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Medication Administration

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Medication Administration Part 1 Keith Rischer, RN, MA, CEN, CCRN * Oral medication administration our focus the next few weeks. EASIEST AND PREFERRED ROUTE Give ... – PowerPoint PPT presentation

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Title: Medication Administration


1
Medication Administration
  • Part 1
  • Keith Rischer, RN, MA, CEN, CCRN

2
Todays Objectives
  • State the primary use and nursing implications
    for drugs in each major classification
  • Describe the characteristics of any drug that the
    nurse is responsible for administering
  • Onset, peak, duration and half-life
  • Mechanism of actiongtSEgtNsg Implications
  • Calculate fractional dosages of drugs
  • Using drug reference text correctly fill out
    clinical paperwork related to medication
    administration

3
Nurses Responsibility
  • How many patients die each year because of
    medication errors in US hospitals?
  • 500
  • 5000
  • 7000
  • 25,000
  • How many patients are injured as a result of
    medication errors annually?
  • 100,000
  • 500,000
  • 1,000,000
  • 1,500,000

4
Pharmacological Concepts
  • Drug Names
  • Chemical name
  • name of a drug as the chemist knows it.
  • Describes the constituents of the drug
  • Ex
  • N-acetyl-para-aminophenol (Tylenol)
  • 2-(acetyloxy)benzoic acid. (Aspirin)

5
Pharmacological Concepts
  • Drug names
  • Generic names
  • Name given to a drug before it becomes official.
  • Name is often listed in the USP as the official
    name
  • Ex Furosemide, Acetaminophen, Atorvastatin
  • Brand name
  • Trademark or name given by drug manufacturer.
  • More that one manufacturer may make the same drug
  • EX Lasix, Tylenol, Lipitor

6
Reading Medication Labels
7
Nursing implications
  • Implications related to administration and
    assessment/monitoring
  • RN responsible for
  • V/S
  • Timing with meals
  • Labs
  • IO
  • Dilute? Crush?

8
Classifications/Nursing Implications
  • Anti-hypertensive
  • Beta Blockers
  • Atenolol
  • Metoprolol
  • Propranolol
  • Calcium channel blockers
  • Diltiazem
  • Nifedipine
  • ACE Inhibitors
  • Captopril
  • Enalapril
  • Lisinopril
  • Diuretics
  • Loop of Henle (Furosemide)
  • Distal tubule-(Hydrochlorothiazide-HCTZ)

9
Classifications/Nursing Implications
  • Analgesics
  • Mild-NSAIDS
  • Tylenol, Ibuprofen, Aspirin
  • Moderate-Opiod Narcotics po
  • Tylenol 3, Vicodin, Percocet
  • Severe-Opiod Narcotics IV
  • Morphine, Dilaudid, Fentanyl
  • Anti-bacterial
  • Penicillins
  • Amoxicillin
  • Cephalosporins
  • Keflex
  • Sulfa
  • Bactrim DS

10
Classifications/Nursing Implications
  • Anti-inflammatory
  • NSAIDS
  • Prednisone
  • Anti-coagulant
  • Heparin
  • Coumadin
  • Anti-platelet
  • Aspirin
  • Plavix
  • Laxative
  • Sennakot, Metamucil

11
Routes of Administration
  • Oral
  • Capsules/tablets
  • Syrup/solution
  • Inhalation
  • Rectal
  • suppository
  • Topical
  • Patch
  • ointment
  • Parenteral
  • IV (intravenous)
  • Sub-q (sub-cutaneous)
  • IM (intra-muscular)
  • ID (intra-dermal)

12
Medication Administration
  • Oral
  • 60-100 mL of fluid
  • Contraindications
  • NPO
  • GI
  • CVA
  • Prevent aspiration (Table 35-16 p.717 PP)

13
Medication Administration
  • Topical
  • Remove old patch before applying new
  • Date and time new patch
  • Use gloves
  • Make sure skin is clean and dry
  • Examples
  • Fentanyl
  • Nitroglycerin
  • Nicoderm

14
Medication Administration
  • Nasal
  • Eye
  • Ear

15
Medication Administration
  • Inhalers
  • Albuterol/Advair
  • Spacer
  • Vaginal
  • Rectal

16
Types of Medication Action
  • Therapeutic/Mechanism of action
  • Side effects
  • Adverse reactions
  • Allergic reactions
  • Idiosyncratic reactions
  • Toxic effects
  • Amiodarone
  • Tolerance
  • Opiate narcotics

17
Time/Action Profile
  • Onset
  • Peak
  • Duration
  • Trough
  • Serum Half life
  • Morphine IV
  • Vicodin po

18
Interpreting Drug Orders
  • Abbreviations - Pickar
  • Do not use of abbreviations list Pickar
  • MS 2 mg IV q4 hours p.r.n for pain
  • Lantus insulin 20u qd
  • Maalox 15cc q6 hours prn

19
Formula Method
  • D X Q X
  • H
  • Desired X Quantity Amount
  • Have

20
Formula Method
  • Heparin subq order for 12,000u due. This
    injection comes in a vial of 20,000u/cc. What
    will be the amount you will administer?
  • Dilaudid 0.25mg IV for pain. The pharmacy
    dispenses a carpuject/vial of Dilaudid 1mg/cc.
    What is the amount you will administer?
  • Solumedrol 25mg IV. It is dispensed as a 40mg/cc
    vial. What is the amount you will administer?
  • Plavix 300mg to be given now. It only comes in
    75mg tablets. How many tabs will you administer
    to give the correct dose?

21
This is your patient
  • MB, 75 yo, admitted to the step down unit with
    exacerbation of heart failure. She complained
    of SOB, 3 pitting edema in lower legs and a
    weight gain of 8 lbs in 3 days. Her K was 3.4
    mEq/L in the ED.
  • Furosemide 40mg IV was given in the ED with 800cc
    urine out
  • P-96 R-32-BP 160/90 initially in ED
  • P-86-R-24 BP 122/78 after Lasix
  • Physician has ordered
  • KCL 30 mEq po bid
  • Pharmacy has dispensed KCL 20 meq/15cc elixir
    unit dose tubs x2. What will be the amount (cc)
    you will administer?
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