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Safe Medication Administration: Guidelines and Best Practices

Learn about drug standards, legislation, pharmacokinetics, drug nomenclature, interactions, side effects, factors influencing drug action, professional roles, safe administration practices, medication compliance, legal aspects, and nursing process.

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Safe Medication Administration: Guidelines and Best Practices

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  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

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