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Annual Up-date

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STATE OF CONNECTICUT Department of Children and Families Medication Administration Certification Training Based on the Basic Medication Administration Curriculum – PowerPoint PPT presentation

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Title: Annual Up-date


1
STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
2
Unit 1
2
Recertification Review Guide, Unit 1
3
5
1. Right Child 2. Right Medication 3. Right
Dose 4. Right Route 5. Right Time
RIGHTS of Medication Administration
3
Recertification Review Guide, Unit 1
4
Three Documents Necessary for Safe Medication
Administration
  • Licensed Practitioners Order
  • Pharmacy Label
  • Medication Administration Record (MAR)

4
Recertification Review Guide, Unit 1
5
The Rule of Three is
Documents Licensed Practitioners
Order MAR Pharmacy Label
3
  • Comparing the licensed practitioners order, MAR
    and the pharmacy label for the five rights three
    times every time you administer the medication

Rights Child Medication Dose Route Time
5
Times every time you administer the medication
3
5
Recertification Review Guide, Unit 1
6
Roles of LP, Pharmacist, Medication Certified
Staff and Nurse
  • Licensed Practitioner may diagnose and
    prescribe treatment/medications. May dispense
    medication.
  • Pharmacist dispenses medications according to a
    licensed practitioners order.
  • Medication Certified Staff may administer
    medications according to a licensed
    practitioners order to children in any DCF
    licensed or operated child-caring facility or
    extended day program.
  • Nurse (RN, LPN or APRN) provides ongoing
    supervision of medication administration
    program/staff.

6
Recertification Review Guide, Unit 1
7
Responsibilities of the DCF Medication
Administration Staff
  • Always follow DCF Med Admin Procedure
  • Always use the Five Rights and the Rule of Three
    before medication administration
  • Know the desired effects of a medication and
    report any side effects
  • Adhere to any precautions
  • Follow instructions from the LP
  • Contact the Chain of Command whenever you have a
    question or concern

7
Recertification Review Guide, Unit 1
8
When you have a question about a LPs order, a
pharmacy label or MAR
There is change in the condition of a child
When to Contact the Chain of Command
A child does not receive his medications as
ordered
Any incident where medication is not properly
safeguarded
Any time you have a question or concern
8
Recertification Review Guide, Unit 1
9
Unit 1 Quiz
1. What are the Five Rights of Medication Administration?

2. What are the three documents you must have to assure safe medication administration?

3. True or False You only need to check the Five Rights and the Rule of Three the first time you give the medication.
9
Recertification Review Guide, Unit 1
10
Answers to Unit 1 Quiz
1. What are the Five Rights of Medication Administration?
1. The right child, right medication, right dose, right route and right time

2. What are the three documents you must have to assure safe medication administration?
2. Licensed practitioners order, pharmacy label, MAR

3. True or False You only need to check the Five Rights and the Rule of Three the first time you give the medication.
False You need to check the Five Rights and the Rule of Three every time you administer a childs medication.
10
Recertification Review Guide, Unit 1
11
STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
11
Recertification Review Guide, Unit 2
12
Unit 2
12
Recertification Review Guide, Unit 2
13
Define the terms trade name and generic name for
medications
Trade name marketing name for example Tylenol

Generic name chemical name for example acetaminophen
13
Recertification Review Guide, Unit 2
14
Define active ingredientsand inactive ingredients
Active ingredient chemical that actually causes the medications desired effect
Inactive ingredient dyes, water and other additives to form a tablet, add flavor or color
14
Recertification Review Guide, Unit 2
15
Define controlled medication
Controlled medications have the potential to
be abused or addictive
15
Recertification Review Guide, Unit 2
16
Define unlabeled (off-labeled)use of medication
  • Unlabeled/Off-labeled use of a medication is the
    use of a medication for a purpose that has not
    been approved of by the FDA

16
Recertification Review Guide, Unit 2
17
Describe the different routesof administration
  • Oral medication
  • Eye drops and ointments
  • Ear drops
  • Nasal sprays
  • Inhaled medication
  • Topical medication

17
Recertification Review Guide, Unit 2
18
List the steps of the DCF Medication
Administration Procedure
  • Approach the task in a calm manner allowing no
    distractions
  • Wash hands before and after medication
    administration
  • Assemble appropriate equipment

18
Recertification Review Guide, Unit 2
19
List the steps of the DCF Medication
Administration Procedure (Cont.)
  • Perform the rule of three
  • Compare the LPs order with the pharmacy label
  • Compare the pharmacy label with the MAR
  • Compare the MAR with the LPs order to see if the
    five rights match

19
Recertification Review Guide, Unit 2
20
List the steps of the DCF Medication
Administration Procedure (Cont.)
  • Pour the correct dose of medication
  • Identify the correct child
  • Administer the medication utilizing the proper
    techniques
  • Perform a mouth check
  • Document
  • Return the medication to the locked area and
    clean up

20
Recertification Review Guide, Unit 2
21
Unit 2 Quiz
1. True or False Unlabeled use means the medication is being used for a purpose that has not been approved by the FDA.

