0

 Generic
 Universal name based on chemical ingredients
 Name starts with a small letter-is longer in length & is
more...

 Body system
 Therapeutic use or clinical indication
 Physiological or chemical action
 Prescription or non-prescrip...

 Drugs act in the human body in the following ways:
 Change physiological activity within the body
 Drugs form a chem...

Factors that affect drug
absorption
 Absorption
 Age and weight of consumer
 Dry or wrinkled skin
 Decreased number ...

Cont….
 Distribution
 Amount of body water
 Decreased levels of plasma proteins
 Metabolism
 Decreased liver functi...

 Is the process by which a drug is transferred from its
site of body entry to circulating body fluids for
distribution....

 Give oral drugs with enough fluid
 Reconstitute and dilute drugs as recommended by
the manufacturer
 Give drugs into...

 Enteral (oral, rectal, or naso-gastric)
 Parenteral (bypass GI tract)
 Subcutaneous
 Intramuscular
 Intravenous
 ...

 Refers to the ways drugs are transported by
circulating body fluids to the sites of action.
 Once absorbed into the b...

 Is the process by which the body in-activates drugs.
 The liver is the primary site for drug metabolism.
Metabolism

 Is the elimination of a drug from the body.
 Urine and feces are the primary routes of excretion.
Excretion

 No drug has a single action.
 When a drug is absorbed and distributed, the
desired action (expected response) usually...

 An unintended reaction to a drug given in a normal
dosage.
 Nausea
 Dry mouth
 Dizziness
 Blurred vision
 Ringing...

 Unintended effect on the body from using a legal
drug, illegal drug, or two or more drugs.
 Rash, itching, high blood...

 Is an unfavorable response to a substance that causes a
hyper-sensitivity reaction.
 Most common reaction is
 Uticar...

 Is something unusual or abnormal that happens
when a drug is first given.
 Can be considered an over –reaction to a d...

 Age
 Body weight
 Metabolic rate
 Illness
 Willingness to take drugs
 Placebo effect
 Tolerance
 Dependence
 C...

 Occurs when the action of one drug is altered by the
action of another drug
 Increase the action of the other (potent...

 American Hospital Formulary Service Drug
Information
 Drug Interaction Facts
 Drug Facts and Comparison
 Handbook o...

 Classification
 Brand Name
 Generic Name
 Therapeutic Use
 Dose
 Side Effects
 Anything unusual
 Any Nsg. Preca...

 Physician
 Physician’s assistant/ nurse practitioner
 Pharmacist
 Director of nurses
 Supervisory nurse
 Medicati...

 Person’s full name
 Date
 Drug name
 Route of administration
 Dose
 Frequency of use
 Duration of order
 Doctor...

 STAT order
 Single order
 Standing order
 PRN order
 Ordering methods
 Written order
 Verbal order
 Telephone o...

 All have to be approved by
 Joint Commission
 Institute for safe Medication Practice
 Facility
Commonly used
Abbrev...

 Weights
 Metric system (microgram, milligram, centigram,
gram, kilogram)
 Apothecary system (grain, seldom used)
 H...

 Addiction
 Adverse reaction
 Allergic reaction
 Anaphylactic shock
 Antagonist
 Contraindication
 Cumulative eff...

 Placebo
 Potentiate
 Side effect
 Therapeutic effect, desired effect
 Tolerance
 Toxic effect
Cont…
 Person’s name, address, phone number
 Pharmacy’s name, address, phone number
 Prescription number
 Date prescription...
 Person’s name, room number, identifying information
 Admission form
 Health history
 Physical examination results
 ...

 Respiratory therapy record
 Consultation reports
 Surgery & anesthesia reports
 Assessments/reports from social ser...

 Medication administration record (MAR)
 Scheduled medications
 Parental medications
 STAT medications
 Pre-operati...

 Summarizes information in medical record
 Quick, easy source of information
 Updated regularly (usually in pencil)
...

 Nurse verifies and transcribes order
 Nurse decides is drug safe to give
 Nurse contacts physician if order deemed u...

 Report
 Person’s name, room number
 Time of observation
 Only what observed or did
 Changes from normal
 Record
...

Four drug distribution
systems
 Floor or ward stock system
 Frequently used
 Avoids waiting or lag time
 Pros and co...

