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Dosage Chapter 1
| Question | Answer |
|---|---|
| How many people are injured yearly? ` | Over 1 million |
| What are the TYPES of medication errors? | Legibility, Prescriptive, Communication, Transcription, Preparation, Administration, Wrong Patient |
| What are the common CAUSES of medication errors? | Distraction, Environment, Fatigue, Knowledge Deficit, Incomplete Information, Memory Lapses, System Issues |
| What is client-centered prevention? | Share all allergies Keep an updated medication list Inform providers of health conditions Use original medication containers Use one pharmacy when possible |
| What is nurse-centered prevention? | Use two identifiers ( name & DOB) Verify all allergies Reconcile medication Use reliable drug sources |
| Do you use the two identifiers on patients with dementia? | Yes, the two identifiers should be used on all patients |
| What makes the drug references reliable? | It must be less than 5 years old , anything older is considered out of date |
| What does reconcile medication mean? | 1. Compare current medication with the meds the pt is actually taking 2. Compare prescriptive and OTC meds to make sure which pt is taking daily 3. Verify all allergies known + suspected with patient to avoid any possible reactions |
| Rights of medication administration | Right client, Right drug, Right dose, Right route, Right time, Right documentation |
| The right ___ must receive the right ____ in the right ___, via the right ___, at the right ___ - with proper ____. | Client/patient , Drug, Dose, Route, Time, Documentation |
| When do you perform the 3 medication checks? | 1. When removing medication 2. During preparation 3. At the bedside before administration ( make sure you check meds with MAR) |
| What is system-centered prevention? | Separate high-alert medication Ensure medication availability Use Tall Man lettering ( ex: oxyCODONE vs oxyCONTIN) |
| Who can change a medication order? | Doctor, PA, NP |
| What do you do when a medication error occurs? | Assess the client immediately Notify the healthcare provider Complete an incident report Continue monitoring and documentation ( always document exactly what happened) |
| True or False: Incident reports go to your MAR | False, Incident reports are for the facility only |
| Incident reports are not ____ - they improve patient safety | Punitive |
| When medication orders are unclear | Clarify the order with prescriber Chart only medication you personally administer Nurses may refuse to administer unsafe order ( from a pharmacist) Always compare the MAR with the medication label |
| Medication: Nurses are responsible for? | Monitoring drug effects Teaching the patient Verifying correct dosing |
| General rules for crushing medications | Consult pharmacy first Consider liquid alternatives Provider approval required Crushing is a last resort |
| Dont' Crush Medications : | ER / XR / XL - extended release SR / CR - sustained or controlled release EC - enteric coated SL - sublingual ODT - orally disintegrating LA - long acting EVT - effervescent Irritants - can damage mucosa Buccal - between cheek and gum |
| A nurse prepares medication during a noisy shift change? What action best reduces medication risk error? | Perform three medication checks |
| Which action help prevention medication errors? | Use two patient identifiers Reconcile medication lists Clarify unclear orders |
| What does ADPIE stand for? | A - assessment D - diagnosis P - planning I - intervention E - evaluation |
| Which part of ADPIE can and LPN perform? | P ( under RN guidance ) I & E |
| Roman numeral number: I | 1 |
| Roman numeral umber: II | 2 |
| Roman numeral umber: III | 3 |
| Roman numeral umber: IV | 4 |
| Roman numeral umber: V | 5 |
| Roman numeral umber: VI | 6 |
| Roman numeral umber: VII | 7 |
| Roman numeral umber: VIII | 8 |
| Roman numeral umber: IX | 9 |
| Roman numeral umber: X | 10 |
| Roman numeral umber: XX | 20 |
| Roman numeral umber: XXXI | 31 |
| Common symbols in medication order | # : number (before) ; pounds (after) %: percent &: and |
| Do NOT use (zero) : | Trailing zeros Ex: No 3.0 mg, Yes 3mg |
| ALWAYS use (zero): | A leading zero Ex: No .5mL Yes 0.5mL |
| Do NOT use: U , Instead: | Unit |
| Do NOT use: US, Instead: | International Unit |
| Do NOT use: Q.D, QD, q.d, QOD, Q,O,D , Instead: | Daily or every other day |
| Do NOT use: MS , Instead: | Morphine Sulfate |
| Do NOT use: MSO4 and MgSO4, Instead use: | Morphine sulfate or Magnesium Sulfate |
| AC | Before meals |
| supp | suppository |
| dil | dilute |
| qhs | at bedtime / hour of sleep |
| pc | after meals |
| IVPB | intravenous piggyback |
| KVO | keep vein open |
| mcg | microgram |
| fl | fluid |
| MDI | meter dose inhaler |
| QID | four times a day |
| GT/NG | gastric / nasogastric |
| elix | elixir |
| Nurses responsibility to check: | for correct dose , instruct the patient about the use and observe for side affects |
| Legibility: | Order cannot be read |
| Prescriptive: | wrong drug, dose, route, or form |
| Communication: | Misunderstanding order; look-alike/sound-alike drugs |
| Transcription: | Order copied incorrectly |
| Preparation: | Wrong dilution or calculation |
| Administration: | Wrong time or route |
| If you miss the dosing time, what other time can you give meds? | 1 hour before or 1 hour after |
| Wrong patient: | Medication given to incorrect client |
| Distraction: | Interruptions during med pass |
| Environment: | Noise, poor lighting, fast pace |
| Fatigue: | Working while exhausted |
| Knowledge Deficit: | Unfamiliar medication |
| Incomplete Medication: | Missing allergies or weight |
| Memory Lapses: | Forgetting to check allergies |
| System Issues: | Improper storage or labeling |
| Enteric coated dissolves in? | Small intestine and has film on it to protect it from acid that may be in stomach / lung |
Created by:
user-2011519