2. What is the description of controlled medication?

3. List the steps of the DCF Medication Administration Procedure.
21
Recertification Review Guide, Unit 2
22
Answers to Unit 2 Quiz
1. True or False Unlabeled use means the medication is being used for a purpose that has not been approved by the FDA.
1. True Unlabeled/Off-labeled use of a medication is the use of a medication for a purpose that has not been approved by the FDA.

2. What is the description of controlled medication?
2. Controlled medications have the potential to be abused or addictive
22
Recertification Review Guide, Unit 2
23
Answers to Unit 2 Quiz (Cont.)
List the steps of the DCF Medication Administration Procedure. List the steps of the DCF Medication Administration Procedure.
1. Approach the task in a calm manner allowing no distractions
2. Wash hands before and after medication administration
3. Assemble appropriate equipment
4. Perform the Rule of Three
5. Pour the correct dose of medication
6. Identify the correct child
7. Administer the medication utilizing the proper techniques
8. Perform a mouth check
9. Document
10. Return the medication to the locked area and clean up
23
Recertification Review Guide, Unit 2
24
STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
24
Recertification Review Guide, Unit 3
25
Unit 3
25
Recertification Review Guide, Unit 3
26
Identify what you must know about a medication
before you administer it
  • Medications name
  • Medications use
  • Medication's action
  • Controlled or non-controlled
  • Usual dose
  • Precautions and considerations
  • Side effects

Recertification Review Guide, Unit 3
27
Describe the process that must occur in thebody
for a medication to have an effect
  • Enter
  • Absorb
  • Distribute
  • Metabolize
  • Eliminate

Recertification Review Guide, Unit 3
28
List and describe the effects a child may have
to a medication
  • Individual effect
  • Desired/Therapeutic effect
  • No effect
  • Side effect
  • Allergic effect

Recertification Review Guide, Unit 3
29
Define the term side effectsand give examples
  • A response to a medication that is not the
    desired effect may be mild to severe and
    includes

nausea headache difficulty sleeping fever muscle
twitching and tics
Recertification Review Guide, Unit 3
30
Identify the correct steps to take if a child
experiences a side effect
  1. Hold the medication
  2. Contact Chain of Command
  3. Document

Recertification Review Guide, Unit 3
31
Describe anaphylaxis and the appropriate steps to
follow
Severe potentially fatal allergic reaction CALL
911 (Follow your facilitys Policies and
Procedures re medical emergencies)
Recertification Review Guide, Unit 3
32
List factors that affect a childs response to
medication
  • Age
  • Weight
  • Route of Administration
  • Drug and Food Interactions
  • Size
  • Gender
  • General Health Status
  • Genetics

Recertification Review Guide, Unit 3
33
Define drug to drug interaction
  • The effects of one medication are changed by the
    presence of another medication.
  • May occur whenever there is more than one
    medication in the childs system.

Recertification Review Guide, Unit 3
34
Describe drug to food interaction
  • The presence of food in the stomach affects how
    medication is absorbed

Recertification Review Guide, Unit 3
35
Factors that affect a childs compliance with
taking medication
  • Taste
  • Smell
  • Color
  • Consistency of the medication
  • Parental approval

Recertification Review Guide, Unit 3
36
Define commonly usedmedical abbreviations
Q Day every day
BID twice a day
TID three times a day
HS at bedtime (Hour of Sleep)
QH every hours
PRN as needed
AC before meals
PC after meals
Recertification Review Guide, Unit 3
37
Define commonly usedmedical abbreviations (Cont.)
mg milligrams
ml milliliters
cc Cubic centimeters
Tab tablet
Cap capsule
tsp teaspoon
Tbsp tablespoon
NTE Not to Exceed
Recertification Review Guide, Unit 3
38
Define commonly usedmedical abbreviations (Cont.)
PO by mouth
OU both eyes
NKA No Known Allergies
NKDA No Known Drug Allergies
SR Sustained Release
CR Controlled Release
DR Delayed Release
XL Extra Long Release
Recertification Review Guide, Unit 3
39
Define commonly usedmedical abbreviations (Cont.)
MDI Metered Dose Inhaler
NPO Nothing by mouth
c with
s without

One tsp 5ml or 5 cc
One Tbsp 15ml or 15cc or 3 tsp
Recertification Review Guide, Unit 3
40
Unit 3 Quiz
1. Translate Depakote 250mg PO TID

2. Identify the correct steps to take if a child experiences a side effect

3. Describe the process that must occur in the body for a medication to have an effect
Recertification Review Guide, Unit 3
41
Answers to Unit 3 Quiz
1. Translate Depakote 250mg PO TID
1. Depakote 250 milligrams, by mouth, three times a day

2. Identify the correct steps to take if a child experiences a side effect
2. Hold the medication Contact Chain of Command Document

3. Describe the process that must occur in the body for a medication to have an effect
Enter, Absorb, Distribute, Metabolize, Eliminate
Recertification Review Guide, Unit 3
42
STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
42
Recertification Review Guide, Unit 4
43
Unit 4
43
Recertification Review Guide, Unit 4
44
Identify the componentsof a licensed
practitioners order
  • Five Rights
  • Signature
  • Date (within the last 90 days)
  • Special instructions

Recertification Review Guide, Unit 4
45
LPs order must be renewed
  • Every 90 days
  • (per DCF regulations)

Recertification Review Guide, Unit 4
46
Documentation necessaryfor OTC medication
  • CT statutes and regulations require a LPs order
    for any medication to be administered to a child.
    That includes OTC medications.
  • Orders must include the Five Rights, be dated
    within the last 90 days and signed by a LP.

