Administer and monitor s8 meds


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Administer and monitor s8 meds

  1. 1. Administer and Monitor Schedule 8 Medications Workshop Presented by Colleen Reeve
  2. 2. Medications <ul><li>Drugs are substances that bring about a chemical change in the body </li></ul><ul><li>When used for therapeutic purposes </li></ul><ul><ul><ul><ul><ul><li>Diagnosis </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Treatment </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Cure </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Relief or prevention of health condition </li></ul></ul></ul></ul></ul>
  3. 3. Nurse’s Role <ul><li>As the person administering medications you have a number of responsibilities </li></ul><ul><li>Key ones includes </li></ul><ul><ul><ul><li>Being aware of </li></ul></ul></ul><ul><ul><ul><li>The action of the medication </li></ul></ul></ul><ul><ul><ul><li>The therapeutic effects </li></ul></ul></ul><ul><ul><ul><li>Non-therapeutic effects </li></ul></ul></ul><ul><ul><ul><li>The reason it has been prescribed </li></ul></ul></ul>
  4. 4. Medication Preparations <ul><li>Variety of forms for administration. </li></ul><ul><li>Choice may depend on a number of reasons </li></ul><ul><li>Absorption rate required </li></ul><ul><li>Difficulties that may be experienced with swallowing </li></ul><ul><li>Drug side-effects </li></ul><ul><li>Patient preferences </li></ul>
  5. 5. Routes of Medication <ul><li>Most convenient and acceptable method for patients to receive medication is orally </li></ul><ul><li>May be administered a number of other ways. </li></ul>
  6. 6. Drug Schedules <ul><li>The assigning of Drugs and Poisons into one of eight schedules is in accordance with the Standard for the uniform scheduling of drugs and poisons published by the Australian Health Ministers’ council. The decision on which drugs go into which group is done by the National Drug and Poisons Schedule Committee for inclusion in the relevant state or territory legislation. The Queensland Act being the Therapeutic Goods Act 1989 (Section 52B). </li></ul><ul><li>The classifications are made according to potency, addictive qualities and suitability for ingestion by humans or animals. </li></ul>
  7. 7. Pharmacology <ul><li>The two main areas of pharmacology that specifically relate to your practice are; </li></ul><ul><li>Pharmacokinetics </li></ul><ul><li>and Pharmacodynamics </li></ul>
  8. 8. Pharmacokenetics <ul><li>How the body handles a drug over a period of time. It deals with the absorption, distribution, biotransformation and excretion of drugs. </li></ul><ul><li>These processes influence the effectiveness of the drug – to be effective it must be available at the site of action in the correct concentration. </li></ul><ul><li>WHAT THE BODY DOES TO THE DRUG </li></ul>
  9. 9. Pharmacodynamics <ul><li>Pharmacodynamics is the process by which specific drug doses produce biochemical or physiological changes in the body. </li></ul>
  10. 10. Adverse Drug Reactions <ul><li>The definition described by the World Health Organisation for an adverse drug reaction is </li></ul><ul><li>‘ any response to a drug which is noxious, unintended and occurs at doses used for prophylaxis, diagnosis and therapy’. </li></ul>
  11. 11. Adverse Drug Reactions <ul><li>While drugs may be prescribed to cure or alleviate a particular problem, because of the intricate workings of the body systems, the response to these drugs can spill over to areas where the effect is not advantageous. </li></ul><ul><li>A term that is commonly used to refer to these is Side–effects </li></ul>
  12. 12. Adverse Drug Reactions <ul><li>To reduce the incidence of severe reactions and to minimise the effect on your patients, it is essential that, as the nurse responsible for administering medication, you have a knowledge of the adverse effects of drugs, how to recognise them and how to prevent them. </li></ul>
  13. 13. Principles of Safe Medication Administration <ul><li>Unfortunately errors in administering medication happen all too often. </li></ul><ul><li>To minimise the risk of these occurring a number of principles need to be followed when preparing to administer medication to a patient </li></ul>
  14. 14. The 5 Rights <ul><li>THE RIGHT TIME THE RIGHT ROUTE </li></ul><ul><li>THE RIGHT AMOUNT/ DOSE </li></ul><ul><li>THE RIGHT MEDICATION/DRUG </li></ul><ul><li>THE RIGHT PATIENT </li></ul><ul><li>ALLERGIES, EXPIRY DATE </li></ul>
  15. 15. Medication Storage <ul><li>Chemical components </li></ul><ul><li>Schedule classification </li></ul><ul><li>Organisation Requirements </li></ul><ul><li>NURSES RESPONSIBILITY TO KEEP LOCKED WHEN UNATTENDED </li></ul>
  16. 16. Calculation Formula <ul><li>Strength required x Volume </li></ul><ul><li>Stock Strength </li></ul>