Cont…
 Computer-controlled dispensing system
 Pharmacy stocks drug cart for patients/residents on unit
 Accessed by s...

Cont…
 Computer-controlled dispensing system
 Pharmacy stocks drug cart for patients/residents on unit
 Accessed by s...

 Inventoried at the end of each shift
 Must be counted by 2 qualified individuals
 If the count is not correct- MUST ...

Drug storage
 Drug cart (locked) as is the room that they’re stored in
 Drugs stored in original container or unit dos...

Disposal of drugs
 Disposed of because
 Person refuses to take drug
 Drug dropped on the floor or bed
 You are to gi...

Six rights
 Right drug
 Read the label before removing from unit dose cart or shelf
 Read label before preparing or m...

Six rights cont…
 Right dose
 Compare dose on label to MAR
 Use appropriate measuring devise
 Report nausea & vomiti...

Six rights cont…
 Right route
 Drug order gives route
 Never change route
 Only give as allowed to give by prescribe...

Drug errors
 Prescribing errors
 Wrong drug for person’s diagnosis
 Drug person allergic to
 Wrong dose for person’s...

Drug errors cont….
 Dispensing
 Sending wrong drug or dose to facility
 Using wrong formulation
 Using wrong dosage ...

Safety rules for drug
administration
 Follow the six rights of drug administration
 Store drugs properly
 Have good l...

Cont…
 Never leave a drug in person’s room to take later
 Never leave a drug unattended
 Refer questions about person...

 Infection is a disease state resulting from the
invasion and growth of microbes (pathogens)
 Bacteria & viruses
 Med...

 Guidelines set by the CDC
 Prevent the transmission of infectious agents
 Blood borne Pathogen Standard
Isolation Pr...

 Hand hygiene
 Gloves
 Gowns
 Masks
Standard Precautions
Day 2 Medication Aide
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Day 2 Medication Aide

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  • Chapter 6, p. 73
  • Chapter 6, p. 74
  • Chapter 7, p. 79-84
  • Chapter 6, p. 74
  • A drug must be dissolved in body fluids before it can be absorbed into body tissues.
  • Blood sample may be studied to determine the amount of a drug present in the blood. This is known as a drug blood level.
  • Chapter 6, p. 75
  • Chapter 6, p. 76
  • Chapter 6, p. 77
  • Chapter 8, p. 87-88
  • Chapter 8, p. 87
  • Chapter 8, p. 89-92
  • Chapter 8, p. 92-93 Administration times -
  • Chapter 6, p. 75-76
  • Chapter 8, p. 94
  • Chapter 8, p. 101
  • Chapter 8, p. 101
  • Chapter 4, p. 50-51
  • Chapter 9, p. 108
  • Chapter 9, p. 109
  • Chapter 9, p. 110- 112
  • Chapter 9, p. 112
  • Chapter 9, p. 112
  • Chapter 9, p. 113
  • Chapter 9, p. 113-116
  • Chapter 9, p. 117
  • Transcript of "Day 2 Medication Aide"

