Pharmacology doh safe dose
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This document discusses safe medication practices for nurses, including legal responsibilities, the nursing process, minimizing errors, and atraumatic pediatric care. It outlines the six rights of medication administration, components of prescriptions, types of prescriptions, and tools for safe practices. Errors are addressed, including assessing and documenting adverse reactions. Atraumatic care involves educating patients, using models, making the environment less threatening, and allowing rest periods between invasive procedures.
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Safety in medication administration
The document discusses medication safety and errors in administration. It defines medication errors, outlines who can administer medications, and lists common reasons for errors like inadequate documentation, labeling issues, and interruptions. The document also covers the rights of safe administration including the right patient, drug, dose, time and route. It provides tips for preventing errors like double checking medications and monitoring for side effects if an error occurs. The goal is to learn from mistakes in a just culture that promotes reporting errors.
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3) Obtaining consent from children requires consideration of their developmental level. For children under age 7, consent is implied. Children ages 7-11 must provide verbal assent. Those 12-17 can provide written assent with parental consent.
Informed consent process
This document discusses the informed consent process. It begins by explaining that informed consent is a process, not just a form. It then provides an IRB submission flow chart and discusses the rules and guidelines that must be followed for informed consent. The document outlines best practices for authoring informed consent forms, including using plain language and avoiding medical jargon. It discusses informed consent considerations for vulnerable populations like children, prisoners, non-English speakers, and cognitively impaired individuals. The document also covers topics like obtaining consent from legally authorized representatives, waiving or altering elements of informed consent, revoking consent, and responsibilities at the end of a study.
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The document discusses the concept of informed consent as it relates to nursing. It states that informed consent involves a patient's right to accept or reject treatment, and is a fundamental principle in healthcare. The role of nurses is to ensure physicians have explained treatments to patients in a way they understand, warned of risks, and documented that informed consent was obtained. It also notes special considerations for emancipated minors and those requiring a legal guardian's consent.
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Informed consent: Definition & elements
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The document discusses the concept of informed consent as it relates to nursing. It states that informed consent involves a patient's right to accept or reject treatment, and is a fundamental principle in healthcare. The role of nurses is to ensure physicians have explained treatments to patients in a way they understand, warned of risks, and documented that informed consent was obtained. It also notes special considerations for emancipated minors and those requiring a legal guardian's consent.
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CONSENT FOR INVASIVE PROCEDURES BY DR SUJITH CHADALA
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This document provides guidance on managing medications and preparing for medical emergencies for children in campus programs. It outlines policies for securely storing and properly administering both prescription and over-the-counter medications with written parental authorization. Staff should be trained to recognize medical emergency situations, activate emergency response as needed, and have an emergency first aid kit and documentation like medical forms and emergency care plans readily available. Programs should coordinate with health services and develop individual plans for any children with special medical needs to ensure their safety.
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The document discusses the key principles of informed consent in medical research, including disclosure, capacity, and voluntariness. It outlines the necessary components of informed consent, such as describing the research purpose and risks/benefits to participants. Practical challenges to fully informed consent and forms of consent are also reviewed, emphasizing that consent must be given freely without coercion.
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The document discusses informed consent and its importance. It defines informed consent as communication between a patient and physician that results in the patient authorizing agreement to a medical intervention. Informed consent is required by law, ethics, and regulations. It helps ensure patient safety, satisfaction, and reduces litigation risks. The clinician is responsible for obtaining informed consent, but a team approach is needed. Informed consent is required for invasive or complex procedures and includes discussing diagnosis, treatment options, risks and benefits, and alternatives. Consent can be provided by a competent patient or their healthcare representative. Improving informed consent involves simplifying language, allowing questions, and ensuring understanding.
SCHS Topic 4: Informed Consent to Treatment
Series of lectures I gave for the PEER (Professionalism and Ethics Education for Residents) Project sponsored and organized by the Saudi Commission for Health Specialties (SCHS).
OUTLINE:
What is an informed consent to treatment?
What is the elf basis to consent?
What makes the consent an ethically valid one?
Types of Consent
When it is needed? When could it be waived?
How to take an informed consent?
What if the patient is not able to give consent?
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CONSENT FOR INVASIVE PROCEDURES BY DR SUJITH CHADALA MD GEN MED ( OSM ) , PGPC ( JOHNS HOPKINS ) , IDCCM
Consent rs
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The document discusses informed consent for medical procedures. It states that informed consent must be documented in writing with the patient's signature. To provide informed consent, patients must be competent and understand the benefits and risks of the procedure, as well as alternative options and potential complications. Failure to obtain valid consent could result in legal issues like battery or negligence. Special considerations for informed consent include emergency situations, mentally incapable patients, advanced directives or living wills, children, and pregnancy.
Medical issues training
This document provides guidance on managing medications and preparing for medical emergencies for children in campus programs. It outlines policies for securely storing and properly administering both prescription and over-the-counter medications with written parental authorization. Staff should be trained to recognize medical emergency situations, activate emergency response as needed, and have an emergency first aid kit and documentation like medical forms and emergency care plans readily available. Programs should coordinate with health services and develop individual plans for any children with special medical needs to ensure their safety.
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immediately.
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completely.