Recertification Review Guide, Unit 4
47
Define standing orders
  • Standing orders are licensed practitioners
    orders that include PRN OTC medications used to
    help treat or manage routine, minor childhood
    illnesses or symptoms

Recertification Review Guide, Unit 4
48
General rules of documentation
  • Use permanent ink no pencils or erasable pens
  • Write legibly
  • Only approved abbreviations
  • No white-out
  • Do not obliterate a documentation error draw a
    single line through the mistake, write your
    initials and date above it
  • Use full, proper names and titles
  • Do not use one childs full name in another
    childs record
  • The time and date should be noted in all
    documentation

Recertification Review Guide, Unit 4
49
DocumentingNon-controlled medications
  • Every child who is prescribed medication must
    have his own MAR for each medication he is
    prescribed

Recertification Review Guide, Unit 4
50
Documenting Controlled Medications
  • When you administer a controlled medication you
    must document how much of that medication remains
  • All controlled medications must be counted and
    the count documented at the beginning of each
    shift or whenever responsibility for the
    controlled medication is transferred from one
    staff member to another

Recertification Review Guide, Unit 4
51
Documenting PRN medications
  • The time, dose, reason and outcome for the PRN
    medication must be documented in an objective
    manner

Recertification Review Guide, Unit 4
52
Unit 4 Quiz
1. Identify the components of a licensed practitioners order

2. Define standing orders

3. When should controlled medications be counted?
Recertification Review Guide, Unit 4
53
Answers to Unit 4 Quiz
1. Identify the components of a licensed practitioners order
1. Five Rights, Signature, Date (within the last 90 days), Special Instructions

2. Define standing orders
2. Standing orders are licensed practitioners orders that include PRN OTC medications used to help treat or manage routine, minor childhood illnesses or symptoms

3. When should controlled medications be counted?
3. All controlled medications must be counted and the count documented at the beginning of each shift or whenever responsibility for the controlled medication is transferred from one staff member to another.
Recertification Review Guide, Unit 4
54
STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
54
Recertification Review Guide, Unit 5
55
Unit 5
55
Recertification Review Guide, Unit 5
56
Household vs. metric terms
5ml 1 tsp
5cc 1 tsp
15ml 1 Tbsp
15cc 1 Tbsp

1ml 1cc
ml and cc are used interchangeably ml and cc are used interchangeably ml and cc are used interchangeably
Recertification Review Guide, Unit 5
57
Identify how weight is measured for medication
administration
  • Milligrams (mg) indicate the weight of the
    medication in a
  • Pill
  • Capsule
  • Tablet
  • In a certain amount of liquid

Recertification Review Guide, Unit 5
58
Units for measuringliquid medication
  • Liquid medication must be carefully measured
    using only standardized or calibrated measuring
    tools
  • Measured in metric (ml or cc) or household
    (tsp or Tbsp) units

Recertification Review Guide, Unit 5
59
Using decimals
Write a 0 in front of the decimal point for doses less than 1 Write a 0 in front of the decimal point for doses less than 1 Write a 0 in front of the decimal point for doses less than 1 Write a 0 in front of the decimal point for doses less than 1
Correct 0.25 mg 0.5 mg Incorrect .25mg .5mg
Do not write a 0 after last number Do not write a 0 after last number Do not write a 0 after last number Do not write a 0 after last number
Correct 0.25 mg 1 mg Incorrect 0.250mg 1.0mg
Write the decimal point clearly so that it is clearly visible Write the decimal point clearly so that it is clearly visible Write the decimal point clearly so that it is clearly visible Write the decimal point clearly so that it is clearly visible
Recertification Review Guide, Unit 5
60
Verify that the dose on the LPs order matches
the pharmacy label and the MAR
To verify that doses all match you will need to
ask
Recertification Review Guide, Unit 5
61
Practice math for medication
administration (click on the link below) Unit 5
Quiz Answers to Unit 5 Quiz
Recertification Review Guide, Unit 5
62
STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
62
Recertification Review Guide, Unit 6
63
Unit 6
63
Recertification Review Guide, Unit 6
64
The physical changes in thelungs of people with
asthma
  • Bronchial constriction
  • Inflammation
  • Increased mucous

Recertification Review Guide, Unit 6
65
Common asthma triggers are
  • Smoke
  • Dust
  • Pollen
  • Fumes
  • Strong odors
  • Strong emotions
  • Exercise
  • Cold air

