Med Aide Written Practice - Nebraska

Medication Administration Record (MAR)

a document that is completed as per agency policy to verify that a patient's medications were administered as prescribed

Med Aide's responsibilites

To provide medications according to the 5 Rights, document meds given & observe/report changes to nurse. It is NOT your job to monitor!!! (Beyond scope of practice)

Medication error is noticed

Report error to nurse immediately. Document. Observe for side effects. Temp? Pain? Life-threatening if breathing problems, irregular HB, swelling of airway.

ml/cc

milliliters, cubic centimeters - Same measurements/amts

Five (5) Rights

Right Meds, Person, Time, Dosage & Route

Non-legend drugs

Over the counter (OTC), advil aspirin, etc.

Legend drugs

prescription drugs

How are medications stored?

In a labeled container, locked up, limited keys. Narcotics/controlled substances are DOUBLE-locked. Counted to prevent theft/misuse of the narcotics.

Who packages and labels drugs for dispensing?

Pharmacist

Who gives a med aide permission to administer drugs?

Dr or Charge nurse

Side effects

Any effects of a medication other than the desired ones.

When do you wear gloves?

ANYTIME chance of body fluids

PO

orally, by mouth

gtt

drop, drops

What are time-released drugs a form of?

Sustained release aka: controlled release

How many safety checks are performed while passing meds?

Three (3) Twice before giving, once after giving

Example of a medication error?

Giving the wrong dose or at the wrong time

List some examples of DRUG ACTIONS

reduce inflammation, pain, fever

What signs/symptoms need reported to nurse ASAP?

heart palps, irregular breathing, seizures

Right to refuse treatment

the legal right of patients to refuse certain forms of treatment or medications. Document refusal (R circled). (Try to encourage resident to take meds, remind them the meds make them feel better, look for other underlying reasons)

How to document entry error on MAR?

Draw one line through error & initial.

What to do when you hear co-worker discussing a resident in front of other residents or people?

Remind them of HIPPA. Ask them to change the subject or move to another area.

Basic routes of medication provisions?

Oral(PO), topical(skin), inhalation, OTIC(ear), Opthomic(eyes)

What is the most important step to prevent spread of infection?

Wash hands. PPE

What position is the ear when administering meds adult? child?

Adult: Pull up & out Child: pull down & out

How to identify correct resident?

Picture ID/photo in MAR

qid

four times a day

Can medication aide do anything labeled STERILE?

NO. Beyond scope of practice.

Opthalmic

Refers to the eye. For treatment of, around or in the patient's eye.

Sublingual

under the tongue

Buccal

cheek

Otic

ear

When are the three safety checks performed during medication setup?

Removing from storage, opening container & returning containter to storage. Always verify with MAR. Pouring med is done AFTER second safety check

Why crush meds? What meds do you NOT crush?

Easier swallowing; Sustained release, enteric coated, buccal or sublingual meds

Do you ever touch meds with your bare hands?

NO - Glove up!

Do not give a drug

unsure of resident's identity, allergic, expired, not on MAR

When do you secure/lock medication cart?

Anytime you walk away from it

Seven (7) steps to setting up meds

Wash hands, 1st safety check, 2nd safety check, pour meds, 3rd safety check, return meds to storage, secure meds.

Beginning Five (5) KIPWE

knock , identify, privacy, wash hands, ensure safety (lower bed, adjust resident)

Ending Five (5) POWER

position, open room, wash hands, ensure safety(lower bed), report/record

Where is the core temperature taken

rectal

What is standard normal body temperature

98.6

Tympanic

ear

Apical pulse

the pulse on the left side of the chest, near heart

Radial pulse

wrist

When is Apical pulse needed vs radial?

Apical is more accurate, esp with irregular HB, specific meds, & children younger than 3 yrs old.

Normal range of respirations?

12-20 breaths per minute

Normal blood pressure BP?

120/80 mmHg

axillary temperature range (armpit)

96.6-98.6 F

tympanic temperature range (ears)

98.6-100.6 F

Rectal temperature range

98.6-100.6 F

Oral temperature range

97.6-99.6 F

What is used to measure liquid medications?

meniscus

What can NOT be done when oxygen is in use

No Smoking

How long should patient/resident hold breath when getting inhaler treatment?