    1. 1.   Generic  Universal name based on chemical ingredients  Name starts with a small letter-is longer in length & is more difficult to pronounce  Trade Name  Name is given by Co. that develops it  Name starts with a capitol letter-is shorter in length & is easier to pronounce Drug Names
    2. 2.   Body system  Therapeutic use or clinical indication  Physiological or chemical action  Prescription or non-prescription  Illegal drugs Drug Classification
    3. 3.   Drugs act in the human body in the following ways:  Change physiological activity within the body  Drugs form a chemical bond within specific sites  Drugs that interact with a receptor to cause a response are agonists  Drugs that attach to a receptor but do not cause a response are antagonists  Drugs that interact with a receptor to cause a response but prevent other responses are partial agonists  Once given, all drugs go through stages  Absorption, distribution, metabolism, and excretion Basic Principles
    4. 4.  Factors that affect drug absorption  Absorption  Age and weight of consumer  Dry or wrinkled skin  Decreased number of hair follicles  Condition of consumer i.e. decreased cardiac output, pain, fever  Inability to chew tablets for chewable drugs  Less saliva production  GI absorption affected by disease processes, presence of other drugs
    5. 5.  Cont….  Distribution  Amount of body water  Decreased levels of plasma proteins  Metabolism  Decreased liver function  Genetics, smoking, diet, gender, liver disease, other drugs  Excretion  Decreased kidney function
    6. 6.   Is the process by which a drug is transferred from its site of body entry to circulating body fluids for distribution. The rate depends on:  The route  Blood flow through the tissue where the drugs was given  How well the drug can dissolve Absorption
    7. 7.   Give oral drugs with enough fluid  Reconstitute and dilute drugs as recommended by the manufacturer  Give drugs into the correct tissue To promote absorption
    8. 8.   Enteral (oral, rectal, or naso-gastric)  Parenteral (bypass GI tract)  Subcutaneous  Intramuscular  Intravenous  percutaneous Drugs are given
    9. 9.   Refers to the ways drugs are transported by circulating body fluids to the sites of action.  Once absorbed into the blood, a drug’s distribution is determined by:  Chemical properties  How it is affected by the blood and tissues it contacts Distribution
    10. 10.   Is the process by which the body in-activates drugs.  The liver is the primary site for drug metabolism. Metabolism
    11. 11.   Is the elimination of a drug from the body.  Urine and feces are the primary routes of excretion. Excretion
    12. 12.   No drug has a single action.  When a drug is absorbed and distributed, the desired action (expected response) usually occurs.  All drugs can affect more than one body system, therefore side effects and adverse drug reactions can occur. Drug Action
    13. 13.   An unintended reaction to a drug given in a normal dosage.  Nausea  Dry mouth  Dizziness  Blurred vision  Ringing in ears Side effects
    14. 14.   Unintended effect on the body from using a legal drug, illegal drug, or two or more drugs.  Rash, itching, high blood sugar (hyperglycemia) and a reduced number of platelets (thrombocytopenia) are common ADRs. Drug reactions/adverse drug reaction
    15. 15.   Is an unfavorable response to a substance that causes a hyper-sensitivity reaction.  Most common reaction is  Uticaria (hives)  Most severe reaction is  Anaphylaxis  Severe, life threatening.  Sweating, SOB, hypotension, irregular pulse, respiratory distress, and swelling of larynx  First exposure- mild reaction  Second exposure- severe reaction Allergic reaction
    16. 16.   Is something unusual or abnormal that happens when a drug is first given.  Can be considered an over –reaction to a drug  Related to the body’s inability to metabolize the drug Idiosyncratic Reaction
    17. 17.   Age  Body weight  Metabolic rate  Illness  Willingness to take drugs  Placebo effect  Tolerance  Dependence  Cumulative effect Factors Influencing Drug Action
    18. 18.   Occurs when the action of one drug is altered by the action of another drug  Increase the action of the other (potentiation)  Decrease the action of the other (antagonist) Drug Interactions
    19. 19.   American Hospital Formulary Service Drug Information  Drug Interaction Facts  Drug Facts and Comparison  Handbook of Nonprescription Drugs  Natural Medicines Comprehensive Database  Physician’s Desk Reference  Package Inserts  Drugs.com Drug Information
    20. 20.   Classification  Brand Name  Generic Name  Therapeutic Use  Dose  Side Effects  Anything unusual  Any Nsg. Precautions Drug Activity
    21. 21.   Physician  Physician’s assistant/ nurse practitioner  Pharmacist  Director of nurses  Supervisory nurse  Medication aide Health Professionals
    22. 22.   Person’s full name  Date  Drug name  Route of administration  Dose  Frequency of use  Duration of order  Doctor’s (prescriber’s) signature Drug order
