Week 4 object post lab quiz guide
Week 4 Lab Learning Objectives: Medication Administration
Topic Knowledge
Principles of Pharmacology
Drug Nomenclature: The naming conventions of drugs, covering both generic and brand names.
Types of Preparations: Various forms in which medications can be obtained, including tablets, capsules, liquids, etc.
Adverse Drug Effects: Unintended and harmful effects that can occur with medication use.
Factors Affecting Drug Action: Variables that can influence how drugs interact with the body, including age, weight, race, gender, and health status.
Dose and Serum Levels: The amount of medication administered and its concentration in the blood, which can affect efficacy and safety.
Principles of Medication Administration
Medication Orders: The instructions for administering specific medications, which must be clearly understood.
Checking & Questioning: Procedures for verifying medication orders to ensure patient safety.
Routes of Administration: Various methods through which medications can be delivered to a patient (oral, topical, etc.).
Supply Systems: Systems in place for organizing and managing medication distribution.
Skills
QSEN: Patient-Centered Care
QSEN: Safety
Medication Safety Measures
Three Checks: Verifying the right medication three times before administration.
“Rights” of Medication Administration: Ensuring the right patient, drug, dose, route, and time.
Maintenance of Environment: Ensuring a safe and clean environment for medication administration.
Handling Controlled Substances: Proper procedures for the management of medications that require special handling due to their potential for abuse.
Patient Identification: Verifying patient identity using two identifiers.
Administering Medications
Oral Medications: Drug delivery by mouth.
Sublingual & Buccal Medications: Administering drugs under the tongue or in the cheek pouch.
Topical Medications
Skin Applications: Guidelines for applying medications directly to the skin.
Eye Drops: Administration techniques for ophthalmic medications.
Ear Drops: Safe techniques for instilling drops into the ear.
Nasal Sprays: Instructions on the application of nasal medications.
Vaginal Applications: Safe administration practices for vaginal medications.
Rectal Suppository: Methods for delivering drugs via the rectum.
Inhalation Medications: Administration of drugs directly into the lungs.
Administration of Parenteral Medications
Ampules & Vials: Understanding the differences and techniques for using these types of containers.
Reconstitution: The process of adding a diluent to powdered drugs.
Intradermal, Subcutaneous, Intramuscular: Techniques and sites for different parenteral routes of administration.
Medication Administration via Enteral Tube
Procedures for administering medications through feeding tubes.
Attitude
Importance of safe medication administration documentation and techniques for preventing and responding to errors.
Instruction on drug use and abuse.
Learning Guidance
Completion of the following is required before attending lab sessions.
Upon Completion of This Lab, the Student Will Be Able To:
Describe Actions of Drugs on the Body:
Onset: The time after administration when the body first begins to respond to the medication.
Peak Plasma Level: The highest concentration of drug in the plasma after a single dose when the drug absorption equals its elimination.
Plateau: A consistent level of drug concentration in the plasma achieved during a series of scheduled doses.
Half-Life: The time required for the plasma concentration of the drug to decrease to half its initial value.
Define the Four Common Types of Orders:
Standing: Given until discontinued or for a specified duration.
Routine: Similar to standing orders but often used for routine medications.
PRN: Administered as needed based on the patient's condition.
One-time: Administered once at a scheduled time.
Stat: Administered immediately.
State the Six Components of a Medication Order:
(1.) Patient name
(2.) Medication name
(3.) Dose
(4.) Route
(5.) Time
(6.) Provider signature
Identify Guidelines for Safe Medication Administration:
Verification of medication orders.
Questioning any unclear orders.
Using two patient identifiers for client identification in compliance with national safety standards.
Employing bar code bands for medication verification.
Describe How to Safely and Accurately Administer Topical Medications:
Wear gloves during application.
Cleanse the skin prior to applying medication.
Apply medication evenly, using the appropriate amount as indicated.
Take precautions to avoid cross-contamination.
Remove any old medication before applying a new dose.
Describe General Guidelines for Administering Sublingual and Buccal Medications:
Do not chew or swallow the medication.
Place the drug under the tongue or in the cheek pocket.
Allow it to dissolve completely.
Avoid eating or drinking until the medication is fully dissolved.
Describe Key Principles for Safely Administering Eye Drops:
Do not let the dropper touch the eye.
Administer drops into the conjunctival sac of the eye.
Apply gentle pressure to the nasolacrimal duct for 30-60 seconds.
Wait at least 5 minutes before administering different eye medications.
Describe Key Principles for the Procedure of Administration of Ear Drops Safely:
Warm the ear drops to room temperature before administration.
For adults, pull the pinna up and back.
For children, pull the pinna down and back.
Describe the Therapeutic Sequencing and Rationale When Administering Bronchodilator and Corticosteroid Inhaler Medications:
Hint: Administer bronchodilator before corticosteroid (B before C).
