Pharm exam 1 introduction
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167 Terms
Whats the nurse role
assesses the client, safely administers the drug, and monitors the outcome
whats the providers role
to prescribe
whats the pharmacist role
the pharmacist verifies and dispenses
what do we do before administering a medication?
we verify the order, identify the client with two identifiers, review allergies, history, medications, vital signs, laboratory values, contraindications, and ability to receive the route
what two identifiers do we use
full name and date of birth
What 5 critical safety rules must the nurse follow during the bedside administration phase of medication delivery?
follow the medication rights, minimize interruptions, use barcode/eMAR correctly, maintain asepsis, and stay with the client when required.
what do we do after administrating a medication
document promptly, monitor therapeutic and adverse effects, reassess relevant findings, teach the client, and report concerns.
What does therapeutic effect mean in a medication
is the medication doing what it is intended to do
what does adverse effect mean
an unwanted, harmful reaction that may require assessment, intervention, holding the medication, or notifying the provider.
what does eMAR stand for
electronic Medication Administration Record
what should you do with eMAR
Compare the eMAR with the provider order and document after administrating
what does BCMA stand for
Barcode Medication Administration.
What is BCMA for
matches the right patient with the right medication order.
Whats medication reconciliation
making sure the pt’s complete medication list matches the new medication orders safely
What are the steps for medication reconciliation
obtain, validate, compare , clarify, communicate/document
What does MAE stand for
medication administration error
Does a pt have to be harmed for an MAE to occur?
No
What does sentinel events mean
extremely serious harm or death
What does near miss mean
caught before reaching the patient
What are elements in client safety
actions and behaviors used to create safety.
What are the benefits of creating a safety culture
positive results produced by those actions
What are the steps to respond to an MAE
Assess the client, notify the provider, document the incident
What are the three types of human error
knowledge, rule and activity/slip based
whats a knowledge based error
the person lacks the needed knowledge
whats a rule based error
a rule is wrong, misapplied or ignored
whats a activity based error
the plan was correct but the execution failed
what does idiosyncratic drug reaction mean
unusual, unexpected, individual reaction
what does interprofessional collaboration mean
the healthcare team works together and shares accurate medication information to keep the pt safe
what are the benefits of interprofessional collaboration
prevent medical errors, and ensures the patient is safe
what are the best practices during interprofessional collaboration
Communicate clearly, accurately, promptly and use ISBARR
what does ISBARR stand for
Identification, Situation, Background, Assessment, RecommendationRead-back
who are the health team members
provider, pharmacist, nurse, assistive personnel
What do we use to prioritize a patient or a medication?
we use ABC
what does ABC stand for?
airway, breathing, circulation
if a nurse is interrupted while preparing medications. What should the nurse do?
Stop preparing, lock up the medications, and restart your safety checks from the very beginning
In an emergency do you still perform ABC?
yes, you perform a rapid assessment and act immediately
what does a stand for in the abc’s
airway
what does b stand for in the abc’s
breathing
what does c stand for in the abc’s
circulation
can the electronic system tell you if a medication is safe or not?
no, the electronic system organizes tasks
can a nurse delegate nursing assessment
no
what does inpatient care mean
the patient has been admitted to the hospital
what does outpatient care mean
the patient visits the clinic and goes home the same day
what does out of hospital care mean
care takes place somewhere that is not a traditional hospital or outpatient clinic
what does EBP stand for
Evidence based practice
What does evidence based practice mean
it combines best current evidence, clinical expertise, and client values and preference
what does PICOT stand for
Population, Intervention, Comparison, Outcome, Time
what do we use picot for
is a template for creating a focused research question
what does the p stand for in picot
population
what does the I stand for in picot
intervention
what does the c stand for in picot
comparison
what does the o stand for in picot
outcome
what does the t stand for in picot
time
where do nurses locate evidences
scholarly databases
what do higher level evidence normally include
Systematic reviews are generally at the top.
what is usually at the bottom of a quality of evidence
background information and expert opinion
Which source provides the highest level of evidence?
systematic review
what does primary research mean
researchers conduct the original study
what does secondary research mean
researchers examine and summarize studies already completed by others.
whats clinical judgement
It is the nurse’s thinking and decision making process
why is clinical judgment important
it is used to make safe choices
what are the six clinical judgment measurement model
Recognize cues, Analyze cues, Prioritize hypotheses, Generate solutions, Take action, Evaluate outcomes
what questions should we ask when recognizing cues
What information matters
what questions should we ask when analyzing cues
What does that information we gathered from recognizing cues mean?
what questions should we ask when Prioritizing hypotheses
Which possible problem is most urgent?
what questions should we ask when generating solutions
what could the nurse do?
what should we do when taking an action
Perform the safest priority intervention.
what should we ask when evualuating an outcome
did the action work?
what is our main concern when administering medication to babies
weight based dosing and they immature organs
what is our main concern when administering medication to the elders
Reduced clearance, polypharmacy and falls
what is our main concern when administering medication to the pregnant or lactating women
Maternal benefit versus fetal/infant risk
what is our main concern when administering medication to all patients
Appropriate formulation, baseline assessment and monitoring
what doe polypharmacy mean
taking 5 or more medication at the same time
what does beers criteria mean
medication that should be avoided or adjusted for the elderly
what does kids list mean
medication inappropriate that should be avoided or adjusted for kids
what does pregnancy and lactating label rule mean
Prescription label information explaining possible medication risks during pregnancy, lactation, and reproduction
what does compatibility in medications asks
asks whether medications and solutions can be mixed or infused through the same line without physical or chemical problems
where does incompatibility in medication occur
happens outside the pt
whats physical incompatibility in medications
whats chemical incompatibility in medications
A chemical reaction occurs when medications are mixed and you might not be able to see it.
what does drug-drug interaction mean
when one medication changes the effect of another medication
where does drug- drug interaction occur
A drug–drug interaction happens inside the patient’s body
what are the 10 right of medication administration
Right client, Right medication, Right dose, Right route, Right time, Right documentation, Right assessment, Right education, Right evaluation, Right to refuse
whats this route of medication “oral”
swallow
whats this route of medication “sublingual”
under tongue
whats this route of medication “buccal”
check
whats this route of medication “enteral tube”
tube
whats this route of medication “rectal”
rectum
whats this route of medication “tropical/transdermal”
skin
whats this route of medication “inhaled ”
breathe
whats this route of medication “subcutaneous”
fat
whats this route of medication “intramuscular”
muscle
whats this route of medication “intravenous”
vein
whats this route of medication “ophthalmic ”
eye
whats this route of medication “otic”
ear
whats this route of medication “nasal”
nose
whats this route of medication “vaginal”
vagina
whats the definition of a control substance
is a drug regulated by the government because it has the potential for misuse, abuse, addiction, or physical and psychological dependence
what are factor to considered when determine a drug status
medical use, abuse potential, dependency and safety
what is a DEA registration number
is the unique identification number assigned to a registered prescriber