Term | Definition |
Medication | Substance administered for the diagnosis, cure,
treatment, relief of symptoms, and prevention of disease. |
Chemical name | identifies drug’s atomic and molecular structure |
Generic name | assigned by the manufacturer that first develops the drug |
Official name | name by which the drug is identified in official publications USP and NF |
Trade name | brand name copyrighted by the company that sells the drug |
Sources of Medication Information | Pharmacology
Pharmacy,Pharmacopoeia,Formularies, Medication handbooks |
Legal Aspects of Medication Administration | Controlled by law and Nursing Practice Acts define and limit nursing function in medication administration |
Safe Nursing Practice | Nurses are responsible for their own actions regardless of what was written by MDs. If a nurse administers a wrong dose even if written by MD both are held responsible for the mistake. Question if inappropiate. |
Controlled substances | Locked, Record on Inventory forms,Special prescriptions required
Must witness discarding |
Pharmacokinetics | - how the body metabolizes the drug (Onset,Peak,½ life,Plateau) |
Pharmacodynamics | -process by which a drug changes the body-alters cell physiology |
Therapeutic effec | desired effect |
Side effect | adverse effects-secondary, unintended and predictable, maybe harmless or harmful and may justify discontinuation of the drug |
Drug toxcity | -overdosage, ingestion of drug for external use, build up of drug, or impaired metabolism |
Drug allergy | -immunologic reaction to the drug can be mild or severe/anaphylactic |
Drug tolerance | -unusually low physiologic response |
Cumulative effect | increasing response to a drug, rate of administration exceeds metabolism |
Idiosyncratic effect | -unexplained individual to a client |
Drug interaction | -administration of one drug before, at the same time or after alters the effect of one or both drugs |
Synergistic effect | -2 drugs increase the action of each |
Signs and Symptoms of Drug Allergy | Rash
Urticaria,Fever,Diarrhea,Nausea,Vomiting,Anaphylactic reaction |
Factors that effect drug actions | Developmental,Gender,Weight,Culture, ethnicity and genetics,Diet
Environment, timing of administration,Psychological,Illness, disease |
Factors Affecting Drug Absorption | Route of administration,Lipid solubility,pH,Blood flow.Rotes of Medication AdministrationLocal conditions at site of administration
Drug dosage |
Rotes of Medication Administration | Oral, Topical, Parental(Subcutaneous,Intramuscular - IM
intradermal- ID,Intravenous- IV,Intrathecal or intraspinal Epidural) |
Criteria for Choosing Equipment for Injections | Route of administration
Viscosity of the solution,Quantity to be administered,Body size
Type of medication |
Preparing Medications for Injection | Ampules,Vials , Prefilled cartridge |
Topical Administration of Medications | Skin applications
Eye instillations and irrigations
Ear instillations and irrigations,Nasal instillations,Vaginal applications,Rectal instillations |
Patient Assessment for Medications | Assess clients' health and medication history,Ask about supplements,Drug allergies,Client’s ability to self administer
Socioeconomic factors, Medication reconciliation on admission, during transfer and at discharge |
Patient 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. |
Type of Medication Errors | Inappropriate prescribing of the drug,Extra, omitted, or wrong doses, Administration of drug to wrong patient,Administration of drug by wrong route or rate,Failure to give medication within prescribed time,Incorrect preparation of a drug, |
Type of Medication Errors Contiuned | Improper technique when administering drug,Giving a drug that has deteriorated |
Medication Errors Procedures | Check patient’s condition immediately; observe for adverse effects.
Notify nurse manager and physician, Write description of error and remedial steps taken on medical record.,Complete special form for reporting errors. |
Role of the Nurse: | Medication administration correct dosage calculation!!:
Reminder: Break scored tablets only! |
Apothecary System: | older than the metric system brought to US from England no longer recommended. |
Household: | least reliable but familiar(tsp., Tbsp., gtts., cup) |
1 ounce = | 30 ml |
1 quart = | 1000 ml |
1 tsp = | 5 ml |
2.2 lbs = | 1Kg |
“Desired over Have” | desired dose/dose on hand X quantity on hand
Leave units of measure in problem |
Reconstitution of Medications from Powder Form | see power point |
Intravenous Calculations | Order must include: Amount and type of solution, amount of additives, period of infusion time.
