Module 4 - High Alert Medications and Controlled Substances

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Last updated 2:02 PM on 9/11/26
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8 Terms

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Controlled Substances

Substances that can alter mental processes and may produce harm to health or society when diverted to an illegal market or misused.

Stored in a designated locked drawer (only RNs/LPNs can access); must be signed out on a special record, narcotics are counted including waste.

Types of controlled substances:

  • Narcotics

    • Hydromorphone/Dilaudid

    • Morphine

    • Codeine

    • Meperidine

    • Tylenol #2 or #3 (acetaminophen combined with codeine)

  • Benzodiazepams

    • Diazepam (Valium)

    • Phenobarb (Diphenylhydantoin)

    • Flurazepam (Dalmane)

    • Secobarb (Seconal Sodium)


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Monitoring for Narcotic Administration

Baseline - RR, Pain, Sedation Scale (0 alert - 3 somnolent; difficult to rouse).

Post-Dose

  • IM, PR, SubQ, PO: 45 - 60 minutes.

  • IV: 5, 15, and 30 minutes.


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High Alert Medications

Medications that bear a heightened risk of causing significant patient harm when used in error.

Examples: insulin, narcotics, anti-coagulants, electrolyte replacements and more.

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Management of High Alert Medications

System Factors

  • Limited access to high alert drugs and high concentration limitations.

  • Ready to use formulations.

  • Assistve technology.

  • High alert labels.

Independent Factors

  • Independent double check.

  • Always use with SMART pump.


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Independent Double Check

Students cannot perform the independent double check but may administer the medication.

Should be free from distraction.

Should be done during second check.

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Nasal Medication Installation

Sprays, drops, tampons (gauze to stop bleeding).

Decongestant is the most common type.

Can cause irritation to the nares.

<p>Sprays, drops, tampons (gauze to stop bleeding).</p><p>Decongestant is the most common type.</p><p>Can cause irritation to the nares.</p>
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Ocular Medication Installation

Drops or ointment.

Used for moisture, vasoconstriction, infections, and glaucoma.

Ensure eye is clean.

Let patient reach room temperature.

Expose conjunctival sac, administer 1-2cm above.

<p>Drops or ointment.</p><p>Used for moisture, vasoconstriction, infections, and glaucoma.</p><p>Ensure eye is clean.</p><p>Let patient reach room temperature.</p><p>Expose conjunctival sac, administer 1-2cm above.</p>
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Aural Medication Installation

Drops or irrigations.

Sensitive to temperature changes.

Straighten ear canal prior to installation.

<p>Drops or irrigations.</p><p>Sensitive to temperature changes.</p><p>Straighten ear canal prior to installation.</p>