Fundamentals of Nursing Chapter 31 11th

A powerpoint on fundamentals of nursing to educate you on the basics of nursing. The powerpoint will help you get a better understanding and a different perspective on these topics that my professor provided me with and helped me out in my first semester of nursing school.

1. Fundamentals of Nursing, 11 th Edition Patricia A. Potter, RN, MSN, PhD, FAAN Anne Griffin Perry, RN, MSN, EdD, FAAN Patricia A. Stockert, RN, BSN, MS, PhD Amy Hall, RN, BSN, MS, PhD, CNE

2. Chapter 31 Medication Administration Part Two

3. FDA Mission The Food and Drug Administration is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation's food supply, cosmetics, and products that emit radiation. 3

4. Scientific Knowledge Base The  generic name  is assigned, in the United States, by an official body—the United States Adopted Names (USAN) Council. The  brand name  is developed by the company requesting approval for the drug and identifies it as the exclusive property of that company. 4

5. Medication Action Absorption Absorption is  the process that brings a drug from the administration, eg , tablet or capsule, into the systemic circulation . Absorption affects the speed and concentration at which a drug may arrive at its desired location of effect 5

6. Medication Action Distribution a drug enters the systemic circulation, it is distributed to the body's tissues . Distribution is generally uneven because of differences in blood perfusion, tissue binding ( eg , because of lipid content), regional pH, and permeability of cell membranes. Metabolism- medications are taken orally and are broken down within the gastrointestinal tract. Once the medication arrives, it is broken down by stomach acids before it passes through the liver and then enters the bloodstream.  6

7. Medication Action Excretion of Medications the removal of waste substances from body fluids, and predominantly occurs  via urine formed in the kidneys . Other routes of excretion from the body can include in bile, saliva, sweat, tears, faeces , milk and exhaled air. Most drugs are metabolised first prior to being excreted. 7

8. Types of medication action Therapeutic effects- Intended effects Adverse effects- unwanted effects Side effects- expected and known effect of a medication intended for a different use. EX: Bendadryl for allergy=drowsy Idiosyncratic reactions-unusual reactions to the medication. Allergic reactions- when immune system reacts to the drug. EX: hives, rash 8

9. Medication interactions- 9 Drug interactions may make your drug less effective C ause unexpected side effects I ncrease the action of a particular drug Decrease the action of a particular drug Some drug interactions can even be harmful. Example: When taking IRON supplements, it is best to drink Orangle juice or take Vit C to help bind the IRON Example: Patients taking ANTIHYPERTENSIVES plus drinking GRAPEFRUIT JUICE, will make BP even lower.

10. DRUG TOXICITY VERSUS DRUG OVERDOSE 10 Drug toxicity generally occurs over time D rug overdose happens when too much of a substance is consumed at once

11. Scientific Knowledge Base Minimum effective concentration- The smallest dosage of a particular drug that produces a specified effect  Therapeutic range- the dosage range or blood plasma or serum concentration usually expected to achieve the desired therapeutic effect 11

12. Drug Half Life 12 What is the half-life of a Drug? The half-life of a drug is an estimate of the time it takes for the concentration or amount in the body of that drug to be reduced by exactly one-half (50%) E xample, if 200mg of a drug with a half-life of 60 minutes is taken, the following is estimated: 60 minutes after administration, 100mg remains

13. Oral routes Sublingual administration- under the tongue Buccal administration between the gums and cheek . Parenteral routes Epidural- space around the spinal cord Intrathecal-  into the spinal canal, or into the subarachnoid space (lining of the brain) Intraosseous- into bone marrow Intraperitoneal- internal space of abd organ area Intrapleural - fluid-filled space in between the parietal and visceral layers of the pleura.(tissue around lungs) Intraarterial – into an artery 13 ROUTES OF MEDICATION ADMINISTRATION

14. Scientific Knowledge Base Routes of administration Topical administration- skin or mucous membranes Inhalation route- inhaled Intraocular route- into the eye 14

15. Scientific Knowledge Base WARNING; Systems of medication measurement Metric system Household measurements- Teaspoon/Tablespoon sizes vary EX: 1 teaspoon= 5 ml PATIENTS NEED EDUCATION 15

16. Adult vs Pediatric Dosing of Meds Adult medications are different from Pediatric medication Medications will need to be calculated using dose, weight and height of pediatric/adult patients 16

17. Nursing Knowledge Base Health care provider’s role MD Verbal orders- document the date, time plus RNs inittials Types of orders in acute care agencies Standing orders or routine medication orders prn Orders- as needed Single (one-time) orders STAT orders- RIGHT NOW Now orders- as soon as possible Prescriptions- NOT over the counter 17

18. Effects of Aging on Medication Metabolism 18

19. Medication Administration Oral administration- pills, tablets, liquids Topical medical applications Skin applications Nasal instillation Eye instillation Intraocular administration Ear instillation Vaginal instillation Rectal instillation 19

20. Equipment for Injections Syringes Needles Blunt needles Filter needles 20

21. Medication Administration Preparing an injection from an ampule Snap off ampule neck Aspirate medication into syringe using filter needle Replace filter needle with an appropriate size needle or needless device Administer injection 21

22. Medication Administration Preparing an injection from a vial If dry, use solvent or diluent as needed Inject air into vial Label multidose vials after mixing Refrigerate remaining doses if needed 22

23. Types of IV Medication Administration Intravenous administration Large-volume infusions (1L) Intravenous bolus Volume-controlled infusions Piggyback (EXAMPLE: ANTIBIOTICS) 23

24. Nurses Role in Medication Administration Be vigilant during medication administration. Ensure patients receive the correct medication. Know why the patient is receiving each medication. Verify that medications have not expired. Use at least two identifiers before administering medications and check against the medication administration record (MAR). Before administering medication, check for accuracy three times. 24

25. Nurses Role in Medication Administration Clarify unclear medication orders. Use available technology. Use strict aseptic technique during parenteral medication preparation and administration. Educate patients about each medication. Most of the time you cannot delegate medication administration. Follow safety guidelines to prevent needlestick injuries. 25