See power point |
Medication Supply Systems | Stock supply
Individual unit dose supply,Medication cart,Computerized automated dispensing system,Bar code–enabled medication cart |
absorption | process by which a drug is transferred from its site of entry into the body to the bloodstream. Influenced by route of administration. |
absorption of lipid solubility | drug that is more lipid soluble can be absorbed more readilu and pass more easily into cell membrane |
absorption of acidic drugs | Well absorbed in stomach. More basic drugs remain ionized or insoluble in acid environ. |
blood flow | absorption is increased with increased blood flow. Impaired circulatory drugs absorded less quickly. |
Conditions at site of adminstration | More extensive absorbing area increase absorption. Burns difficulty with intramuscular aborption. Food in stomach can delay or enhance rate. Absorption manipulated with xr or enteric -coatd |
enteric coat | resistance to the digestive system. |
drug loading | larger than normal does given to patient in acute distress and need maximum therapy |
maintenance does | lower dosage that becomes usual or daily dosage |
distribution | depends on blood flow to tisuee , drug's ability to leave bs and drug's ability to enter cells. |
metabolism | or biotransforemation is the change of drug to a new form . liver primary site for drug meta. |
excretion | process of removing the or its meabolites from the body. Inactive form of drug. kidneys job. drug route excretion bile , sweat, salivary and mamary gland.s |
antagonist effect | combined effects of two or more drugs acting simultaneously produces an effect of less thatn that of the drug s alone. |
teratogenic | drugs know to hae potentila to cause development defectis in embryo or fetus. |
placebo | pharmacologically inactive substance |
standing order | drug orders are carried out as specified util it is cancelled by another order. |
p.r.n. order | as needed : patient request or required |
one time ordre | directive is carried out only once at a time stated by prescriber. |
stat order | single order carried out immediately |
Parts of medicatio order | Pat. name, date/time of written order, name of drug, dosage, route of drug adminstration, frequence of adminl, and signature. |
name of drug | can be brand or generic : most hospitals believe generic is safesft |
inunction | rubbing drug into skin |
CMAR/MAR | nurse is responsibl for checking that the medication order was transcribed corrrectly by comparing it with the orginal order |
Things to do when preparing to give meds | Make sure right drug, right reason (symptoms warrant it), right dose and preparation (ensure label is legible and clear) |
Things to de immediately before adminstering Meds | Right patient (verify nm and bd) Right time (Check the last time), and right route. |
Things to do after medication is admin | Right drug , right does, right rate (how is patient responding) and right documentation |
paternal | outsie the intestines or alimenatary canal |
needle gauges | diameter increases the guage number decreases. The finer needle the larger gauge number. |
ampule | glass flask that contains a single dose of medication - discard remainder |
vial | glass bottle with self sealing stopper through which medication is removed. Can remove several doses from container (good 24 hr so record time 1st used) Wipe top with alchol swab. |
intradermal injections | inject into dermis which is just below epidermis. Longest absorption time of all parenteral. Used for sensitivity test - tB allergies |
subcutaneous injection | inject into adipose tissue layer juste dermis. Few BV so slow sustained rate of Absoprtion(insulin & heprin) Sites abs, upper arm, anterior leg. 3/8" to 5/8" needles used |
intramuscular injections | through skin and subcutaneous into muscles. Usual cites deltoid, vastus lateralis, vetroglutal cite - betwee iliac crest aand iliac spine
Needle lenght based on site and patient age and fat. Gauge is determined by medication being adminstered 18-25 |
intramsucular injections. | volume is 1 ml to 4 ml with 1 ml max at deltoid |
transdermal route | applying to skin a disk or patch that contains medication intended for daily use or longer intervals. Patch for hormones , nictone, narcotic analgesics, cardiac medication. |