Medication Administration 2 ppt (1) (3) (1)
Medication Administration
Nursing Fundamentals course content from Kellogg Community College.
Objectives
Identify nursing roles and responsibilities in medication administration.
Assess the client's need for medication and their response to it.
Understand the six rights of medication administration.
Educate clients and families about prescribed medications.
Explore nursing actions to prevent medication errors.
Summarize medication administration principles across routes:
Oral (sublingual & buccal)
Enteral Tube
Topical (eyes, ears, nose, rectal/vaginal suppositories, transdermal)
Inhalation
Medication Legislation and Standards
Federal regulations dictate medication use.
Pure Food and Drug Act
FDA overseeing medications, including MedWatch program.
State and local regulations and their impact on medication laws.
Medication laws are encapsulated in Nurse Practice Acts.
Pharmacological Concepts
Medication Names
Chemical Name: Exact composition of the drug.
Generic Name: Assigned by the first manufacturer; listed in the U.S. Pharmacopeia.
Trade Name: Brand name used for marketing.
Example:
Chemical: N-acetyl-para-aminophenol
Generic: Acetaminophen
Trade: Tylenol, Panadol.
Classification of Medications
Based on:
Effect on body systems.
Symptoms relieved.
Desired effect.
Medication Forms
Solid, liquid, topical, parenteral.
Pharmacokinetics: Absorption
Absorption routes - slowest to fastest: topical, gastrointestinal, mucous membranes, IV.
Liquids absorb faster than solids like pills/capsules.
Factors affecting absorption include blood supply, surface area, lipid solubility.
Pharmacokinetics: Distribution
Factors include circulation and membrane permeability.
Medications bind to protein, affecting their activity (free medications are unbound and active).
Medication Actions
Therapeutic Effect: Expected physiological response.
Adverse Effect: Unwanted and unpredictable reactions.
Side Effect: Predictable and unavoidable secondary effects.
Toxic Effect: Medication accumulation in the bloodstream.
Idiosyncratic Reaction: Different than expected reactions (over/underreaction).
Allergic Reactions: Range from mild to severe.
Teratogenic Effects: Harmful to fetal development.
KCC Medication Process
Review medication information with a clinical instructor.
Perform three checks before administering:
Check Pyxis with MAR or Computer.
Confirm at bedside with MAR or computer.
Verify ID with computer and patient.
Ensure to follow the 6 Rights of Medication Administration:
Right patient
Right medication
Right dose
Right route
Right time
Right documentation
Common Dosage Administration Schedule
AC (before meals), PC (after meals), prn (as needed), BID (twice a day), qam (every morning), Q4h (every four hours), STAT (immediately).
Tools for Safe Medication Administration
ISMP provides resources for preventing medication errors.
Error-Prone Abbreviations and Confused Drug Names
Avoid using abbreviations known for misinterpretation.
Use both brand and generic names to minimize confusion.
Medication Routes
Oral: Easy and comfortable, but has disadvantages like GI issues or unconscious patients unable to swallow.
Sublingual/Buccal: Rapid absorption but may not be suitable for all patients.
Inhalation: Requires proper technique for effectiveness and may involve spacers.
Topical: Local effect with few side effects, but be cautious with skin abrasions.
Nursing Implications for Oral Medication Administration
Assess the client's ability to take medications orally and verify if food is required.
Administer fluids properly with medications and verify tube placements.
Education for Patients and Families
Important information includes potential side effects, dietary restrictions, when to contact a doctor, potential interactions, dosing schedules, health literacy, language barriers, and educational materials used.
References
Potter, P.A., et al. (2021). Fundamentals of Nursing (10th ed.). St. Louis: Elsevier/Mosby.