Recertification Review Guide, Unit 6
66
Common symptomsof an asthma attack are
  • Shortness of breath
  • Cough
  • Wheezing
  • Chest tightness
  • Difficulty breathing
  • Chest and neck retractions

Recertification Review Guide, Unit 6
67
Two general types ofasthma medications are
  • Rescue inhaled bronchodilator will quickly
    open constricted airways during an asthma attack
  • Maintenance or Prevention inhaled steroids,
    cromolyn sodium, Leukotriene antagonists, oral
    steroids taken daily to keep asthma under
    control and prevent attacks

Recertification Review Guide, Unit 6
68
Know how to administer an MDI
  • Hold the inhaler upright and shake it
  • Exhale completely
  • Hold the inhaler 1 to 2 inches from the mouth
  • or
  • Place the mouth piece of the inhaler in the mouth
    forming a tight seal

Recertification Review Guide, Unit 6
69
Know how to administer an MDI (Cont.)
  • Depress the canister once while inhaling for 25
    seconds
  • Hold breath for up to 10 seconds or as long as
    possible
  • Wait 1 minute and repeat the entire process if a
    second puff is ordered

Recertification Review Guide, Unit 6
70
Unit 6 Quiz
1. What are the three physical changes that occur in the body during an asthma attack?

2. True or False Inhaled bronchodilators (rescue medications) are typically used to treat an asthma attack.

3. True or False Chest and neck retractions and cough are two symptoms of an asthma attack.
Recertification Review Guide, Unit 6
71
Answers to Unit 6 Quiz
1. What are the three physical changes that occur in the body during an asthma attack?
1. Bronchial constriction Inflammation Increased mucous

2. True or False Inhaled bronchodilators (rescue medications) are typically used to treat an asthma attack.
2. True

3. True or False Chest and neck retractions and cough are two symptoms of an asthma attack.
3. True
Recertification Review Guide, Unit 6
72
STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
72
Recertification Review Guide, Unit 7
73
Medications for Medical Conditions
Unit 7
73
Recertification Review Guide, Unit 7
74
Antibiotics
Treat Bacterial Infections
Recertification Review Guide, Unit 7
75
Anti-viral medications
  • Treat viral infections
  • Reduces symptoms will not cure viral infection
  • Must start at the earliest sign of viral infection

Recertification Review Guide, Unit 7
76
Scabicides
  • Treat scabies infestation of the skin
  • Follow orders and directions exactly
  • May cause serious adverse effects if overused
  • Potentially toxic to the Central Nervous System
  • LPs order required for administration
  • Contact the chain of command if child is
    re-infected

Recertification Review Guide, Unit 7
77
Pediculocides
  • Treat lice infection
  • Follow orders and directions exactly
  • May cause serious adverse effects if overused
  • Potentially toxic to the Central Nervous System
  • LPs order required for administration
  • Contact the chain of command if child is
    re-infected

Recertification Review Guide, Unit 7
78
Antifungal medication
  • Treat fungal infection
  • Treatment may take a long time
  • Keep infected area clean and dry
  • Good hygiene prevents spread of infection
  • Report any side effects to chain of command

Recertification Review Guide, Unit 7
79
Analgesics
  • Relieve pain
  • Frequent, unusual, or pain that interferes with
    childs usual activity must be reported to the
    chain of command

Recertification Review Guide, Unit 7
80
Antipyretics
  • Reduce fever
  • Monitor childs temperature before and 1 hour
    after administering antipyretic
  • Fever is a change of condition that must be
    reported to the chain of command

Recertification Review Guide, Unit 7
81
Expectorants
  • Promote coughing up mucous
  • Report any persistent cough to the childs
    physician
  • Increased fluid intake will help to loosen
    secretions

Recertification Review Guide, Unit 7
82
Antitussives
  • Suppress cough
  • May mask signs of infection such as pneumonia or
    bronchitis
  • May be ordered at night to quiet a cough that
    interrupts sleep
  • Narcotic antitussives should be used cautiously
    with clients who have a history of drug or
    alcohol abuse

Recertification Review Guide, Unit 7
83
Decongestants
  • Reduce congestion in the sinuses and nasal
    passages
  • May cause excitability and insomnia
  • Avoid administering at bedtime

Recertification Review Guide, Unit 7
84
Antihistamine
  • Reduce symptoms of allergic reactions
  • May cause drowsiness use with caution
  • May cause decreased ability to urinate

Recertification Review Guide, Unit 7
85
Cardiovascular medications
  • Affect the heart and circulatory system
  • BP and pulse must be checked routinely
  • Do not stop abruptly
  • Doses should not be missed
  • Unlabeled use Anxiety and ADHD

Recertification Review Guide, Unit 7
86
Anticonvulsants
  • Reduce or prevent seizures
  • Give consistently on time
  • May require periodic blood work
  • Unlabeled use mood disorders

Recertification Review Guide, Unit 7
87
Laxatives
  • Promote bowel movements treat constipation
  • Increased fluids, fiber, and activity may reduce
    the need for laxative medication

