Administering of Medications/Drugs Objectives: 1. Describe how medications are stored and supplied in healthcare facilities. •Most healthcare facilities have a “med room” or separate area for medications. •The facility may store medications in locked movable carts that allow nurses to prepare medications in close proximity to client’s room. •Some medications require refrigeration to preserve their chemical properties. •Most acute care facilities use some sort of computerized dispensing machine. In long term care facility, a locked medication cabinet may be within the client’s room or directly outside of it. •All narcotics and other controlled substances are kept double locked. 2. Discuss the importance of documenting medication administration in the medication administration record, the computerized record, or the client’s chart. •Documentation is an important part of medication administration. Actions not documented are considered not to have been done. Proper documentation communicates to other members of the healthcare team which medications were administered and when. . Differentiate between STAT, PRN, and HS medications. •STAT means that medication must be administered immediately while PRN means as needed or on request. Medication is an important nursing responsibility that often is learned with experience. HS or Hours of Sleep (Bedtime) Doses or commonly known as sleeping pills. 4. Discuss the importance of the “Five Rights” of medication administration, including steps to observe before administering medications. •Right Client- Ensure that the correct medication is given to the correct client.
Direct total attention to giving medications -Check two safety: Always check at least two forms of identification before giving any medications. •Right Medication- Compare and Confirm the medication’s name and dosage with client’s MAR at least three times before administering it. -First Check: Removing the medication from the storage area. -Second Check: Placing it in the medication cup or envelope. -Third Check: Opening the medication unit-dose package at the client’s bedside. •Right Dose- Double check that the amount of medication supplied matches the amount needed for ordered dose. Make sure to calculate a dose if supplied medication is not exactly the same amount as the ordered dose. -Verify that the dose ordered is appropriate for the client. •Right Time- Administer all medications at the time for which they are ordered. -Administer medications as ordered is important to maintain the medication’s therapeutic effects. Deviation from the “time window” is a medication error. •Right Route- Check the physician’s orders and the MAR to verify the route by which the medication id to be given -Remember the three checks.
Administering a medication by the wrong route, even though it is the correct medication, could be fatal. 5. Differentiate between desired and undesired effects and local and systematic medication effects. Desired and undesired effects- The effects of medications in the body. It can be both desire and undesired effect. These include: Therapeutic effect: This medication’s desired effect, meaning that the medication produces the result for which it was given.
Adverse effect: This is not intended or desired. Some adverse effects are minor (called side effects). Constipation is an example of side effects Serious adverse effect: Some side effects, such as respiratory depression or neurologic damage, are potentially fatal. Anaphylaxis: The medication causes client to experience a severe, immediately life-threatening, allergic reaction.
Medication toxicity: also an undesired, harmful effect that results from increased blood level of medication beyond its therapeutic level. Paradoximal effect: The client’s response is opposite to that which is desired. Potentiation: Two drugs may potentiate each other. That is, the effects of the two medications are greater than the effects of two should be when added together.
Potentiation multiplies the effect of the drugs. This can be a very dangerous situation. •Local Effects: Topical application (applied directly to the skin or mucous membranes) can cause a local effect. Anti-inflammatory creams and lotions and medications to relieve itching are examples of medications used for their local effects. These may be applied to the mucous membranes of the eye, mouth, nose, throat, vagina, or rectum by instillation, irrigation, swabbing, or spraying.
The advantage of local medications is that their affects are limited to the area of application, thus reducing the possibility of undesired systemic reactions. •Systemic Effects: Medication can be administered in a number of ways to achieve systemic effects. These are drugs that the body absorbs into the general circulation (ie, the blood and lymphatic fluids) and then transports to a specific body area or to the entire body. To achieve systemic effects, medications often are administered by transdermal application, mouth, or injection, although other methods, such as nasal inhalation, can also produce systemic effects. 6.
Explain what is meant by enteral and parenteral administration. •Enteral: Indicates the medication administration by way of the digestive tract. This route includes administration orally, bucally (inside the cheek), and via gastrointestinal tubes. •Parenteral: Means medication administration into any part of the body other than by way of the gastrointestinal tract. This route includes medications administered via vagina, eye, ear, nose and respiratory tract, skin, and by injection. Intramuscular (IM), Intradermal (ID), and Intravenous (IV) methods of administration are examples of parenteral administration by injection.