Safe Medication Administration and Error Reduction

Comprehensive practice flashcards covering safe medication administration protocols, nursing responsibilities, injection techniques, and specific drug considerations based on lecture notes.

What are the primary responsibilities of a healthcare provider regarding medication?

Obtaining medical history, performing physical examinations, diagnosing, prescribing medications, monitoring response to therapy, and modifying prescriptions as necessary.

What are the primary responsibilities of a nurse regarding medication?

Preparing/administering medications, evaluating client responses, maintaining an up-to-date knowledge base (uses, mechanisms, dosages, etc.), and reporting medication errors.

According to the Medication Administration Record (MAR) example, what was the prescribed dose and route for Humulin NPH Insulin?

$24\text{ Units}$ administered via the Subcut (subcutaneous) route.

What steps must a nurse take when receiving a telephone prescription?

Write the order down, read it back to the provider (including name, medication, dosage, time, frequency, and route), and get confirmation.

How should numbers be stated during a telephone prescription to ensure accuracy?

State numbers separately (e.g., "one, seven" for $17$).

When must a provider sign, date, and it time a transcribed telephone order?

Within a specific timeframe dictated by facility policy, which is often $24\text{ hours}$.

What is Medication Reconciliation?

A process of verifying medications to prevent errors during admission, transfer between units, or discharge by comparing current medications against medical records.

What are the "10 Rights for Safe Medication Administration" listed in the notes?

Right Drug, Right Patient, Right Dose, Right Route, Right Time, Right to Refuse, Right Knowledge and Understanding, Right Questions or Challenges, Right Response or Outcomes, and Right Advice.

How many client identifiers are required by The Joint Commission, and what are some examples?

Two identifiers; examples include the client's name, assigned ID number, telephone number, birth date, or government-issued ID number.

At what three points should a nurse compare the medication label with the MAR?

1. Before removing the medication from the container; 2. When preparing the medication; 3. Before administering the medication.

Which two specific medications mentioned in the notes should be verified by another nurse before administration?

Insulin and Heparin.

Why should enteric-coated medications never be crushed?

Crushing destroys the protective layer designed to protect the drug and the stomach.

What is the specific administration window for time-critical medications?

Within $30\text{ min}$ of the prescribed time.

What are the administration requirements for levothyroxine?

Give in the morning on an empty stomach, usually $30\text{--}60\text{ minutes}$ before breakfast.

What is the administration requirement for alendronate?

Give first thing in the morning with plain water, and the client must stay upright for $30\text{ minutes}$.

What are examples of high-alert medications as defined by the ISMP?

Insulin, Heparin, Opioids, and IV medications.

What is the difference between a Nasogastric (NG) tube and a PEG tube?

An NG tube is inserted through the nose into the stomach for shorter periods; a PEG tube is inserted directly into the stomach for long-term management.

What are the recommended needle angles for Intramuscular (IM) and Subcutaneous (SC) injections?

IM is $90^\circ$ and SC is $45^\circ$.

What are the recommended needle angles for Intravenous (IV) and Intradermal (ID) injections?

IV is $25^\circ$ and ID is $10^\circ\text{--}15^\circ$.

Which site is considered the safest for adult IM injections because it has no major nerves or vessels?

The Ventrogluteal site (hip).

What is the Z-track technique and its purpose?

It involves pulling the skin and subcutaneous tissue ($2.5\text{--}3.75\text{ cm}$) to one side before injection to create a zig-zag path that seals medication inside the muscle.

What assessment must be performed before administering digoxin?

Measure the apical heart rate for one full minute.

What parameters should be checked before administering furosemide?

Blood pressure, potassium, kidney function, and daily weight.

What is the nurse's responsibility regarding the "Right to refuse"?

Respect the client's right, explain the consequences of refusal, inform the provider, and document the refusal.

What does the "Right programming" refer to in medication administration?

Correctly setting medication delivery devices, such as IV infusion pumps or PCA (patient-controlled analgesia) pumps.