Medication Administration

What is the difference between a medication ordered q6h and qid?

q6h is given every 6 hours around the clock, while qid is given four times daily during waking hours.

What is a PRN medication order?

A medication given as needed based on client assessment and prescribed parameters.

What is a stat medication order?

A medication that must be administered immediately and only once.

What is a now order?

A one-time medication order that should be administered promptly but not as urgently as a stat order.

Why can't a nurse substitute a liquid medication for a tablet without a new order?

Different forms may have different concentrations, absorption rates, and dosing requirements.

What does PO mean?

By mouth or orally.

Where is a sublingual medication placed?

Under the tongue until dissolved.

Where is a buccal medication placed?

Between the cheek and gum until dissolved.

What medications should never be crushed for tube administration?

Enteric-coated, sustained-release, sublingual, and buccal medications.

What is a common cause of medication errors?

Interruptions and distractions during medication preparation and administration.

What assessment is required before administering digoxin?

Assess the apical pulse for one full minute.

What assessment is required before administering an antihypertensive medication?

Assess the client's blood pressure.

Who is the last line of defense against medication errors in the hospital setting?

The nurse administering the medication.

What is the first point at which a nurse verifies the right drug?

When removing the medication from the drawer or dispensing system.

What is the second point at which a nurse verifies the right drug?

While preparing the medication and comparing it with the MAR.

What is the third point at which a nurse verifies the right drug?

At the bedside immediately before administration.

Why should a nurse never administer a medication they did not prepare?

The nurse administering the medication is responsible for verifying its accuracy and safety.

What should the nurse do if there is any question about a medication order?

Hold the medication and clarify the order with the provider or pharmacist.

Why should medications never be left unattended at the bedside?

To prevent medication errors, misuse, or administration to the wrong client.

What should be verified to ensure the right dose is being administered?

The calculation, medication strength, and appropriateness of the ordered dose.

When should another nurse verify a dosage calculation?

When calculating high-risk or critical medication doses.

What equipment should be used when measuring liquid medications?

Graduated medication cups, oral syringes, or calibrated droppers.

Why is it important to verify the frequency of a PRN medication?

To ensure enough time has elapsed since the previous dose.

Why do healthcare facilities use military time?

To reduce confusion between AM and PM times.

When should medication administration be documented?

After the medication has been administered.

What information must be documented when administering a PRN medication?

The indication for administration and the client's response.

What should the nurse verify about a medication before administration besides the Six Rights?

Allergies, expiration date, and the provider's order.

What assessments may need to be performed before medication administration?

Vital signs, pain assessment, laboratory values, physical assessment findings, and allergy verification.

What teaching should be provided when administering a medication?

The medication's name, purpose, dose, and potential side effects.

What details should be documented when a client refuses a medication?

The reason for refusal, education provided, and provider notification.

What should be documented if a manual override is used in the medication system?

The reason for the override.

Why should blanks and empty spaces be avoided in documentation?

To prevent alterations and incomplete records.

What questions should the nurse ask about medication allergies?

Ask what allergies the client has and what reactions occur.

Why should the nurse ask about the client's use of OTC medications, herbs, and supplements?

They may interact with prescribed medications.

What questions should be asked about medication adherence?

Ask whether the client takes medications as prescribed and what, if any, barriers exist.

Why should gloves be worn when applying topical medications?

To prevent medication absorption through the nurse's skin.

What should be done before applying a new transdermal patch?

Remove the old patch, assess the skin, clean and dry the new site, rotate locations, label the new patch with initials, time and date

Why should a needle never be recapped after use?

Recapping increases the risk of needlestick injuries.

A client states, "This pill looks different from what I normally take." What should the nurse do?

Stop and verify the medication before administering it.

A client refuses an oral medication. What is the nurse's priority action?

Assess the reason for refusal and provide appropriate education.

A nurse discovers that a medication expired yesterday. What should the nurse do?

Do not administer the medication; obtain a non-expired dose.

A nurse prepares two injectable medications in separate syringes. What must be done before leaving the medication-preparation area?

Label each syringe with the medication name and dose.

A nurse administers a PRN pain medication. What follow-up assessment is required?

Reassess the client's pain after 30 minutes and evaluate the medication's effectiveness.

A nurse is preparing a transdermal patch. The skin under the previous patch is red and irritated. What action should the nurse take?

Select a different site and do not apply the patch to irritated skin.

A client states that they frequently forget to take medications at home. What assessment question should the nurse ask next?

"How do you currently remember to take your medications?" or "What barriers make it difficult to take your medications as prescribed?"