L9- Oral Medications - Lecture notes 9 PDF

Preview

Summary

Prof CS...

Description

N106

Lecture 9- Oral Medication Administration Oral Routes of Medication Administration  Oral  Sublingual (under the tongue ie. Ativan)  Buccal (In the cheek) Best Practice- What’s the best way to…?  Pour and measure a liquid medication? o Look for the bottom of the meniscus using a graduated cylinder, look at in on eye level.  Administer oral medication from a single dose package vs. multi-dose bottle? o Single dose easy to put into a little cup. Multi- dose bottle put it in the cap, then use a glove to pick one out of the lid and put the rest back or use a spoon to take one out. If you do have to discard a half dose, throw it out into the sharp’s container attached to the wall.  Crush Medication  when and how? o Look at drug guide to see if you can actually crush the meds or check the up to date app. Could be due to aspiration or swallowing difficulties (Have to mix it with apple sauce or something)  Reconstitute a powdered medication? o It’ll say on the label, or you can look in the drug guide. Want to make sure you’re mixing the right amount of liquid (Laxaday is the most common medication to reconstitute) The 7 Rights of Medication Administration 1. The right drug 2. The right dose 3. The right time 4. The right route 5. The right patient 6. The right documentation (Sign the MAR, may have to put in nursing notes) 7. The right reason 8. EXTRA: The right to refuse 9. EXTRA: The right patient education 10. EXTRA: The right evaluation Components of a Medication Order  Patient’s name  Date of the order  Name of the drug  Dosage  Route of administration  Time and frequency of administration  Signature of prescriber Steps to Oral Medication Administration  Check MAR with doctor’s order  Assess the patient prior to medication administration, consider any extra assessments and complete your physical assessment. (Want to make sure the medication is actually necessary, or you want to check the pt’s. baseline to determine if you can give diabetes meds or BP meds)  Assess the patient’s medical history and allergies.  1st Check: “Pull”  Check AUD strip and med pkg, with MAR  2nd Check: “Pour”  Pour med into med cup and circle time on MAR. Repeat this step for all meds due (THIS HAPPENS AT BEDSIDE)

N106 3rd Check: “Give”  Check patient ID arm band with MAR, and ask patient to state their name and birthdate  Compare with MAR. Assess for allergies. Give Meds, ensure they’re swallowed. Initial MAR for each circled med.  Provide pt. teachings as required.  Return MAR to binder. Narcotic Administration 1. Store all narcotics in a locked, secure cabinet 2. Secure code used to unlock narcotic cabinet. ALWAYS check the count of the medication before you take a narcotic medication out. 3. With AUD system  A special inventory record is used each time a narcotic is dispensed. This record is used to document the patient’s name, date, time of drug administration, name of drug, dosage, and the nurse dispensing the drug. The record provides an on-going count of narcotics used and remaining.  Every shift-change, 2 nurses count all narcotics. Both nurses sign the narcotic records to indicate the count is correct.  Discrepancies in narcotic counts are reported immediately. 4. With Pyxis System  The count is ongoing, and no end of shift count is done.  Discrepancies in narcotic counts are reported immediately.  Narcotic inventory is completed weekly. 5. If only part of the premeasured dosage of a controlled substance is given, a second nurse must witness the disposal of the unused portion and document on the narcotic record form (AUD system) or witness and record in Med Station (pyxis) Handling Precautions for Hazardous Drugs  Hazardous Drugs: Pharmacologic compounds that are detrimental or destructive to cells within the body, human or animal. Hazardous drugs include antineoplastic, antiviral drugs, hormones, some bioengineered drugs and other miscellaneous drugs.  These may include: o Antineoplastic o Carcinogenic o Cytotoxic. ...