Recertification Review Guide, Unit 7
88
Antacids
  • Control or reduce acid in stomach
  • Check with pharmacist or licensed practitioner
    before administering at the same time as another
    medication may interfere with absorption of
    other meds
  • Frequent complaints of heartburn or stomach upset
    should be evaluated by a physician

Recertification Review Guide, Unit 7
89
Birth control / contraceptives
  • Prevent pregnancy
  • Must be administered as ordered for maximum
    effectiveness
  • Follow LPs order re missed doses
  • May be prescribed to regulate menstrual cycle

Recertification Review Guide, Unit 7
90
Unit 7 Quiz (click on the link below and print)
  • Medications to treat medical conditions
  • Answers to Medications to treat medical
    conditions

Recertification Review Guide, Unit 7
91
STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
91
Recertification Review Guide, Unit 8
92
Medications for Psychiatric Conditions
Unit 8
92
Recertification Review Guide, Unit 8
93
Antipsychotic
  • Treat psychotic conditions/symptoms
  • For suspected side effects hold the medication,
    contact the chain of command, and document
  • Difficulty swallowing, drooling, facial tics,
    twitches, and change in gate may be the first
    sign of a serious side effect
  • Fever is also a possible side effect
  • Call 911 if appropriate
  • Certified staff must directly consult with a LP
    before administering any psychotropic PRN

Recertification Review Guide, Unit 8
94
Anticholinergic
  • Treat muscle movement disorders associated with
    antipsychotic meds
  • Adequate fluid intake is essential, especially in
    hot weather
  • Contact the chain of command if symptoms dont
    improve/get worse

Recertification Review Guide, Unit 8
95
Antidepressant
  • Treat depression
  • Watch for signs of worsening depression or
    thoughts of suicide

Recertification Review Guide, Unit 8
96
Mood stabilizer Lithium
  • Treats mood disorders
  • Encourage adequate fluid intake
  • Routine blood test may be ordered
  • Ibuprofen should not be administered to patients
    treated with Lithium

Recertification Review Guide, Unit 8
97
Mood stabilizer Anticonvulsant
  • Off-labeled use to treat mood disorders
  • Must be given on time as ordered
  • Take as prescribed
  • Routine blood test may be ordered

Recertification Review Guide, Unit 8
98
Anti-anxiety
  • Treats anxiety, tension and nervousness
  • May be controlled medication
  • Med certified staff must directly consult with a
    LP before administering a PRN anti-anxiety
  • Overdose can be fatal

Recertification Review Guide, Unit 8
99
Stimulants ADHD medications
  • Treat attention deficit hyperactivity disorder
  • Usually not administered late in the day
  • Monitor weight and food intake
  • May be controlled medication
  • May delay growth

Recertification Review Guide, Unit 8
100
Hypnotics sleep medication
  • Promotes sleep
  • Offer non-medication interventions first
  • Report insomnia or poor sleeping to the LP

Recertification Review Guide, Unit 8
101
Serious side effects(adverse reactions)
  • Some serious side effects are potentially
    life-threatening or may become permanent.
  • If you notice or the child complains of any of
    these side effects, hold the medication, contact
    your chain of command and document.

Recertification Review Guide, Unit 8
102
Serious side effects (adverse reactions) (Cont.)
  • Fever or complaint of sore throat
  • Drooling or difficulty swallowing
  • Changes in gait (walking)
  • Confusion or increased sedation
  • Muscle stiffness, esp. in the neck or mouth area
  • Eyes rolling back involuntarily
  • Complaint of stomach pain
  • If you notice or the child complains of any of
    these side effects
  • ? hold the
  • medication
  • ? contact your
  • chain of
  • command
  • ? document

Recertification Review Guide, Unit 8
103
Other side effects(Must report to chain of
command)
Sensitivity to sun Apply sunscreen
Sensitivity to heat Encourage increased fluid intake
Constipation Encourage fluids, fiber, exercise
Appetite changes Monitor food intake, encourage healthy food choices
Weight gain Follow nutritional recommendations
Sleep disturbances Allow for relaxing bedtime routine
Dry mouth Encourage fluids to relieve dry mouth
Recertification Review Guide, Unit 8
104
Unit 8 Quiz (click on the link below and print)
  • Medications to treat psychiatric conditions
  • Answers to Medications to treat psychiatric
    conditions

Recertification Review Guide, Unit 8
105
STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
105
Recertification Review Guide, Unit 9
106
Medication Administration Techniques
Unit 9
106
Recertification Review Guide, Unit 9
107
General Information
  • Follow the steps of the Medication Administration
    Procedure every time you administer any
    medication to any child. You must perform the
    Five Rights and the Rule of Three making sure
    that the five rights match on all three documents
  • Thoroughly wash your hands before and after you
    administer medication
  • Use Standard Precautions whenever necessary

107
Recertification Review Guide, Unit 9
108
Standard Precautions(aka Universal Precautions)
  • A set of practices that prevent the spread of
    infection including the use of personal
    protective equipment such as gloves, gowns, masks
    and goggles
  • Frequent hand washing is the best way to prevent
    the spread of infection