Rationale: The bronchodilator opens the airways, allowing for better steroid penetration.
Identify Breath-Holding Time After Administering a Meter Dose Inhaler (MDI):
Patients should hold their breath for 10 seconds after inhalation.
Identify Key Concepts in Safe Administration of Rectal Medications:
Positioning: Left Sims’ position is recommended.
Insert the suppository past the internal sphincter (approximately 1 inch for adults).
Encourage the patient to retain the medication after administration.
State the Cardinal Rule for Preventing Accidental Needle Sticks with the Administration of Parenteral Medications:
Activate the safety device immediately after administering an injection.
Never recap a needle post-administration.
Describe the Correct Procedure for Safely Breaking an Ampule and Withdrawing Medication:
Tap the ampule to move the medication to the bottom.
Use gauze or an ampule opener to break it.
Break the ampule away from your body.
Use a filter needle to withdraw the medication.
Identify the Purpose of Using a Filter Needle:
Prevents glass particles from contaminating the syringe during withdrawal of medication from an ampule or vial.
Explain the Rationale for Injecting Air into a Vial:
Injection of an amount of air equal to the prescribed amount of medication before withdrawal is necessary to prevent the formation of a vacuum in the vial.
Define Reconstitution:
The technique of adding a diluent to a powdered drug to convert it into a usable liquid form.
Commonly used diluents include sterile normal saline or sterile water.
Identify Two Types of Insulin That Should Not Be Mixed in the Same Syringe:
Lantus (glargine) and Levemir (detemir) should not be mixed due to the alteration of their action and absorption.
Key Concepts When Performing an Intradermal Injection:
Skin should be taut.
Needle entry angle should be 10–15°.
The needle bevel should be positioned upward.
Length of needle inserted should be about 1/8 inch.
Describe the Landmarks Used for Intradermal Injection:
Various safe sites for intradermal injections will be covered in accompanying diagrams.
List Two Medications Administered Subcutaneously for Which Aspiration is Not Recommended:
Heparin—never aspirated upon administration.
Insulin—aspiration is generally not necessary.
Explain Criteria for Determining the Angle of a Subcutaneous Injection:
Based on patient size and adipose tissue thickness: 45° for thin patients and 90° for average/obese patients.
Describe Landmarks for Subcutaneous Injection Administration:
Diagrams will illustrate multiple safe sites for administration.
Describe Landmarks for Enoxaparin (Lovenox®) Subcutaneous Injection Administration:
Diagrams will highlight safe injection sites.
Procedure for Preparing and Administering a Subcutaneous Injection:
Cleanse the site before injection.
Pinch the skin at the injection site.
Insert the needle at the correct angle.
Inject slowly and steadily.
Avoid massaging the injection site immediately after administration.
Injection Landmarks for Safe Administration of Intramuscular Injections:
The abdomen (at least 2 inches from the umbilicus), outer upper arms, anterior thighs, and upper buttocks are common sites.
Identify Items to Check Before Mixing Medications in the Same Syringe:
Compatibility of the medications, including limited compatibility which may necessitate timely administration (within 15 minutes).
Procedure for Preparing and Administering an Intramuscular Injection:
Select the correct site and needle size.
Cleanse the injection site.
Insert the needle at a 90° angle.
Inject the medication steadily and apply gentle pressure after removal.
Ways to Maintain Patient Comfort During IM Injection:
Use the appropriate needle size; relax the muscle; inject slowly; utilize Z-track technique if indicated.
Purpose of Z-Track Technique for IM Injections:
Ensures that medication does not leak back into the subcutaneous tissue, reduces pain and discomfort, and prevents irritation or discoloration (such as with iron).
Steps for Safe Administration of Medications via Nasogastric Tube:
Verify tube placement before administration.
Flush the tube before and after delivering medications.
Administer medications separately, using liquid forms when possible.
How Medication Errors Occur When the “RIGHTS” of Medication Administration are Not Followed:
Errors may stem from wrong patient, drug, dose, route, time, or documentation.
Response to Medication Error:
Ensure patient safety first.
Notify the instructor and healthcare provider.
Document the error per facility policy.
Complete an incident report as required.
Example Calculation for Dosage:
Order: Zithromax 250 mg, po, once a day.
Drug Available: 500 mg/1 mL.
Calculation: (250mg/500mg = 0.5 mL).
Therefore, the dose is 0.5 mL.Second Example Calculation for Dosage:
Order: Zofran 6 mg, IM, every 4 hours as needed.
Drug Available: 4 mg/5 mL.
To calculate:
(6mg / 4mg = 1.5 mL )
Thus, ( 1.5 mL \times 5 mL = 7.5 mL) per dose.
Therefore, the dose is 7.5 mL per dose.