Search Ebook here:


Mosby’s Pharmacology Memory NoteCards: Visual, Mnemonic



Mosby’s Pharmacology Memory NoteCards: Visual, Mnemonic PDF

Author: JoAnn Zerwekh EdD RN

Publisher: Mosby

Genres:

Publish Date: June 1, 2018

ISBN-10: 0323549519

Pages: 224

File Type: PDF

Language: English

read download

Book Preface

Medication Administration Six Rights of Medication Administration
• Medication • Patient • Route • Dosage • Time • Documentation Routes of Administration
• Enteral or oral (most common)—ingested into gastrointestinal tract • Parenteral—injected into blood or body tissues (intravenous [IV], intramuscular [IM], subcutaneous [SC]) • Topical (transdermal)—absorbed across skin or mucous membrane • Inhalation—inhaled directly into lung to elicit local effects • Rectal and vaginal suppository—inserted for local effects Nursing Implications
1. Only administer medications you have prepared. 2. Read medication label carefully; not all formulations of parenteral medications are appropriate for IV administration (e.g., insulin for IV use). 3. Know your medications. • Why is this patient receiving this medication? • What nursing observations will tell you the desired medication action is occurring? • What are the nursing implications specific to this medication? 4. Do not leave medications at the bedside. 5. Check medication compatibility if administering IV. 6. Medications prepared for one route may differ in concentration for another different route (e.g., epinephrine SC is concentrated, whereas IV preparation is dilute). • Administering a SC epinephrine preparation IV could be fatal because of an overstimulation of the cardiac system. 7. Use at least two identifiers to determine the correct patient before administering any type of medication (e.g., armband with barcode and date of birth). 8. Have another nurse check medication calculations. 9. IM injections: • Do not inject more than 3 mL at one time. • Use the smallest gauge needle necessary to administer medication correctly.

Medication Calculation Methods of Calculation
• Drugs requiring individualized dosing can be calculated by body weight (BW) or body surface area (BSA). • BW and BSA methods are useful when calculating pediatric medications and antineoplastic medications, as well as for patients with low BW, patients who are obese, or older adults. • Before calculating a dose, all units of measurement should be converted to a single system, preferably what is on the drug label. For example: If the medication is supplied in milligrams (mg) and the drug is ordered in grams (g), then convert the g to mg. Nursing Implications
1. Always have another registered nurse (RN) double-check medications when you have to calculate the dosage. 2. Consult the health care provider if the dosage is outside the recommended range. 3. Do not administer medications if someone else has calculated the dose for you; administer only those medications you have calculated and prepared. 4. Be very cautious about calculating drug dosages for pediatric patients. 5. Even when an intravenous (IV) pump for the patient is in place, you still need to know how many milliliters per hour the IV should be infusing. This infusion rate is important to know to set the pump and to check the accuracy of delivery. 6. The West Nomogram uses a child’s height and weight to determine the BSA. The BSA formula is used to determine the medication dosage for a specific pediatric patient.

Medication Safety National Patient Safety Goals
• Identify patients correctly using two identifiers, such as the patient’s armband and date of birth. • Provide important test results to the right person on time. • Before a procedure, label medications that are not labeled (e.g., medication in syringes), and do this in the area where the medication is set up. • Use handoff communication techniques to pass along correct information about a patient’s medication. • Review new medications with current medications and be sure patient understands. • Have patient bring an up-to-date list of medications every time there is a visit to the health care provider. Reduce Medication Errors
• Use Medication Guides (MedGuides), which are approved by the U.S. Federal Drug Administration (FDA) and created to educate patients about how to minimize harm from potentially dangerous drugs. • Review all black box warnings before administering medication. • The Institute of Medicine (IOM) identifies three categories of fatal medication errors: human factors (e.g., administering a drug IV instead of IM), communication mistakes (e.g., illegible handwriting of an order), and name confusion (e.g., medications that sound like or look like another medication). Nursing Implications
1. All high-alert medications should have a safety checklist. 2. Replace handwritten medication orders with a computerized order entry system (CPOE). 3. Ensure that a clinical pharmacist accompanies ICU physicians on rounds. 4. Avoid using error-prone abbreviations; see “Do Not Use List” from the Joint Commission. 5. Conduct a medication reconciliation by comparing what medications the patient is currently taking with a list of new medications being prescribed. 6. Use a computerized bar-code system that matches the patient’s armband bar code to a drug bar code. 7. Administer only medications that you prepare. 8. Have two nurses sign off on high-risk medications (e.g., epinephrine, insulin, chemotherapy).

Ear Drop Administration Procedure
• Position patient supine on his or her side with affected ear up. • Medication should be at least room temperature, not cold. • Open ear canal of an adult by drawing back on the pinna and slightly upward. • Open ear canal of a child less than 3 years of age by drawing back on the pinna and slightly downward. • Allow the prescribed number of drops to fall along the inside of the ear and flow into the ear by gravity. Do not attempt to put the drops directly on the eardrum. • Have patient remain supine for a few minutes to keep the medication from leaking out. Uses
• Treat ear infections • Dissolve earwax (cerumen) • Decrease pain Nursing Implications
1. If medication is not instilled at room temperature, the patient may experience vertigo, dizziness, pain, and nausea. 2. If ear drainage is observed, assess patient and determine whether the eardrum is ruptured. If ruptured, do not administer medication until health care provider is consulted. 3. Do not occlude ear canal with dropper or syringe. 4. Never force medication into an occluded ear canal; doing so creates pressure, which could damage or rupture the eardrum


Download Ebook Read Now File Type Upload Date
Download here Read Now PDF July 18, 2020

How to Read and Open File Type for PC ?