108
Recertification Review Guide, Unit 9
109
Forms of oral medication
  • Liquid medications
  • Tablets
  • Capsules
  • Gel caps
  • Chewable tablets
  • Quick dissolving tablets

109
Recertification Review Guide, Unit 9
110
Forms of oral medication (Cont.)
Enteric coated tablets have a special coating so that the tablet will not be absorbed until it reaches the small intestine
Sustained Release tablets designed to be absorbed over a long period of time so that the child may not need to take the medication several times daily
XR, XL, CR, or SR after the medication name indicate a sustained release medication
110
Recertification Review Guide, Unit 9
111
Scored tablets
  • Scored tablets a scored tablet has a groove(s)
    dividing the pill in equal parts (half, third,
    etc.)
  • A groove across the center of the tablet
    indicates that the tablet may be cut exactly in
    half

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General guidelines foradministering oral
medication
  • Ask the child to remove gum, candy or food from
    his mouth before you administer medication to him
  • Always give oral medication with fluids water is
    usually the best choice
  • A mouth check should be done to make sure that
    the child swallowed the medications
  • If you must directly touch a tablet, wear gloves

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Forms of oral medicationsthat should not be
crushed
  • Enteric coated tablets
  • Sustained release tablet
  • Gel caps
  • Other liquid filled capsules

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How to crush a tablet
  • Use a clean, dry mortar and pestle, a pill
    crusher or place the tablet between the bowls of
    two spoons
  • Wrap the tablet in waxed paper or in a paper med
    cup to prevent the crushed medication from
    spilling
  • Mix the crushed medication with a small amount of
    food (applesauce, yogurt, pudding, etc.) Use no
    more than a tablespoon or two to mix with the
    medication
  • Offer glass of water after administering the
    medication

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Liquids
  • Liquid medications are often prescribed for young
    children or for children who cannot swallow pills
  • Any dose of medication that is less than 5cc/ml
    must be measured in an oral syringe or calibrated
    dropper

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Measuring liquid medications
  • The medication cup must be placed on a flat
    surface at eye level
  • While pouring medication from the bottle hold the
    label facing upward to avoid spilling the
    medication onto the label

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Technique foradministering oral medications
  1. Follow the medication administration procedure
  2. Pour the accurate dose place the prescribed
    number of pills or pour the correct amount of
    liquid into a medication cup
  3. Administer the medication to the client with
    water or juice
  4. After administering the medication, perform a
    mouth check to ensure that the child swallowed
    the medication

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Eye medications
  • Wash hands and wear gloves when administering eye
    medication
  • Ask the child the following questions
  • Does the eye feel worse?
  • Does the eye hurt?
  • If the child answers yes to either of these
    questions
  • Hold the medication
  • Contact the chain of command
  • Document and follow instructions

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Eye medications (Cont.)
  1. After administering an eye medication, have the
    child remain in a safe environment until
    medication is completely absorbed and the
    clients vision is cleared
  2. Never bandage an eye unless there is a specific
    order to do so

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How to clean an infected eye
  • Wash hands and wear gloves
  • Moisten a washcloth, gauze, or cotton ball with
    warm water
  • Wipe the infected eye gently from the inner to
    outer corner
  • To prevent spreading the infection, never use the
    same area of the washcloth for more than one wipe
    AND use separate washcloth for each eye
  • Remove your gloves and wash hands when the eye is
    clean
  • Put on clean gloves before handling the medication

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Technique foradministering eye ointment
  1. Follow the DCF Med Admin procedure
  2. Prepare medication correctly place the cover of
    the medication on its side to avoid
    contamination. Warm the medication to room
    temperature.
  3. Clean the childs eye if necessary
  4. Wear gloves. Squeeze a small amount of medication
    out of the tube onto a tissue before
    administering
  5. Have the child tilt his head slightly backward,
    resting it against a hard surface if possible.
    Ask the child to look up and away

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Technique foradministering eye ointment (Cont.)
  1. Do not touch the eye with the medication
    container
  2. Gently pull down the lower eyelid using the side
    of a finger. Beginning at the inner corner of
    the eye, place a thin ribbon of medication into
    the lower lid
  3. Instruct the child to close his eyes for 1-2
    minutes so the medication may be absorbed
  4. Gently wipe away any excess medication that may
    have dripped out of the eye.

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Technique foradministering eye drops
  1. Follow the DCF Med Admin procedure
  2. Have tissues available place the cover of the
    medication on its side to avoid contamination.
    Warm the medication to room temperature.
  3. Clean the childs eye if necessary

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Technique foradministering eye drops
  1. Wear gloves. Have the child tilt his head
    slightly backward, resting against a hard surface
    if possible. Ask the child to look up and away.
  2. Do not touch the medication dropper to the eye or
    eyelashes
  3. Gently pull down the lower eyelid using the side
    of your finger. Form a small pocket and place
    the prescribed number of drops into pocket.