    23. 23.   STAT order  Single order  Standing order  PRN order  Ordering methods  Written order  Verbal order  Telephone order  Faxed order  Electronic order Drug orders
    24. 24.   All have to be approved by  Joint Commission  Institute for safe Medication Practice  Facility Commonly used Abbreviations
    25. 25.   Weights  Metric system (microgram, milligram, centigram, gram, kilogram)  Apothecary system (grain, seldom used)  Household system (pound)  Volume  Metric (milliliter, centiliter, deciliter, liter)  Apothecary (minim)  Household system (tablespoon, teaspoon, cup, ounce) Measurements in drug orders
    26. 26.   Addiction  Adverse reaction  Allergic reaction  Anaphylactic shock  Antagonist  Contraindication  Cumulative effect  Drug abuse  Habituation  Idiosyncrasy  Initial dose  Maintenance dose  Nursing precautions, interventions Terms for describing drug interactions
    27. 27.   Placebo  Potentiate  Side effect  Therapeutic effect, desired effect  Tolerance  Toxic effect Cont…
    28. 28.  Person’s name, address, phone number  Pharmacy’s name, address, phone number  Prescription number  Date prescription filled  Original date of prescription  Doctor’s name  Brand name of drug  Generic name of drug  Manufacture’s name  Drug dosage  Amount in container  How often to take  Warnings  Number of refills allowed  Expiration date or when to discard Information on the label
    29. 29.  Person’s name, room number, identifying information  Admission form  Health history  Physical examination results  Doctor’s order form  Doctor’s progress notes  Nursing team progress notes (describes care given, person’s response & progress)  Graphic sheet (records, measurements/observations made daily, every shift, or 3 or 4 times a day  Flow sheet  Laboratory & x-ray reports  IV therapy record Medical record
    30. 30.   Respiratory therapy record  Consultation reports  Surgery & anesthesia reports  Assessments/reports from social services, dietary service, and physical, occupational, speech and recreational therapy  Consent forms  PRN/unscheduled medication record Continue
    31. 31.   Medication administration record (MAR)  Scheduled medications  Parental medications  STAT medications  Pre-operative medications  PRN medications (date, time, drug given, dose given, route, reason for giving, person’s response)  Time drug given and by whom Cont….
    32. 32.   Summarizes information in medical record  Quick, easy source of information  Updated regularly (usually in pencil)  Not formal, legal part of medical record  Destroyed when person leaves facility Purpose of a Kardex
    33. 33.   Nurse verifies and transcribes order  Nurse decides is drug safe to give  Nurse contacts physician if order deemed unsafe, physician may cancel or rewrite order  Transcribe (copied)  Copied to Kardex and MAR (secretary may copy)  Nurse signs, dates, times transcription on original order  Nurse sends order to pharmacy to fill  Order may  New drug  Discontinued drug  Change an order  STAT or one-time-only order Transcribing drugs orders
    34. 34.   Report  Person’s name, room number  Time of observation  Only what observed or did  Changes from normal  Record  What observed  What you did  Person’s response  Record administration of medication as soon as given  Sign per facility policy, date & time medication given  Report medications refused, not given; not of medication record; discard drug  Record PRN medication immediately with reason given and results  Report unusual reaction How to accurately report and record
    35. 35.  Four drug distribution systems  Floor or ward stock system  Frequently used  Avoids waiting or lag time  Pros and cons  Individual prescription order system  3-5 day ordered drug  Stored in patient bin  Safe system  Pharmacist/nurse review order before drug given  Pharmacy monitors drug expiration date  Fewer drugs for drug diversion (taking person’s drug for your own use)  STAT, PRN drugs available
    36. 36.  Cont…  Computer-controlled dispensing system  Pharmacy stocks drug cart for patients/residents on unit  Accessed by security code/password  Drug bar coded, patient ID bracelet also bar coded  Patient’s ID scanned and drug scanned (provides check of correct drug and automatically documents drug administration)  Unit dose system  Single-unit dose package dispensed for each dose ordered  24 hour supply (refilled every day) in nursing centers may be for week or month at a time  Safe, cost, and time efficient  Reduces risk of drug diversion  May be color coded for different times of day
    37. 37.  Cont…  Computer-controlled dispensing system  Pharmacy stocks drug cart for patients/residents on unit  Accessed by security code/password  Drug bar coded, patient ID bracelet also coded  Patient’s ID scanned and drug scanned (provides check of correct drug and automatically documents drug administration)  Narcotic control systems  Regulation of controlled substances  Single-unit packages kept in locked cabinet in medication room; or in a special container in the med cart- charge nurse has the key which cannot be given to anyone except the person giving the narcotic