  17. 17. Drugs and Poisons Regulation 1996 <ul><li>Sections relevant to Enrolled Nurses </li></ul><ul><li>Section 52 </li></ul><ul><li>Section 58A </li></ul><ul><li>Section 155 </li></ul><ul><li>Section 162 </li></ul><ul><li>Section 252 </li></ul>
  18. 18. Opioid analgesics <ul><li>Non-clinical use criminalized since 1914 </li></ul><ul><li>Widely used in medicine as strong analgesics </li></ul><ul><li>Analgesia derives from Greek an- “without” and algia “pain” </li></ul><ul><li>Narcotic effects can be reversed by the drug naloxone (Narcan) </li></ul>
  19. 19. Advantages <ul><li>Despite extensive research , no other analgesics have been found that are more effective for severe pain. </li></ul><ul><li>No upper limit to dosage and achievable pain relief as long as dose increased gradually to allow tolerance to develop to adverse reactions </li></ul>
  20. 20. Types of Routes and Preparations <ul><li>Injection – can be given IV, IMI, SC and epidural </li></ul><ul><li>Oral – Mixtures and Controlled release tablets </li></ul><ul><li>Patches for transdermal absorption </li></ul><ul><li>Dose required intravenously and by epidural is significantly less than when given IV, IMI or orally. </li></ul>
  21. 21. Key Opioid Side Effects <ul><li>Cough suppression </li></ul><ul><li>Decreased gastrointestinal motility </li></ul>
  22. 22. Common Side effects <ul><li>Nausea and vomiting </li></ul><ul><li>Drowsiness, dizziness, headache </li></ul><ul><li>Orthostatic hypotension </li></ul><ul><li>Respiratory Depression </li></ul><ul><li>Itchiness </li></ul><ul><li>Dry mouth </li></ul><ul><li>Miosis – pupil constriction </li></ul><ul><li>Urinary retention </li></ul><ul><li>Constipation </li></ul>
  23. 23. Serious Side Effects <ul><li>CNS disturbances; </li></ul><ul><ul><ul><ul><ul><li>Confusion </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Hallucinations </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Delirium </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Urticaria </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Hypothermia </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Bradycardia/Tachycardia </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Ureteric or Biliary spasm </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Muscle rigidity </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Myoclonus- convulsive body movements </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Flushing- due to histamine release </li></ul></ul></ul></ul></ul>
  24. 24. Opioid Side Effects <ul><li>Psychologic Dependence – Addiction </li></ul><ul><li>A pattern of compulsive drug use </li></ul><ul><li> A continuous craving for an opioid </li></ul>
  25. 25. Tolerance <ul><li>Necessity for increasing the dose over time to achieve the desired clinical effect. </li></ul><ul><li>Develops to analgesic effects </li></ul><ul><li> sedation </li></ul><ul><li> emetic effects </li></ul><ul><li> euphoria </li></ul><ul><li> respiratory depression </li></ul>
  26. 26. Dependence <ul><li>Withdrawal syndrome – caused when drug discontinued </li></ul><ul><li>dosage rapidly reduced </li></ul><ul><li>when antagonist administered. </li></ul>
  27. 27. Withdrawal Syndrome <ul><li>Severe dysphoria </li></ul><ul><li>Anxiety </li></ul><ul><li>Eye tearing </li></ul><ul><li>Rhinitis </li></ul><ul><li>Goose bumps </li></ul><ul><li>Sweating </li></ul><ul><li>Nausea and vomiting </li></ul><ul><li>Cramps and deep pains </li></ul>
  28. 28. S8 Storage Regulations <ul><li>Kept in a separate locked cabinet with keys kept in possession of an RN. </li></ul><ul><li>Cabinet must be minimum of 10mm thick steel with continuous welding to all joints. </li></ul><ul><li>Door of cabinet the same with pick proof lock and steel back plate. </li></ul>
  29. 29. S8 Regulations <ul><li>A Register must be kept with all drugs signed in and out and checked by two nurses: RN/EN (Med) </li></ul><ul><li>All medications selected, administered and recorded by the SAME NURSE </li></ul>
  30. 30. S8 Register <ul><li>Information recorded includes </li></ul><ul><li>Patient’s name </li></ul><ul><li>Prescribed drug and dose </li></ul><ul><li>Date and time of administration </li></ul><ul><li>Balance of medication </li></ul><ul><li>Both Nurse administering and the witness must sign the register. </li></ul>
  31. 31. Administration Procedure <ul><li>Ensure legal medication order </li></ul><ul><li>Witness RN/EN(Med) unlocking S8 cabinet. </li></ul><ul><li>Check drug together against order </li></ul><ul><li>Observe removal of drug and return balance. </li></ul>
  32. 32. S8 Administration <ul><li>Accompany RN/EN (Med) to the patient </li></ul><ul><li>Witness the administration of drug </li></ul><ul><li>Counter sign medication sheet </li></ul><ul><li>Assessment, monitoring and evaluation of patient for analgesic effects as well as adverse reactions. </li></ul><ul><li>Documentation of these effects </li></ul>