure illness. Causes a specific physiological response. Generic Name: Simple chemical name of the medication Trade Name: Manufacturer’s name for the drug: Brand name Controlled Substance - Specific manufacturing, prescribing, and Dispensing requirements ● Schedule 1 drug: No healthcare value— EX: Heroin ● Schedule 2 drug Has health benefits, but may still cause addiction/dependency EX: Morphine or Fentanyl ● Schedule 3 ● Schedule 4 ● Schedule 5 As the schedules increase, as does the medicinal value. The degree of addiction also decreases as you move to higher grades. ● Any controlled substance that you waste (or dispose of) must be witnessed by another licensed individual. REGULATIONS ● ● ● ● The goal of regulation is to: prevent poor outcomes of narcotic medications Exist at a federal, state, and local level Institution-based laws cannot be less stringent than those of the federal and state laws. Georgia Nurse Practice act: - States that the Nurse is 100% responsible for medication administration and monitoring outcomes - If a nurse is found in violation of these laws they can be fined - Once they have been fined, you can be sent to jail or have your license revoked. DRUG ACTIONS Pharmacokinetics: how the medication enters, moves through, and leaves the body - Step 1: absorption- takes place in the mouth - Step 2: Distribution Step 3 metabolism Step 4: excretion: ● Factors that affect pharmacokinetics - Kidney function - Body mass - Kidney function - Drug tolerance - Gender - Race Pharmacodynamics: Reflects how the medication interacts with the body to produce a desired effect. EFFECTS AND INTERACTIONS ● ● ● ● Side effects may be normal (and predictable) , but are sometimes mistaken as allergies - Generally unpleasant - predictable Adverse effects - Unpredictable - As the nurse: you must stop the medication, document the instance, and alert the physician. Toxic effect - Impaired metabolism and excretion - May be lethal Anaphylaxis: - Severe allergic reaction - Emergency - Treated with epinephrine - Also treated with steroids, antihistamines, and fluids - First danger: Airways close up (solved by epinephrine) MEDICATION HISTORY ● Swollen eyes: Per-iorbital edema ● Swollen lips: Circumoral swelling What helps with this? - Stop the med - Stop eating whatever is causing the reaction Ask your patient: ● What are you taking? ● Where? ● Why? ● How long? (they may have built up a tolerance to it) ● Does it work? Allergies: - Description of the reaction Prescription and non prescription medications: - Prescription and herbal/ folk remedies can interact what a prescription medication is trying to do Alcohol: - Always ask a self-proclaimed social drinker what that means TO THEM SIX RIGHTS ● ● ● ● ● ● Medication - For fuck’s sake do not administer anything that someone else prepared Dose: - Amount prescribed Time: - Acute care: 30 mins grace time around medication administration - If you have 5 patients with 8:00 medication administrations, you can’t do all of them at exactly 8:00^^^ - ALWAYS ALWAYS ASSESS YOUR PATIENT BEFORE GIVING THEM ANY MEDICATION Route: - Oral - Intravenous - Etc Patient - Always !! Check!! That you have !! the right !! mf!! Patient!!! Document - Always document after administration not before - A patient can refuse medication - in this case simply alert the physician In 2003, these four rights were added - Right to be informed of the name, purpose, and potential side effects - Right to refuse medication - Do not try to coerce them -explain what the medication does to help them -Alert charge nurse and physician - Right to have an accurate medication history taken by a qualified person - right to receive medication in accordance with the six rights of medication administration ● ● ● ● ● ● ● ● ● ● ● ROUTES Oral - Kids struggle with oral medication - They can be given a slurry or some other alternative Sublingual: Commonly given: Nitroglycerin - Let it absorb. Do not chew Topical - Antibiotic ointment - Steroid skin etc Transdermal - Commonly given: birth control - Shave hair first for better adhesion - Fentanyl patch: also very common Ophthalmic - Goes in your eye - MUST BE STERILE Otic: - In the ear - Does not have to be sterile Nasal - Goes up your nose - boringggggg Inhalation - We don't want it to stay in the mouth - We want it to go to the lungs Vaginal - Suppository Rectal - Commonly used on children who cannot swallow oral meds Parenteral - Intradermal -given just underneath the skin - Subcutaneous - Pinch adipose tissue and insert it there - Example: insulin - Antithrombotic medicine Intramuscular: - immunizations are where they are most commonly found Intravenous: - Absorbed directly into veins MEDICATION ADMINISTRATION RECORD ● Scheduled vs PRN - PRN must have guidelines as well as a reason, otherwise they are counted as invalid and must be reissued.
