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Fundamentals of nursing fatima


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fundamentals of nursing:medication administration

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Fundamentals of nursing fatima

  1. 1. FUNDAMENTALS OF NURSING MEDICATION ADMINISTRATION Instructor: Dr. Fatemeh Khoshkhou Nursing Student Semester: 1 Session 12
  2. 2. By end of this session Students will be able: Explain the mechanism of the drug Understand effective factors on medication function Discuss side effects Explain medication orders Calculate a prescribed medication dose Discuses different name of drugs Explain the seven rights of medication administration Explain different routes of administration Describe the importance of safe medication techniques How to read medication abbreviation Explain the nursing process and medication administration LEARNING OBJECTIVES:
  3. 3. Medication are administered to clients to prevent, diagnose, or treat disease and health condition As a nurse you need to understand the actions and effects of the medications your client take. To safely and accurately administer medications, nurses must have an understanding of pharmacology, pharmacokinetics, human growth and development, human anatomy, pathophysiology, psychology, nutrition and mathematics. SCIENTIFIC KNOWLEDGE BASE
  4. 4. MEDICATION ADMINISTRATION Medication administration is an important component of nursing care
  5. 5. MECHANISM The nurse should know about the mechanism of drugs. Absorption Distribution Metabolism Excretion Effective factors on medication function Growing stages Weight Gender Culture and genetic factors Mental factors Environment Pathology Timing of administration
  6. 6. SIDE EFFECTS Iatrogenic Drug allergy (rash, diarrhea, nausea, vomiting, fever) Anaphylactic (respiratory distress, broncho-spasm, cardiovascular collapse) (treatment: epinephrine, bronchodilators) Tolerance effect Cumulative effect Idiosyncratic effect Drug interaction
  7. 7. A medication order is required for any medication to be administered by a nurse. Nurse can take orders from: physician, dentists (see the hospital rules) Before carrying out a medication order: determine that the order is clear, complete, current, legible and appropriate, and verify that the order, pharmacy label and/or medication administration record (MAR) are complete. A complete order includes: client name date prescribed medication name strength and dosage route dose frequency why the drug is prescribed (when it is a PRN medication) quantity to be dispensed (if appropriate) Prescribed signature MEDICATION ORDERS
  8. 8. TYPES OF ORDERS Routine medication orders PRN (as needed) (for controlling of pain) Single orders (one-time) (before operation) STAT orders (anaphylactic shock)
  9. 9. THE NAME OF DRUGS 1-Chemical name (chemical and molecular instructor) 2-Generic name (The first factory, from chemical name) 3-Official name (Formal publication) 4-Trade name (The name of specific factory for sale) For example: acetaminophen, Tylenol, tempra, liquiprin
  10. 10. GENERAL PRINCIPLES AND PRACTICES OF MEDICATION ADMINISTRATION The right medication The right dose The right time The right route The right client The right documentation The right reason (the nurse must check the drugs 3 times before taking)
  11. 11. ROUTS OF ADMINISTRATION Drugs inter the body through three general Routes: 1-Enteral 2-Precutaneous 3-Parenteral The drugs that enter the boy by these routs come in various forms.
  12. 12. ENTERAL Drugs that enter through the enteral (by the GI tract) Routs are given in these forms: 1-powders (often mixed with a liquid before administration) 2-pills (powder mixed with sticky substances) (round, solid drug form that must be broken down into solution form in the stomach) 3-Tablets (round, spherical, or oddly shaped forms that dissolve in the stomach, types of tablets include: capsule, lozenge,…) 4-Liquids and suspension 5-Suppositories (drugs mixed with lubricated substances, molded to insert into body cavities such as rectum)
