Dosage Calculation and Safe Medication Practice

30 Question-and-Answer flashcards summarizing nurse responsibilities, legal aspects, prescription types, safety rights, nursing process, error prevention, and client-safety strategies in medication administration.

What are the Six Rights of Medication Administration?

Right person, right medication, right dose, right time, right route, and right documentation.

Before giving a medication, what patient data must the nurse assess?

Current medications, possible interactions, allergies, and pertinent physical-assessment findings.

List at least four elements of medication knowledge a nurse should know before administration.

Purpose, mechanism of action, safe dosage range, side effects, adverse/toxic effects, precautions, and contraindications.

Which federal law governs the storage and monitoring of controlled substances?

The Controlled Substances Act.

What can failure to comply with the Nurse Practice Act result in?

Charges of negligence or malpractice against the nurse.

Name the main types of medication prescriptions.

Routine, standing, single (one-time), stat, PRN, and now prescriptions.

What does a ‘stat’ prescription require?

Immediate administration of a single dose of the ordered medication.

State the five traditional steps of the nursing process.

Assessment, analysis (diagnosis), planning, implementation, and evaluation.

What are the six steps of the NCSBN Clinical Judgment Model?

Recognize cues, analyze cues, prioritize hypotheses, generate solutions, take action, evaluate outcomes.

Give three common medication-error categories.

Wrong medication/strength/route, incorrect rate/time, and omission or giving a known allergen.

Which four major organizations issue guidelines for safe medication practice?

The Joint Commission, ISMP, QSEN, and the Institute of Medicine.

Identify two technological tools that reduce medication-administration risk.

Electronic Medical Records (EMRs) and Automated Medication-Dispensing Systems.

What is medication reconciliation and what is its first step?

A mandated process to prevent discrepancies in therapy; first step is creating a complete list of all current patient medications (name, dose, route, frequency, indication).

During medication reconciliation, what must be compared?

The patient’s current medication list with all medications ordered in the new care setting.

Name three error-prone abbreviations from the ‘Do Not Use’ list.

QD, QOD, U (unit), IU, HS, DC, MS (any three).

Why should a leading zero always precede a decimal in a medication dose?

To prevent misreading of doses less than one (e.g., 0.5 mL instead of .5 mL).

Provide two examples of look-alike/sound-alike drugs that use Tall Man lettering.

buPROPion vs. busPIRone or traZODone vs. traMADol.

List two patient populations at increased risk for adverse drug reactions.

Older adults, pediatric patients, those with polypharmacy, or individuals with multiple comorbidities (any two).

What voluntary system can nurses use to report serious adverse drug reactions?

The U.S. FDA’s voluntary reporting program (MedWatch).

Give four nurse actions that help improve client medication safety.

Complete medication history with allergies, perform medication reconciliation, review the chart/lab results, understand indications and adverse effects, and anticipate/monitor for reactions.

What is the primary purpose of completing an incident report after a medication error?

To document the event objectively for quality improvement and prevent future errors.

Define negligence or malpractice in the context of medication administration.

Failure to meet the standard of care, such as not following the Nurse Practice Act or the Six Rights, resulting in patient harm.

Differentiate between a ‘routine’ and a ‘PRN’ prescription.

Routine orders are given at set times until discontinued; PRN orders are given only when the patient’s condition indicates the need.

Why is ‘DC’ on the Do-Not-Use list of abbreviations?

Because it can be misread as either ‘discharge’ or ‘discontinue,’ leading to errors.

What does QSEN stand for, and why is it important?

Quality and Safety Education for Nurses; it sets competencies for nursing safety and quality, including medication safety.

When must the medication-reconciliation process be repeated?

At every transition of care—admission, transfer, and discharge.

Define Continuous Quality Improvement in medication safety.

An ongoing effort to analyze processes (e.g., medication administration) and implement changes to enhance quality and safety.

What detailed information must each entry on the medication-reconciliation list include?

Drug name, dose, route, frequency, and indication.

How should a dose of five milliliters be written to avoid error?

5 mL (without a trailing zero).

Why should nurses review laboratory results before administering certain medications?

To identify contraindications, adjust doses, and monitor for potential toxicity or therapeutic effectiveness.