Unit A

Medication Administration

$       Medication Names

-Chemical

                        -Generic or Official (furesemide)

                        -Trade Name (Lasix)

$          Pharmacokinetics

-Absorption

                        -Distribution

                        -Metabolism

                        -Excretion

$          Effects of Medications

-Therapeutic effects, side effects, adverse effects, toxic effects, idiosyncratic reactions, allergic reactions, medication interactions, medication dose response

$          Medication Orders

-Standing or Routine Order - carried out as specified until it is canceled by another order (ex: Ampicillin 250mg po q 6h)

-recognize some meds may need to be reordered after so many days or they are automatically discontinued

-Prn Order - (as needed) this means the pt will receive medication when it is requested or needed (ex: Demerol 50mg IM q 4hr prn)

-Single Order - order is to be carried out only once, would include pre-op meds or orders for only one dose of medication (ex: Lasix 40mg IV at 0800 today)

-Stat Order - a type of single order that is to be carried out immediately & only once (ex: Morphine 2mg IV stat)

$          6 Rights

-Medication

-3 checks of the drug label to medication Kardex before giving medication:

                                                1. When removing from shelf or drawer

                                                2. When placing med package in cup

                                                3. When opening package at bedside

                                                4. When documenting

                        -Client

                                    -primary source of identification = name band

-2ndary source = ask pt to state name (DO NOT SAY “are you Joe Smith?”)

-two unique identifiers are required - pt name & date of birth or pt name & medical record number as examples

                        -Route

                                    -oral, topical, inhalation, parenteral (IM, SubQ, IV, intradermal)

                        -Dosage

-medications may be prescribed in the metric, apothecary or household system

-the first step in dosage calculations is to ensure that the desire & the have are in the same system & same unit of measurement. Convert if necessary

                                    Formula:         Desire   x Quantity

                                                                 Have

                        -Time

-medications should be given within 30 minutes before or after prescribed time

                                    -q 8 hours vs. tid

                        -Documentation

                                    -documentation of medications should occur after medications are given

-the label should be checked one last time as documentation is completed to ensure that no errors were made

$          Hints for Safe Med Administration

-take med Kardex into pt’s room to ID pt, 2 unique identifiers required

-be careful to do 3 checks of the medication label to the medication order before the medication is given

-if you are not familiar w/a med, look it up before you give it

                        -if a med is held or refused, document appropriately

                                    -never give anything that someone else prepared

                        -never leave medications unattended

-if a parameter is needed prior to giving the medication, keep that medication separate from others until the parameter is checked (BP, pulse, etc.)

-recognize that some medications have automatic stop dates or reorder requirements per institutional policy (ex: narcotics must be reordered every 3 days or they are discontinued)

                        -chart the medication as soon as you give it