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Technique foradministering ear drops
  1. Follow the DCF Med Admin procedure
  2. Wash hands and wear gloves
  3. Remove the cover and place on its side to avoid
    contamination warm the medication to room
    temperature
  4. Position the child with the ear to be treated
    upward

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Technique foradministering ear drops (Cont.)
  • Straighten the ear canal by the following
    methods
  • 3 years old or younger gently pull ear lobe
    down and back
  • Over 3 years old gently pull upper part of the
    ear up and back
  • Place the prescribed number of drops against the
    side of the ear near the ear canal opening to
    allow the medication to roll in
  • Have the child remain with affected ear upward
    for 3-5 minutes

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Technique foradministering nasal spray
  1. Follow the DCF Med Admin procedure
  2. Have the child gently blow his nose. Have
    tissues available.
  3. Wear gloves. While plugging one nostril, place
    the tip of the sprayer 1cm (3/8 inch) into the
    other nostril
  4. Ask the child to breathe in through his nose as
    the spray is administered
  5. Have the child exhale through his mouth after the
    spray is administered, repeat the procedure if
    prescribed
  6. Discourage him from blowing his nose for 5 minutes

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Types of inhaler devices
Metered Dose Inhaler (MDI) use chemical propellants to push out the medication from the inhaler. A spacer or aero-chamber may be prescribed to use with the MDI to make proper use easier and the medication more effective.
Dry powder or Rotary Inhalers (Turbuhaler, Discus) dry powder inhalers are activated through breathing they release the medication through rapid inhalation instead of using propellants
Nebulizers convert liquid medication into a fine mist and deliver the mist through a face mask or mouth piece that is connected to the nebulizer machine with plastic tubing. Your program nurse should teach you the correct way to use a particular childs nebulizer before you use it.
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Administeringtopical medication
  1. Allow for client privacy
  2. Clean the skin if necessary per LPs directions
  3. Wear disposable gloves
  4. The skin should be dry prior to applying topical
    medication
  5. Apply enough medication to cover the area to be
    treated, unless otherwise directed

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Administeringtopical medication
  1. Except for powders, never apply a topical
    medication directly from the container onto the
    skin. Place a small amount of medication onto
    clean gauze then apply to the skin. This
    prevents contamination of the medication
    container.
  2. Observe the client for any rashes that are new or
    that get worse

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The correct method for applying and removing
transdermal medication patches
  • Gloves should be worn to apply or remove
    transdermal patches
  • The patch should be applied to clean, intact, dry
    skin that is not infected, scarred, callused or
    tattooed
  • Wash the skin with soap and water both where the
    new patch will be placed and where the old patch
    was removed
  • Remove the old patch before applying the new one.
    Check the skin under the patch for redness or
    rash

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The correct method for applying and removing
transdermal medication patches (Cont.)
  • Change application sites to avoid skin irritation
  • Peel backing off the patch, press onto the skin
    and apply pressure to assure that it sticks to
    the skin
  • Document in the childs record the site where you
    applied the patch (for example 6/18/2010, upper
    right arm)
  • Read package instructions for any further
    information

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The role of DCF Med Admin certified staff in
administering rectal and vaginal medication
  • Do not directly administer to any child
  • DCF Med Admin certified personnel are not trained
    nor certified to administer any rectal or vaginal
    medications
  • The children who have these types of medication
    ordered must be able to self administer the
    medication or have a nurse available to
    administer the medication

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The role of DCF Med Admin certified staff in
administering rectal and vaginal medication
(Cont.)
  • Medication certified staff may provide the child
    with instructions on self administration. This
    information may be found on the package
    information.
  • Review of instructions may be done by a staff
    member of the same sex as the child and in the
    presence of another staff member as witness.
    This review should be documented.

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Unit 9 Quiz
1. True or False After administering oral medication you must always perform a mouth check.

2. True or False Hand washing is the most effective way of preventing the spread of infection.

3. True or False To administer ear drops to a 2year old child you straighten the ear canal by gently pulling the ear lobe down and back.
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Answers to Unit 9 Quiz
1. True or False After administering oral medication you must always perform a mouth check.
1. True

2. True or False Hand washing is the most effective way of preventing the spread of infection.
2. True

3. True or False To administer ear drops to a 2year old child you straighten the ear canal by gently pulling the ear lobe down and back.
3. True
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STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
137
Recertification Review Guide, Unit 10
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Unit 10
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Regulations re safeguarding the medications and
the medication storage keys
  • The medication storage keys must be carried by
    the medication certified staff person or licensed
    medical person on duty

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Storage requirement fornon-controlled medications
  • Non-controlled medications must be stored in a
    locked, immobile container that is accessible
    only to med certified or licensed medical staff

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Storage requirement forcontrolled medications
  • Controlled medications must be stored in a
    locked, immobile container that is inside another
    locked, immobile container accessible only to
    medication certified staff or licensed medical
    staff

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Controlled medication count
  • Must be performed at the change of shift or
    whenever the responsibility for the medications
    changes

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IncorrectControlled medication count
1
If the controlled medication count is
wrong (there is a discrepancy)
Contact your chain of command
2
Complete an incident report
3
Forward the incident report to the Dept. of
Consumer Protection Drug Control Division and to
DCF
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Refrigerated medications
  • The medication refrigerator must be kept at 36 -
    46F. Medications stored in the refrigerator
    must be accessible only to med certified or
    licensed medical staff

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Storage of external, internal and emergency
medications
  • Internal medications and external (topical)
    medications must be stored separately from each
    other
  • Emergency medications (Epi-pens and rescue asthma
    inhalers) must be stored where all trained staff
    may have easy access to them. They should not be
    locked with other medications.

