Nursing review Medications 2022.pptx.pdf

Fundamental level of nursing medications

1. Chapter 21
Medications
SQ/ IM

2. •Right Patient
•Right Medication
•Right Dose
•Right Route
•Right Time
•Right Documentation


6 Rights of Medication
Administration

3. Components of Medication
Orders
•Medication name
•Medication dosage
•Route of
administration
•Purpose
•Provider’s signature
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4. Systems of Medication
Distribution
•Automated
medication-dispensin
g system
• (Fig. 21-2)
•Bar code medication
administration
•Self-administered
medication system
PowerPlugs Templates for PowerPoint Preview

5. 3 checks
to
Prevent
Mistakes
(6 Rights)
Check order to
ensure accuracy
(First check)
Remove meds from
dispensing unit
(Second Check)
In room after asking
patient identifier
questions
(Third Check)
Document
administration and
patient response

6. Preventable
Errors
Medication is given in the wrong dose
or at the wrong time.
Documentation is inaccurate or not
performed in a timely manner.
Medication is administered according
to the order, but the order is
inappropriate for the patient.
IV medication is given at the wrong
rate.

7. System
Issues
•Inadequate
staffing- more
responsibilities
as a nurse

•Increased
patient acuity
levels

•Lack of access to
medication
information

•Conflicting
organizational
routines

•Issues with
organizational
communication
channels such
as lack of
medication
reconciliation
policies at
patient handoff

•Inappropriate
care delivery
models

8. Practice
Errors
Failure to comply with
policies and procedures
Distractions
Improper dosage
calculation
Inadequate knowledge
about medications

9. Ethics/Legal Aspects
•Food and Drug Administration (FDA)
•Nurse Practice Acts
•Institutional Medication Policies
•Patients’ Rights
•Controlled Substances Substance Abuse
•Patient’s Refusal
Read back orders
Safety Alerts Declining orders
Patient right to refuse

10. Drug Action (Pharmacodynamics)
The physiologic and
biochemical effects
of a drug on the
body.
Therapeutic effects:
Desired and
intentional effects
Adverse effects:
Side effects: Minor
adverse effects
Tolerance:
Decreased response
to medication over
time
Allergic reactions:
Immunologic response
to a medication Toxicity:
Overdose or buildup of
medication in the blood
due to impaired
metabolism or excretion

11. Drug Action (CON’T)
•Interactions: Occurs when a medication’s effects are
altered by the concurrent presence of other medications
or food
•Compatibility: Occurs when drugs are mixed together
and one or both are rendered chemically inactive or if a
precipitate forms

12. Safe Medication Administration
•Interpreting the order
•Calculating adult and child medication dosages
•Administering medications according to the six rights
•Documenting according to best practice
•Recognizing and preventing potential medication
administration errors
•Promoting clear communication with patients and
other members of the healthcare team

13. Safe Medication Administration
(CON’T)
Assessing
Assessing
knowledge
and
adherence
Teaching
Patient
teaching
Evaluating
Evaluating
patient
response to
medication
Promoting
Promoting
healthcare
planning
and home-
or
community
-based care

14. Medication Routes
(Subcutaneous (SQ)
Procedure 21-7
•Subcutaneous
administration
•(Figs. 21-15 and 21-16)
•Insulin administration
•Heparin administration

15. Equipment
•Syringes
•Needles
•Antiseptic Swabs
•Small gauze with tape/Band-Aid's

16. SQ
•Small amount
( 0.5 ml)
•Small gauge
(26-30 gauge)

17. SQ Medications
•Procedures
21-3

•Procedures
21-4

•Ampules/Vial

18. Instructional Videos

19. Insulin
Administration
•Units (not mL)
•High Alert Medication
•2 Nurse check
•Avoid 2 inches around navel
•Ask patient where he prefers
injection

•(Same technique for Heparin)


PowerPlugs Templates for PowerPoint Preview 19

20. IM Medications
Intramuscular administration (Figs. 21-17,
21-18, Procedure 21-8, Tables 21-5, 21-6)
Deltoid site (Fig. 21-19)
Rectus femoris and vastus lateralis sites
(Figs. 21-20 and 21-21)
Ventrogluteal site (Fig. 21-22)
Dorsogluteal site

21. Z -Tract
PowerPlugs Templates for PowerPoint Preview 21

22. PowerPlugs Templates for PowerPoint Preview 22

23. Different
Administration
Techniques
•Intravenous
administration
•Intravenous push
(bolus)
•Intermittent infusion
(IV drip)
•Continuous infusion
technique
•Epidural analgesia
•Patient-controlled
analgesia (PCA)PowerPlugs Templates for PowerPoint Preview 23

24. References:
•PowerPlugs Templates for PowerPoint Preview
•Lippincott Wolters Klumer
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