Safe Medication Administration: Guidelines and Best Practices

1. Chapter 30 Medication Administration

2. Drug Standards and Legislation • Standards: • Ensure uniformity • Predict effects • United States Pharmacopeia (USP) • National Formulary (NF) (continued)

3. Drug Standards and Legislation • Federal legislation: • Pure Food and Drug Act of 1906 • USP and NF establish drug standards • State and local legislation • Health care institution regulations

4. Pharmacokinetics • Absorption • Distribution • Metabolism • Excretion

5. Drug Nomenclature • Chemical name • Precise description of composition • Generic name • Given by U.S. Adopted Names Council • Trade or brand name • Given by pharmaceutical companies • Used during marketing

6. Drug Action • Pharmacology • Medication management • Classification (continued)

7. Drug Action • Pharmacology • Preparation and route • Oral • Parenteral • Topical • Inhalants • Intraocular route

8. Drug Interaction • Effect of one drug on another • Deliberate combining • Not all drug combinations therapeutic

9. Side Effects and Adverse Reactions • Side effects • Mild • Predictable • Nontherapeutic • Adverse reactions • Unexpected • Potentially hazardous (continued)

10. Side Effects and Adverse Reactions • Food and drug interactions • Drug effects on nutritional status • Food effects on drug absorption • Food effects on drug utilization

11. Factors Influencing Drug Action • Genetics • Age • Height • Weight • Physical conditions • Mental conditions

12. Professional Roles in Medication Administration • Health care providers • Orders • Administration of drugs • Teaching • Observation (continued)

13. Professional Roles in Medication Administration • Types of orders: • Stat • Single-dose • Standing • PRN • As needed • Parts of drug order

14. Systems of Weight and Measure • Metric • Apothecary • Household

15. Approximate Dose Equivalents • Converting units of weight and volume • Measurement conversions within metric system • Measurement conversions between systems • Drug dose calculations • Pediatric dosages

16. Safe Drug Administration • Guidelines for medication: • Right drug • Right dose • Right client • Right route • Right time (continued)

17. Safe Drug Administration • Document: • Critical element • Only after client has taken drug • Drug supply and storage • Unit dose form • Stock supplied drugs • Narcotics and controlled substances (continued)

18. Safe Drug Administration • Drug abuse • Addiction • Physiological or psychological dependence on substance or behavior (continued)

19. Safe Drug Administration • Drug abuse • Dependence • Reliance on or need to take drug • Physiological • Psychological

20. Medication Compliance • Compliance • Taking medication as prescribed • Improved through client understanding • Noncompliance • Inconsistent use as prescribed • Self-adjusted dosing or scheduling

21. Legal Aspects of Administering Medications • Questioning medication order • Responsible • Accountable • Preventing medication errors

22. Medication Administration and the Nursing Process • Assessment • Medical history • Drug history • Allergies • Prescription drugs • Over-the-counter drugs • Complementary therapy • Herbal supplements (continued)

23. Medication Administration and the Nursing Process • Assessment • Biographical data • Cultural diversity • Lifestyle and beliefs • Sensory and cognitive status • Physical exam • Diagnostic and laboratory data (continued)

24. Medication Administration and the Nursing Process • Diagnosis • NANDA statements • Deficient knowledge • Ineffective health maintenance • Impaired physical mobility • Disturbed sensory perception • Readiness for enhanced knowledge (continued)

25. Medication Administration and the Nursing Process • Planning and outcome identification • NOC for medication administration: • Knowledge • Medication • Medication response • Self-care • Nonparenteral medication (continued)

26. Medication Administration and the Nursing Process • Implementation • Assessment • Administration • Teaching (continued)

27. Medication Administration and the Nursing Process • Implementation • Oral medication administration • Most common route • Gag reflex • Consciousness • Nausea or vomiting • Medication administration • Sublingual and buccal (continued)

28. Medication Administration and the Nursing Process • Implementation • Enteral medication administration • Delivery through gastrointestinal tube • Equipment • Risk for aspiration (continued)

29. Medication Administration and the Nursing Process • Implementation • Parenteral medication administration • Routes • Intradermal • Subcutaneous • Intramuscular • Intravenous (continued)

30. Medication Administration and the Nursing Process • Implementation • Parenteral medication administration • Equipment • Syringes • Needles • Ampules and vials • Angle of injection (continued)

31. Medication Administration and the Nursing Process • Implementation • Intradermal medication administration • Purposes • Slow absorption • Small quantity of solution • Procedure (continued)

32. Medication Administration and the Nursing Process • Implementation • Subcutaneous medication administration • Purposes • Heparin • Insulin • Sites • Procedure (continued)

33. Medication Administration and the Nursing Process • Implementation • Intramuscular medication administration • Purposes • Sites • Procedure • Z-track injection (continued)

34. Medication Administration and the Nursing Process • Implementation • Intravenous medication administration • Purposes (continued)

35. Medication Administration and the Nursing Process • Implementation • Intravenous medication administration • Procedure • Infusion pump • Adding drugs to volume-control administration set • Administering by intermittent infusion • Intermittent infusion devices • Administering intravenous push medications (continued)

36. Medication Administration and the Nursing Process • Implementation • Topical medication administration • Eye • Ear • Nasal • Rectal • Vaginal (continued)

37. Medication Administration and the Nursing Process • Evaluation • Ongoing responsibility of nurse • Client’s response to medications • Changes in client’s condition • Client’s ability to self-manage