  13. 13. THE ENTERAL ROUTES 1-PO: by mouth 2-Tubal: by nasogastric, gasterostomy, Jejunostomy tube, into the stomach 3-Suppository: by rectum, vagina, urethra 4-Enema: by rectum
  14. 14. PERCUTANEOUS Through the skin or mucus membranes Include: Lotions Ointments Creams Powders
  15. 15. PARENTERAL They are usually thought of as the “needle” Route. Ampules Vials
  16. 16. THE PARENTERAL ROUTES 1-IM: Intramuscular (within the muscle) 2- SC, SQ or Subq: subcutaneous(under the dermis Fatty tissue) 3-ID: Intra-dermal (within the dermis) 4-IV: Intra venous (within the vein)
  17. 17. INTRAMUSCULAR INJECTIONS Places Ventrogloteal Dorsogloteal Vastus lateralis Deltoid
  19. 19. DORSOGLUTEAL MUSCLE This site is not used with infants or children Under 3 years of age due to underdeveloped Muscle Risk of sciatic nerve 5 cc for injection Needle 20-23 and 3.75-7.5 length Angle of insertion is 90 degrees
  21. 21. VASTUS LATERALIS MUSCLE Is the preferred site for children under 3 years of age because it is free of nerves and blood vessels.
  22. 22. DELTOID MUSCLE The brachial vein and artery and the radial nerve are in this area. 0.5-2 cc for injection Needle 23-25 and 1.5-2.5 length Angle of insertion is 90 degrees
  23. 23. INTRADERMAL INJECTIONS 1- for skin test agent 2-vaccine Needle 25-26-27 with 0.6-1.5 length Small volumes: 0.01-0.1 cc Create small bubble like Angle of insertion is 15 degrees
  25. 25. SUBCUTANEOUS INJECTIONS Insulin and heparin are given by SC route. Between the dermis and the muscle layer No more than 1 cc or ml Angle of insertion is 45 degrees. Because is not as richly supplied with blood as the muscles, drug absorption is somewhat slower than with IM injections. Sites: outer aspect of upper arms, the abdomen, thighs, scapula.
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  29. 29. ADMINISTERING EAR DROPS For adults and for children over 3 years old, pull earlobe upward and back to straighten external auditory For children under 3 years old pull earlobe downward and back
  30. 30. ADMINISTERING EYE DROPS To apply drops, expose lower conjunctival Sac by having patients look upward while gentle traction is applied to lower eyelid.
  31. 31. ADMINISTERING EYE OINTMENTS To apply ointments, expose lower conjunctival Sac by having patients look upward while gentle traction is applied to lower eyelid.
  33. 33. CLINICAL CALCULATIONS Conversion system Dose calculation Dose ordered/dose on hand × Amount on hand=Amount to administer Pediatric doses(?)
  34. 34. ABBREVIATION Bid (twice a day) Tid (three times daily) Qid (four times a day) Qd (every day) Ac (before meals) Pc (after meals) Hs (at bedtime) PRN(As needed) Stat (immediately) IM IV SC, SQ ID Syr (syrupus) Susp(suspension) Supp (suppository) Cap
  35. 35. ABBREVIATION Tab Amp Dropp Gtt Ml Cc Mg gr Mg/dl Od Os Ou Po NPO Inhalation Z reack Qh (every hours) Q2h (every two hours) Q3h (every three hours)
  36. 36. 1-Assessment History History of allergies Medication data Diet history Client’s perceptual or coordination problems Client’s current condition Client's attitude toward medication use Client's knowledge and understanding of medication therapy 2-Nursing Diagnosis Anxiety Ineffective health maintenance Deficient knowledge of medications Impaired swallowing Ineffective therapeutic regimen management 3-Planning Goals and outcomes Setting priorities Collaborative care 4-Implementation Health promotion Acute care 5-Evaluation Use evaluation measure Apply various evaluation measure NURSING PROCESS AND MEDICATION ADMINISTRATION
  37. 37. REFERENCES 1-Taylor C, Lillis C, LeMone P, Kluwer W. (2007) Fundamentals of Nursing: The Art and Science of Nursing Care, Health/Lippincott Williams & Wilkins. 2- Perry AG, Potter PA, Stockert P. (2006) Fundamentals Of Nursing - Text And Clinical Companion Package. Mosby 3- Ladner PK, Delaune SC. (2008)Fundamentals Of Nursing. Delmar Publishers 5-Khoshkhou F. Fundamental of Nursing, Available at: 6- ‫کتاب‬‫دوگاس‬ ‫پرستاری‬ ‫اصول‬-‫تايلور‬ ‫پرستاری‬ ‫فنون‬ ‫و‬ ‫اصول‬-‫سادات‬ ‫مليحه‬ ‫پرستاری‬ ‫فنون‬ ‫و‬ ‫اصول‬ ‫موسوی‬‫خانی‬ ‫عالی‬ ‫مريم‬ ‫و‬
  38. 38. This lecture is available at: Please feel free to contact through my website
  39. 39. See you in Nursing Simulation Lab