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Guidelines for destroying non-controlled and
controlled medications
  • 2 DCF med certified staff may destroy
    non-controlled medications
  • Contact Drug Control Division of Consumer
    Protection if controlled medications need to be
    destroyed
  • Follow your facilitys policy and procedure for
    destroying medications

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Unit 10 Quiz
1. Who may legally dispense medication? Who may legally dispense medication?
a) licensed practitioners, RNs, med admin certified staff
b) pharmacists, licensed practitioners, RNs
c) pharmacists, licensed practitioners
d) pharmacists, med admin certified staff

2. True or False The controlled medication count must be performed at the change of shift or whenever the responsibility for the medications changes True or False The controlled medication count must be performed at the change of shift or whenever the responsibility for the medications changes

3. True or False 2 DCF med certified staff may destroy non-controlled medications True or False 2 DCF med certified staff may destroy non-controlled medications
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Answers to Unit 10 Quiz
1. Who may legally dispense medication?
1. c) pharmacists, licensed practitioners

2. True or False The controlled medication count must be performed at the change of shift or whenever the responsibility for the medications changes
2. True

3. True or False 2 DCF med certified staff may destroy non-controlled medications
3. True
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STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
149
Recertification Review Guide, Unit 11
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Unit 11
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Types of medication errors
  • Error in communication
  • Error in documentation
  • Error in storage and control
  • Error in ordering or dispensing medications
  • Error in administration

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Steps to take if an error occurs
  1. Check on the child and follow your facilitys
    policy and procedures
  2. Inform your supervisor and chain of command and
    follow any directions
  3. Document the error use objective description

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Documenting a medication error
  • Note the childs name, medication, the date and
    time, staff involved
  • Write an objective description of the error what
    happened, action taken, and status of the child
  • Documentation must be completed before the end of
    the shift by the person who made or discover the
    error
  • Follow facility policy and procedure on
    submitting required documentation to DCF Risk
    Management

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Reporting medication error that leadsto the
child needing medical attention
In addition to the documentation already discusse
d
  1. Notify childs guardian, social worker
  2. Call DCF Careline if after hours
  3. Send copy of incident report to the DCF Medical
    Director within one business day

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When to contact the Dept. of Consumer Protection
Drug Control Division
  • When controlled medications appear to be missing
  • If controlled medications need to be destroyed

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Unit 11 Quiz
1. True or False Documenting a medication error must be completed before the end of the shift by the person who made or discover the error

2. Who must be contacted when controlled medication appears to be missing or needs to be destroyed?
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Answers to Unit 11 Quiz
1. True or False Documenting a medication error must be completed before the end of the shift by the person who made or discover the error
1. True

2. Who must be contacted when controlled medication appears to be missing or needs to be destroyed?
2. The Department of Consumer Protection, Drug Control Division
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STATE OF CONNECTICUT Department of Children
and Families Medication Administration
Certification Training Based on the Basic
Medication Administration Curriculum 2010 Edition
Recertification
Review Guide
158
Recertification Review Guide, Unit 12
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Unit 12
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A LPs ordershould be questioned when
  • You do not understand the order
  • Unusual quantities or doses are prescribed
  • The medication is ordered to be given at unusual
    times

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Medication should not be administered when
  • You have a question about the order
  • A child has a sudden change in physical or mental
    state
  • The pharmacy label is illegible
  • The child refuses to take medication
  • Any of the five rights is violated
  • If there is no LPs order or you cannot perform
    the Rule of Three
  • If storage practices are questionable
  • Medication looks unfamiliar to you or the child

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Steps to take whenquestioning an order or a
medication
  • Do not administer the medication (hold the
    medication)
  • Contact the chain of command and follow
    directions
  • Document contacts and directions
  • Follow up on directions

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Why borrowing medicationis not permitted
  • Med admin certification permits you to administer
    medications only when the Five Rights match on
    the order, pharmacy label and MAR.
  • If you are borrowing on childs medication for
    another child, the Five Rights will not match on
    all three documents.

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Criteria for administering medicationat the
right time
  • Medications may be administered one hour before
    until one hour after the scheduled administration
    time unless the LP has ordered the medication to
    be given at a specific time.

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Dispensing
  • The act of placing a medication into a container,
    labeling the container and giving the container
    for someone else to administer
  • Medication certified staff may not dispense
  • Only LPs and pharmacists may dispense medications

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Unit 12 Quiz
1. When would you not administer a medication? When would you not administer a medication?
a) if there is no change in status of the client
b) if the client refuses
c) if the medication is stored in a locked and immobile container
d) if the licensed practitioner's order is present
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Answers to Unit 12 Quiz
1. When would you not administer a medication?
1. b) if the client refuses
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