    38. 38.   Inventoried at the end of each shift  Must be counted by 2 qualified individuals  If the count is not correct- MUST investigate  Each narcotic has its own inventory sheet which must match the count of that narcotic Narcotic count
    39. 39.  Drug storage  Drug cart (locked) as is the room that they’re stored in  Drugs stored in original container or unit dose package in person’s individual bin  Some drugs may need to be stored in refrigerator; tight containers- moisture & heat can destroy drug  Assisted living residents may store own drugs if able to self medicate-otherwise are stored in a locked room  Controlled substances (narcotics) double locked –may be on drug cart or separate cabinet  Emergency medications may be stored in floor or stock system  Medications for external use stored separate from those for internal use
    40. 40.  Disposal of drugs  Disposed of because  Person refuses to take drug  Drug dropped on the floor or bed  You are to give only part of drug dispensed  Drug becomes contaminated  Person discharged  Person died  Doctor discontinued drug  Follow facility disposal policy  Do not return to stock supply  Document according to facility policy
    41. 41.  Six rights  Right drug  Read the label before removing from unit dose cart or shelf  Read label before preparing or measuring prescribed dose  Read label before returning drug to shelf or opening unit dose packet  Right time  By drug order  Standard administration times  Blood level  Best drug absorption time  Diagnostic tests  One-time-only, PRN, STAT
    42. 42.  Six rights cont…  Right dose  Compare dose on label to MAR  Use appropriate measuring devise  Report nausea & vomiting  Correct drug calculation (may need to be nurse)  Right person  Compare person’s ID to MAR  Two identifiers  Name  Birthdate  ID number  Check for allergies
    43. 43.  Six rights cont…  Right route  Drug order gives route  Never change route  Only give as allowed to give by prescribed route  Routes  IV (most rapid onset action)  IM (next fastest onset action)  Sub-Q (probably next fastest)  Intradermal (absorption slow)  What you can give  Inhalation(fastest)  Sublingual(next fastest)  Suppository(next)  Oral (slowest onset)  Right documentation  Record as quickly as possible  Follow documentation standards  Right documentation
    44. 44.  Drug errors  Prescribing errors  Wrong drug for person’s diagnosis  Drug person allergic to  Wrong dose for person’s diagnosis  Transcription errors  Misinterpreting/misunderstanding drug ordered or directions  Interpreting hand-writing, not legible  Using unapproved abbreviations  Omitting a drug order  Using wrong spelling  Writing wrong dates or times
    45. 45.  Drug errors cont….  Dispensing  Sending wrong drug or dose to facility  Using wrong formulation  Using wrong dosage form  Giving drugs  Giving wrong drug  Giving wrong dose  Giving an extra dose  Giving drug not ordered for person  Missing or skipping a dose  Giving a drug at wrong time  Giving drug in wrong way
    46. 46.  Safety rules for drug administration  Follow the six rights of drug administration  Store drugs properly  Have good lighting to read Kardex, MAR  Stay focused, don’t get distracted  Keep working area clean, neat, orderly  Check container label for drug name, dose, route  Check person’s chart, Kardex, MAR, ID for allergies  Check person’s chart, Kardex, MAR for rotation schedules for drugs applied to skin  Know why drug ordered, side effects, adverse reactions  Calculate drug dosages accurately  Identify person before giving drug  Position person for route of administration  Have correct fluids ready for person to swallow oral drugs  Stay with person to make sure drugs have been swallowed  Follow facility policy for self-administered drugs
    47. 47.  Cont…  Never leave a drug in person’s room to take later  Never leave a drug unattended  Refer questions about person’s drug or treatment plan to nurse  Do not prepare or give drug if container not properly labeled or unreadable  Give only drugs you are allowed to administer  Give drugs only prepared by pharmacist  Check drug name, dose, frequency, route, against order  Do not return unused drug to stock supply  Do not mix liquid drug with water or other fluid unless directed to  Ask nurse if you have any questions, concerns  Practice good hand hygiene  Never touch actual drug  Check drug carefully (may look alike)  Listen to patient – knows drugs best  Observe for side effects  Make sure drug cabinet/cart is locked
    48. 48.   Infection is a disease state resulting from the invasion and growth of microbes (pathogens)  Bacteria & viruses  Medical asepsis (clean technique)  Hand washing! Preventing Infection
    49. 49.   Guidelines set by the CDC  Prevent the transmission of infectious agents  Blood borne Pathogen Standard Isolation Precautions
    50. 50.   Hand hygiene  Gloves  Gowns  Masks Standard Precautions
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