NURS3802 Module 13: Medication Administration

What is a drug?

any substance that positively or negatively alters physiologic function

What is a medication?

a drug specifically administered for its therapeutic effect on physiologic function

What is the primary difference between a drug and a medication?

a. A drug is a chemical substance, while a medication is a drug used for medical treatment.

b. A medication is a drug that has been approved by the FDA, while a drug can be either approved or experimental.

c. A drug is only used for pain relief, while a medication can be used for any medical condition.

d. A medication is always prescribed by a physician, while a drug can be purchased over the counter.

a. A drug is a chemical substance, while a medication is a drug used for medical treatment.

What is the generic name of a drug?

simple chemical name that often identifies the class of medication

What is the trade name of a drug?

the brand name assigned by the drug manufacturer

What is a controlled substance?

type of medication that have government-regulated manufacturing, prescribing, and dispensing requirements

How are controlled substances classified?

schedule 1-5

What is a schedule 1 drug?

it is a drug with no medical use and has a high risk for abuse

What is a schedule 5 drug?

lowest abuse potential and less harmful

How should a narcotic be wasted?

- in front of another licensed individual

- must be recorded

When are narcotics counted?

at the beginning and end of each shift, with two licensed people

What is the goal of medication regulations?

prevent poor outcomes

What is an example of a state regulated drug in Georgia?

marijuana (THC)

What does the GA Nurse Practice Act determine regarding medications?

the licensed nurse is responsible for medication administration

What can result from violations of medication regulations?

- fines

- imprisonment

- loss of nurse license

What is pharmacokinetics?

the study of how a medication enters the body, moves through the body, and is excreted

What are the 4 principles of pharmacokinetics?

- absorption

- distribution

- metabolism

- excretion

What factors affect pharmacokinetics?

- age

- sex

- weight

- genetics

- race

What is pharmacodynamics?

the process in which a medication interacts with the body's cells to produce a biological response

What are side effects?

- predictable but unwanted and sometimes unavoidable reactions to medications

- not life threatening

- ex. nausea, vomiting, diarrhea, drowsiness, headache, insomnia

What are adverse effects?

- severe, unintended, and unwanted drug reactions

- may be unpredictable

What are toxic effects?

- impair metabolism and excretion

- may be lethal

What is anaphylaxis?

- severe allergic reaction

- emergency

- treated with epinephrine, steroids, antihistamines, and hydration

periorbital edema

- swelling of the tissues surrounding the eye or eyes

- seen with allergic reaction

What needs to be recorded when taking a medication history?

- allergies

- prescription medications

- non-prescription medications

- alcohol

- tobacco

- nicotine

- vitamins

- alternative therapies

- illegal drugs

What should be asked when a patient reports a medication allergy?

"What happens when you take this medication?"

What is a prescription medication?

medications that require a legal prescription from a provider

What is a non-prescription medication?

medications that can be obtained without a provider's authorization

What are the 6 rights of medication administration?

- medication

- dose

- time

- route

- patient

- documentation

When should documentation of medication administration be done?

after the medication has been given

What new rights were added in 2003 regarding medication administration?

- to be informed of the name, purpose, and potential SE

- to refuse

- to have an accurate medication history taken by a qualified person

- to receive medications in accordance with 6 rights of medication administration

oral

by mouth

sublingual

placed under the tongue and allowed to dissolve

topical

placed on the skin surface, mucous membranes, or in body cavities

transdermal

- absorbed through the skin

- released slowly

ophthalmic

- administered directly into the eye

- must be sterile

otic

administered to the ear canal

nasal

administered to the nasal cavity

inhalation

sprayed into the nose or mouth

vaginal

administered into the vagina

rectal

inserted into the rectum

What are the 4 parenteral routes of medication administration?

- intradermal

- subcutaneous

- intramuscular

- intravenous

intradermal

injection into the dermis

subcutaneous

injection into the subcutaneous/hypodermis tissue

What route is insulin given?

subcutaneous

intramuscular

injection into a muscle

intravenous

injection into a vein

MAR

medication administration record

PRN

as needed

ac

before meals

pc

after meals

h or hr

hour

bid

two times a day

tid

three times a day

qid

four times a day

q

every

g or gm

gram

mcg

microgram

mL

milliliter

IM

intramuscular

IV

intravenous

PO

by mouth

NPO

nothing by mouth

SL

sublingual

STAT

immediately

SQ

subcutaneous

How many checks should the nurse perform before administering medication?

3

What is done during the 1st medication administration check?

- ensure medication matches the MAR

- calculate the dose

- check the expiration date

What is done during the 2nd medication administration check?

- preparing the medication

- ensure the medication matches the MAR

What is done during the 3rd medication administration check?

ensure the medication matches the MAR at the bedside

Prior to preparing to administer medications to the patient, the nurse should compare the provider orders with what document?

a. Flow sheet

b. Kardex

c. MAR

d. Admission summary

c. MAR

In which situation would sublingual medication be administered?

a. When a patient is unconscious.

b. When a medication needs to be absorbed quickly into the bloodstream.

c. When a medication needs to be applied to the skin.

d. When a medication needs to be administered in a large quantity.

b. When a medication needs to be absorbed quickly into the bloodstream.

What should the nurse do if a medication order appears to be illegible or unclear?

a. Administer the medication anyway and confirm later.

b. Contact the prescribing physician for clarification before administering.

c. Look up the medication in a drug reference guide and administer.

d. Skip the medication until a clearer order is received.

b. Contact the prescribing physician for clarification before administering.

Which of the following is the most appropriate action if a patient experiences adverse effects from a medication?

a. Discontinue the medication immediately and contact the healthcare provider.

b. Wait for the reaction to subside on its own.

c. Increase the dose of the medication to counteract the adverse effects.

d. Administer the medication with food to minimize the side effects.

a. Discontinue the medication immediately and contact the healthcare provider.