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Fundamentals of Nursing Medication Administration (1)

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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.
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Any controlled substance that you waste (or dispose of) must be witnessed by another
licensed individual.
REGULATIONS
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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
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Step 2: Distribution
Step 3 metabolism
Step 4: excretion:
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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
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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
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Swollen eyes: Per-iorbital edema
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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
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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
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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
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Scheduled vs PRN
- PRN must have guidelines as well as a reason, otherwise they are counted as
invalid and must be reissued.
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