Fundamentals of Nursing Care: Concepts, Connections, & Skills
Chapter 35
Researching and Preparing
Medications
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Terminology Related
to Effect of Medications
 Desired effect: the reason medication is
prescribed
 Adverse effect: unintended harmful effects
 Side effect: an unintended outcome
 Therapeutic level: amount of medication in
blood it takes to reach desired effect
 Toxicity: too much medication in the body
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Names of Medications
 Chemical name: name of the exact ingredients
of the medication
 Generic name: assigned by the USANC;
shorthand version of chemical name
 Brand name (trade or proprietary name):
shorter, easier to remember name owned by
the pharmaceutical company
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Two Types of Medications
 Prescription
 Available with a written direction from a healthcare provider with prescriptive authority
 Over the counter
 Available without a prescription; can be purchased
by the consumer for use at recommended
dosages
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Routes of Medication
Administration
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Oral
Mucosal
Topical
Parenteral
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Scheduled (Controlled) Drugs
 Schedule I: highly addictive; have no medical purpose; street
drugs
 Schedule II: have high potential for abuse and do have
accepted medical use
 Schedule III: have some potential for abuse, are at less risk to
be abused than those in schedule I and II
 Schedule IV: have a lower potential for abuse than schedule I,
II, and III medications
 Schedule V: have the lowest potential for abuse.
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Multiple Choice Question
A nurse is administering methadone to a
recovering drug addict. What schedule drug is
methodone?
A. Schedule I
B. Schedule II
C. Schedule III
D. Schedule IV
E. Schedule V
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Answer
B. Schedule II
Rationale: Schedule II drugs have great
potential for abuse and do have accepted
medical use. Examples include morphine,
codeine, fentamyl, oxycodone, methadone,
meperidene, amphetamines, and short-acting
barbiturates.
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Reason Adverse Effects May Occur
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Chronic illness affecting metabolism
Drug allergies
Liver or renal impairment
History of previous drug reactions
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Effects of Anaphylaxis
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Swelling of airways
Shortness of breath
Respiratory arrest
Decreased blood pressure
Circulatory collapse
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Categories of Medications Causing
Allergic Reactions
 Antibiotics, especially penicillin and sulfa
drugs
 Iodine and dyes injected for procedures
 Vaccines
 Anticonvulsants (seizure medications)
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Resources Providing Information
on Specific Drugs
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Pharmacist
Physicians’ Desk Reference
Nursing drug handbooks
Pharmacology textbooks
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Sections of the
Physicians’ Desk Reference
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Manufacturer’s index
Brand and generic name index
Product category index
Product identification section
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Common Drugs
That May Cause Toxicity
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Digoxin
Aminophylline
Gentamicin
Imipramine
Phenobarbital
Procainamide
Valproic acid
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Classifications of Medications
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Cardiovascular
Gastrointestinal
Endocrine
Immune system
Nervous system
Respiratory
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Multiple Choice Question
An antibiotic is an example of which of the
following categories of medications?
A. Respiratory
B. Cardiovascular
C. Endocrine
D. Immune system
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Answer
D. Immune system
Rationale: An antibiotic is considered an
immune system drug. It is used to treat
infections caused by bacteria by interfering
with the way bacteria live and reproduce.
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Information Included
in Medication Orders
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Date and time of the order
Name of medication, either generic or brand
Dosage of medication
Frequency for taking the medication
Route of administration
Patient’s name
Signature of the prescriber
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Converting Between Units of
Measurement in the Metric System
To change between units of measurement in
the metric system, move the decimal three
places to the right to convert to a smaller unit;
move the decimal three places to the left to
convert to a larger unit.
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
True/False Question
A nurse accurately converts a medication
dosage from 0.5 grams to 500 milligrams.
A. True
B. False
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Answer
A. True
Rationale: The nurse moves the decimal point
three places to the right to convert from
grams to milligrams.
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Formula for Calculating
Medication Dosages
H = D
V
X
HX = VD
X = VD
H
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Methods of Dispensing Medications
 Computerized cabinets
 Medication cart
 Locked bins in patient rooms
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
6 Rights of Medication
Administration
1.
2.
3.
4.
5.
6.
Right medication
Right dose
Right route
Right patient
Right date and time
Right documentation
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Guidelines for Preparing Medications
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Check orders for discrepancies
Look up unfamiliar medications
Wash or sanitize hands
Obtain ordered medications; verify six rights
and any allergies
 Perform first two safety checks
 Perform any necessary drug calculations
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Guidelines for Preparing
Medications (cont.)
 Place unopened medication in medicine cup
 Close and lock the cart or bin
 Immediately take medication to patient’s
bedside
 Perform third safety check
 Assess any required vital signs
 Administer medication and ensure it is
swallowed
Copyright © 2011 F.A. Davis
Fundamentals of Nursing Care: Concepts, Connections, & Skills
Avoiding Medication Errors
 Be extremely careful during preparation
 Question anything that does not seem correct
about the order
 Know what you are giving, the expected
effects, and the potential side effects
Copyright © 2011 F.A. Davis