Medication administration, considerations across the lifespan and calulation

List the 10 right of medication administration

Right person, Right dose, Right medication, Right time, Right route, Right documentation, Right education, Right reason, Right response/evaluation, Right to refuse

List common types of medication errors

Prescribing errors

Transcription errors

Incorrect patient

Incorrect dose preparation or timing

Allergic reactions

Renal or liver function dosing errors

Describe common causes of medication errors

Poor communication

• Poor handwriting

• Written or verbal transcription errors

High volume

Distraction

• # of nurse-to-patient ratio

Lack of monitoring

• Age related considerations

• Co-morbidities

• Allergies

• Contraindications

Harm

Impairment of the physical, emotional, or psychological function or structure of the body and/or pain resulting there from

Monitoring

To observe or records relevant physiological or psychological signs

Intervention

May include change in therapy or active medical/surgical treatment

Intervention necessary to sustain life

Includes cardiovascular and respiratory support

Category A-1

Circumstances or events that have the capacity to cause error

Do not use list

IU, U or u, Q.D. QD q.d or qd, Q.O.D QOD q.o.d qod, MgSO4, MS MSO4, Lack of a leading decimal before a decimal point, Trailing zero after a decimal point

How is the table categorized

Abbreviations for doses/Measurement units

Abbreviations for route of administration

Abbreviations for frequency/instructions for use

Miscellaneous abbreviations associated with medication use

Drug name abbreviations

Stemmed/coined drug names

Dose designations and other information

Symbols

Apothecary and household abbreviations

Four different routes of medication administration and examples of each

Enteral: Oral, sublingual, rectal

Topical: Epidermal, instillation, irrigation

Inhalation: Intranasal, Inhaled, Vaporized, Nebulized, Gas inhalation

Which needle gauge is thinner 30 or 25

30 gets thinner the higher the number

Benefits of IV medication delivery systems

Rapid effects, precise amounts, consistent blood levels, Less irritation to subcutaneous tissue, good for poorly soluble meds, good for large volumes

Disadvantages of IV medication delivery systems

Little room for error, vein lining irritation, risk of infection (phlebitis), Circulatory fluid overload, Catheter embolus, infiltration, extravasation

Infiltration

Occurs when a non-vesicant fluid leaks into surround tissue, does not typically irate tissue, redness and discoloration

Extravasation

Occurs when a vesicant fluid leaks into surrounding tissues, irritation and damage to tissues, pain, burning, swelling, and redness

Explain why weight based dosing in necessary in pediatric patients

Because a child’s weight can vary widely

Identify ADME considerations for geriatric patients

Absorption: Decreased gastric acidity, delayed absorption, delayed onset, delayed gastric emptying

Distribution: Shift from muscle mass to higher body fat, decreased total body water, decreased protein binding sites

Metabolism: liver function slows, decreases breakdown

Excretion: kidney function slows - decreased filtration and creatinine clearance, decreased elimination