Hold for 10 seconds, then breathe out

When do you pour the medicine into the cup?

After the second (2nd) safety check

How do you safely identify the patient/resident before giving meds?

Verify photo ID in MAR

How many safety checks are done when passing meds?

Three (3)

How long does a standard nebulizer treatment last?

15 minutes

How is oxygen flow rate measured?

LPM (liters per minute) Watch for any skin breakdowns, use cheek/ear cushions when needed.

Anticoagulant drugs

reduce the likelihood of blood clotting. Bruise easily.

Why use an ice bag?

reduce swelling, help clot

What are the basic steps to applying a clean & dry dressing?

(Wear gloves when removing dressing, put fresh gloves on before applying new dressing) Get the right wound-care supplies.

Wash and dry your hands.

Remove the old wound dressing.

Clean the wound.

Let the wound dry.

Apply the new dressing.

Secure the new wound-care dressing.

When would you need to call the Abuse Hotline?

If a reported abuse goes unacknowledged. Ignoring call lights/residents, physical abuse, verbal or emotional abuse

What are the four stages of medications/drugs?

absorption, distribution, metabolism, excretion

How are oral medications absorbed?

Gastrointestinal tract, small intestine

What is drug tolerance? What is drug sensitization?

When a medication no longer works as well as it once did; reverse tolerance/increased effect

What are some signs of a medicine allergic reaction?

swelling, fever, redness

Why are some meds given with food?

To prevent upset stomach, protects stomach

What is polypharmacy?

the simultaneous use of multiple drugs to treat a single ailment or condition

What is excretion?

Eliminating or expelling waste

What is absorption?

Passage of substance across and into tissues. Taking digested food into the blood stream

What is a theraputic drug?

One taken every day at the same dose

What organ excretes most drugs?

kidneys

What organ metabolizes drugs?

liver

What AFFECTS drug absorption?

blood flow, stress, hunger, fasting, pH, body size,

pain, food, circulation, and medicine

What is the most common way of distributing or transporting a medication to the site of action?

Bloodstream Sublingual/buccal/topical/inhalation/injection: Intravenous, intramuscular, subcutaneous, intradermal(TB)

What are undesirable SYMPTOMS of medications?

nausea, vomiting, diarrhea

What is the generic name?

Is as assigned generic name by the pharmaceutical manufacturer who develops the drug before it receives official approval by FDA

What is a brand name drug?

Specific company that made the drug

What is a chemical name of a drug?

Specifies the chemical structure of the drug and uses standard chemical nomenclature

What is metabolism?

a broad term that includes all chemical reactions that occur within the body

What is pain assessment?

intensity, location, duration and description of pain

What is kyphosis

A curving of the spine that causes a bowing or rounding of the back, which leads to a hunchback or slouching posture

What is posture?

the way a person holds and positions his body

What is range of motion (ROM)?

It is the maximum movement possible at a joint.

What is remodeling?

breakdown and buildup of bone tissue; changing

What is adjunctive therapy?

Drug that is given in addition to the main to modify its effects or side effects

What is a common side effect of an anti-inflammatory drug?

Upset stomach

What is a pain scale

A tool used to help patients describe and identify their pain. Use the SAME pain scale every time.

How do you chart a pain assesment?

Location & level of pain charted in MAR. Re-assess after each intervention

What is the dermis?

middle layer of skin- contains blood vessels (Epidermis is the outer layer)

What are some age-related changes in the skin?

Dry skin, decreased skin elasticity, decreased collagen, thinning, slow wound healing, and decreased subcutaneous padding

Pruritus

severe itching

Anesthetic

Numbs skin

What are some side effects of a topical ointment?

Allergic reaction: rash, redness, swelling

Topical ointment: application

Applied to specific area. Wear gloves, use applicator or tongue blade when applying

What is a mucus membrane?

Mucus membranes line the body cavities that have openings to the exterior of the body

What is melanin?

Black or brown pigment in the skin and hair

What is the skin function?

Protect, support, insulate, regulate temp, communicate