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pharm
med administration
| Question | Answer |
|---|---|
| ten rights of med admin | right pt, right med, right dose, right time, right route, right documentation, right education, right reason, right response, right to refuse |
| common types of medication errors | prescription errors, transcription errors, incorrect patient, incorrect medication or dose, incorrect dose prep or timing, allergic rxn, renal or liver functioning dose |
| most common of the med errors | prescription errors, transcription errors |
| common causes of med errors | poor communication high volume lack of monitoring |
| poor communication | bad handwriting written or verbal trancription errors |
| high volume | distraction # of nurse-to-patient ratio |
| lack of monitoring | age related considerations co-morbidities allergies contraindictions |
| routes of med admin | enteral parenteral topical inhalation |
| enteral | oral sublingual rectal |
| parenteral | IM SubQ IV Intradermal local injection |
| topical | epidermal instillation irrigation |
| inhalation | intranasal inhaled vaporized nebulization gas inhalation |
| IVP | intravenous push |
| IVPB | IV piggyback |
| IM | intramuscular |
| ID | intradermal |
| IT | intrathecal |
| IP | intraperitoneal |
| IN | intranasal |
| TOP | topical |
| Vag | vaginally |
| IM sites | deltoid, vastus lateralis, ventrogluteal 90 degree angle |
| SubQ sites | abdominal, scapula, backs of arms, mid thigh 45 degree angle |
| Gauge of needle | lumen size |
| large gauge | smaller needle lumen |
| IM needle size | 22-25 G 1-1.5" length |
| SubQ needle size | 25-30 G 1/2 - 5/8" length |
| responsibilities for IV or central line | DR: orders meds, type of fluid, volume, rate, and total amount of time Pharm. : verifies orders for safety, prepares med RN: double check order for safety, administers med, regulated infusion |
| benefits for IV or central line | rapid effects precise amounts consistent blood levels less irrigation to subq tissue good for poorly soluble meds good for large volumes |
| disadvantages for IV central line | little room for error vein lining irrigation risk of infection (phlebitis) circulatory fluid overload catheter embolus infiltration extravasation |
| infiltration | occurs when a non-vesicant fluid leaks to surrounding tissue does not irate tissue redness and discoloration |
| extravasation | occurs when a vesicant fluid leaks into surrounding tissue irritation and damage to tissues pain, burning, swelling, and redness |
| medication delivery systems | systemic, local, other |
| systemic | oral (capsules, tables, liquids, sublingual, buccal) nasogastric inhalation |
| local | topical (creams and lotions) suppositories eye drops ear drops |
| other | transdermal patch injections pump delivery |
| pediatric considerations | based on WEIGHT or body surfacer area A- gastric pH higher D- more body water, low plasma protein, BBB underdeveloped M-liver enzymes not mature E-kidney function immature, slower renal clearance |
| acetaminophen for peds | 10-15 mg/kg per dose. no more than 75 mg/kg/day |
| ibuprofen for peds | 5-10 mg/kg/dose. no more than 40 mg/kg/day |
| acetaminophen for adults | 500-1000 mg every 4-6 hours no more than 3g/day OTC or 4g/day Rx |
| ibuprofen adults | 200-400mg every 4-6 hours do not exceed 1.2g/day OTC or 2.4mg/day Rx |
| geriatric considerations | A- dec GI acidity, delayed absorption and onset D- lower muscle:fat ratio M-liver function slows E- kidney function slows |
Created by:
ago24