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foundations exam 1
types of orders and procedures, administration of meds
| Question | Answer |
|---|---|
| Standing order (routine order) | carried out until cancelled by another order |
| PRN order | as needed |
| Single or one-time order | times 1 |
| stat order | carried out immediately, emergency |
| parts of the medication order | Patient’s name Date and time order is written Name of drug to be administered Dosage of drug Route by which drug is to be administered Frequency of administration of the drug Signature of person writing the order |
| parts of the medication order are essentially | the 5 rights |
| Medication Supply Systems | Stock supply Individual unit dose supply Medication cart Computerized automated dispensing system Bar code–enabled medication cart (BCMA) |
| stock supply | med room |
| med carts have | folders with certain drugs |
| Computerized automated dispensing system is the | mckesson |
| Bar code–enabled medication cart (BCMA) | IV fluids, etc |
| all med systems have | barcoded and must be scanned |
| three checks of medication administration | first, second, third check |
| first check | When the nurse reaches for the container or unit dose package - getting the meds |
| second check | After retrieval from the drawer and compared with the eMAR/MAR, or compared with the eMAR/MAR immediately before pouring from a multidose container - when you are in the hall, hold up to EMAR |
| third check | Before giving the unit dose medication to the patient or when replacing the multi-dose container in the drawer or shelf - in the pt room, check their band and scan the med |
| rights of medication administration | Right medication Right patient Right dosage Right route Right time Right reason Right assessment data Right documentation Right response Right to education Right to refuse |
| controlled substances required information | Name of patient receiving the controlled substance Amount of the substance used Hour the controlled substance was given Name of the prescribing provider Name of the nurse administering the substance |
| what do you have to do as a nurse when dealing with controlled substances | open the drawer and count how much is in there before and after |
| do you still scan controlled substances in an emergency | yes |
| what do you need when you are returning or wasting a controlled substance | a witness |
| identifying the pt | Checking the bracelet Patient’s name (first identifier) Validating the patient’s ID number, medical record number, and/or birth date (second identifier) Comparing with the EMAR Asking the patient to state his or her name if possible |
| medical record documentation | Name, dosage, route and time of med Name of person giving med Site used if injection Location of topical/transdermal applications Naris, eye, or ear used for those administrations Intentional or inadvertently omitted drugs Refused drugs Med errors |
| types of med errors | Inappropriate prescribing of the drug Extra, omitted, or wrong doses Giving to wrong patient Giving wrong route or rate Giving outside prescribed time Wrong preparation of drug Improper technique when giving drug Giving drug that has deteriorated |
| Inappropriate prescribing of the drug is not | the RNs fault |
| Extra, omitted, or wrong doses | skipped or given too many |
| Giving wrong route or rate could be done by | typing wrong rate into pump |
| Giving outside prescribed time - exception | if pt is not on the unit at the time, it is not your fault |
| Improper technique when giving drug | injected wrong or not flushed |
| Giving drug that has deteriorated | expired or discolored - happens when air is introduced to it |
| if a med error occurs, what needs to be done immediately | Check patient’s condition immediately; observe for adverse effects |
| after checking on the pt after a med error, | Notify nurse manager and primary care provider |
| you must complete what if there is a med error? | Complete form used for reporting errors, as dictated by the facility policy |
| ways to prevent errors | Medication Reconciliation Prepare meds for one pt at a time Rights of administration Check calcs of high alert meds, verify with someone Question unusual doses Read labels 3x, compare to MAR 2 pt ID Verify allergies Educate patient |
| high alert meds | insulin, heparin infusion |
| medication reconciliation | have home meds ordered when admitted |
| when is it 'okay' to override technology | in emergencies |
| pt teaching | Review techniques of medication administration Remind the patient to take the medication as prescribed for as long as prescribed Instruct the patient not to alter dosages without consulting a physician Caution the patient not to share medications |
Created by:
leh195