SafeMedicate Intro + Prescriptions & SI Units

Absorption in older adults

- slower GI movement

- decreased GI blood flow

- decreased absorptive surface

Metabolism in older adults

- reduced capacity of liver to produce microsomal enzymes

- reduced hepatic blood flow

- liver damage common

Distribution in older adults

- decreased total body water, increased fat-water ratio

- reduced protein synthesis by liver, reduced protein binding sites

Excretion in older adults

- decreased GFR

- decreased renal blood flow

- decreased # of intact nephrons

- kidney damage common

Authentic Diagnostic Assessment environment (ADA)

used in undergrad healthcare practitioner programs to diagnose the progressive development, integration, and assessment of medication dosage calculation

- conceptual competence

- calculation competence

- technical measurement competence

Authentic Assessment environment (AA)

used in undergrad programs, following achievement of 100% on the ADA and prior to registration as a healthcare practitioner + competence audit programs + during recruitment and selection

- all diagnostic equation frameworks are removed and the assessment evaluates med dosage calc. competence under virtual clinical conditions

Essential patient information

- name

- sex

- age

- height

- weight

- body surface area (BSA)

- presenting complaint

- allergies

Drug monograph

a statement that specifies the generic name of a drug, the drug action, indications, dose, routes, frequency of administration for different age groups, etc

Dimensional analysis

based on the principle of cancelling out all measurement units in the equation other than the desired unit

- ex. 200mg/250mg x 10mL = 200/250 x 10 mL = 8 mL

Rules for calculating capsule and tablet doses

- capsule-based doses never split; equation answer always whole number

- may be necessary to split scored tablets into 2 half doses

Rounding rules for liquids + injections

- rounded to the nearest 10th (one decimal place) if the amount > 1 mL (ex. 3.75 = 3.8 mL)

- if amount < 1 mL, dose is rounded to nearest 100th (2 decimal places) and a 1 mL syringe is used (ex. 0.777 = 0.78 mL, 0.814 = 0.81 mL)

Rounding rule for IV infusions crystalloids and colloids + IV pump blood and blood products (adults)

- mL/hr infusion rates rounded to nearest whole number (ex. 83.333 = 83 mL/hr, 166.66667 = 167 mL/hr)

Formats of medication orders

- as required (PRN)

- regular prescription/scheduled

- once only; pre-procedure, pre-anesthetic

Info required on med order

generic name, start date, ordered dose, route, dose calculation, max 24hr dose, indication, frequency/time of admin, signature of HCP, [pharmacist signature]

As required (PRN) medications

only administered when requested by the patient or at the discretion of the administering nurse

Regular prescription medications

administered to the patient on a regular basis at the frequency times stipulated by the HCP on the order

Once only medications

to be administered only once on the date and at the time stated by the healthcare provider

Ordered dose

dose ordered by the prescriber (also known as desired dose)

Dispensed dose

mg per tablet/capsule or mL; amount of drug contained in a capsule, tablet, liquid, etc

SI units

major system of measurement used in healthcare; uses decimals and basic set of units for measuring weights and volumes

SI units of weight

grams, milligrams, micrograms

SI units of volume

liter, milliliter

Infusion prescription chart info

- admin date

- type and strength of IV fluid

- volume

- route

- infusion rate

- max 24hr dose

- instructions

- HCP signature

Moving decimal point 1 place to left/right

divides/multiplies by 10

Moving decimal point 2 places to left/right

divides/multiplies by 100

Moving decimal point 3 places to left/right

divides/multiplies by 1000

ex. nanograms to micrograms to milligrams to grams etc