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Nail Abnormalities
This document discusses various nail abnormalities including brittle or crumbly nails which can be caused by aging, water/chemical exposure, fungal infection, lichen planus, thyroid disorders or psoriasis. Discolored nails are also covered, such as yellow nails from fungus or psoriasis. Loose nails can result from injury, infection or conditions like amyloidosis. Koilonychia causes indented spoon-shaped nails due to iron deficiency or other issues. Clubbing refers to unusually curved fingertips/nails associated with lung or heart conditions. Common treatments involve moisturizers, antibiotics or soaking affected areas.
Eye & Vision Assesment
This document provides an overview of eye and vision assessment. It describes the structures of the eye including the sclera, iris, pupil, cornea, aqueous humor, lens, intraocular pressure, canthus, and conjunctivae. It also discusses the 6 muscles that control eye movement and their innervation by cranial nerves, as well as the functions of refraction, pupillary constriction, accommodation, and convergence. Common errors of refraction like hyperopia, myopia, and astigmatism are defined. The document outlines methods for eye assessment including patient history, physical assessment of the eye structures, vision testing, and diagnostic tests. Age-related changes to eye structure and function are also reviewed.
Connective tissue diseases
This document summarizes several connective tissue diseases including polymyositis, systemic necrotizing vasculitis, polymyalgia rheumatica, giant cell arteritis, ankylosing spondylitis, Reiter's syndrome, and Marfan syndrome. For each disease, the document describes characteristics such as symptoms, risk factors, complications, diagnostic tests, and treatment options including drug and supportive therapies.
Pediatric Nursing Review 2
This document provides an overview of key theories and concepts related to pediatric nursing, including:
- Erikson's psychosocial stages of development and Piaget's stages of cognitive development.
- Guidelines for physical assessment of infants and children, including growth milestones.
- Principles of pediatric nutrition at different developmental stages.
- Theories of play development from infancy through school age.
- Best practices for medication administration in children, pain management, and immunizations.
Gout
Gout is a form of arthritis caused by urate crystals depositing in joints due to high uric acid levels. It exists in primary and secondary forms. Primary gout is caused by inborn errors in purine metabolism and usually affects older men. Secondary gout is caused by other conditions like renal insufficiency that decrease uric acid excretion. Gout progresses through asymptomatic, acute, and chronic stages and is characterized by painful joint inflammation and tophi formations. Treatment involves medications like allopurinol to reduce uric acid production as well as a low purine diet and increased fluid intake.
Hri heat related illnesses
This document discusses heat-related illnesses, including heat exhaustion and heat stroke. It provides information on prevention, symptoms, assessment, and treatment for each condition. For heat exhaustion, it recommends stopping activity, moving to a cool place, cooling measures, oral rehydration, and monitoring vital signs. Hospitalization may be needed for severe cases or if symptoms persist. Heat stroke is a medical emergency, with symptoms including high body temperature, altered mental status, and organ dysfunction. Immediate cooling through methods like cold water immersion is critical to prevent complications and death. Treatment also includes IV fluids, monitoring for complications, and slow cooling once the temperature drops below 102F.
Cold related illnesses (cri)
This document discusses cold related injuries including hypothermia, frostnip, and frostbite. It defines each condition and provides details on assessment, risk factors, classification, goals of treatment, and nursing interventions. Hypothermia is categorized as mild, moderate, or severe based on core temperature. Signs and symptoms vary with each category. Rewarming methods depend on severity, with external warming used for mild cases and internal core rewarming for more severe hypothermia. Frostnip causes pain and numbness and is treated by rewarming the affected area. Frostbite classification is based on depth of tissue damage. Nursing interventions aim to prevent further injury and include rapid rewarming, analgesia,
Care of arthritis
This document provides information on the care of arthritis, including osteoarthritis and rheumatoid arthritis. It discusses the characteristics, risk factors, affected joints, education, medications, and management for osteoarthritis. For rheumatoid arthritis, it outlines the pathophysiology, associated symptoms, labs, imaging, and medical and complementary treatments. Post-operative care is described for total hip and knee arthroplasties. The importance of exercises, joint protection, and energy conservation techniques are also highlighted.
Care of hypersensivity and autoimmunity
This document discusses the five types of hypersensitivity reactions: Type I immediate hypersensitivity mediated by IgE antibodies (allergies, anaphylaxis), Type II cytotoxic reactions mediated by IgG antibodies, Type III immune complex-mediated reactions, Type IV delayed hypersensitivity mediated by T cells, and Type V stimulatory reactions involving autoantibodies stimulating normal cell receptors. It then focuses on Type I allergic rhinitis and anaphylaxis, providing details on symptoms, treatments including avoidance, medications, and emergency response for anaphylaxis.
Hormonal Agents – Prostate Cancer Medications
This document summarizes hormonal agents used to treat prostate cancer, including gonadotropin-releasing hormone agonists (GRHA) like leuprolide, and androgen receptor blockers like flutamide. GRHAs like leuprolide stop testosterone production and are used for palliative treatment of advanced prostate cancer. Common side effects of GRHAs include hot flashes and decreased bone density, which can be managed through calcium/vitamin D supplements and exercise. Androgen blockers like flutamide also cause hot flashes and decreased libido. Flutamide may cause nausea/vomiting or hepatitis, requiring monitoring. Drug interactions to watch for include flutamide with warfarin.
Counseling Strategies 4 RN's
This document outlines several counseling strategies including behavior modification using positive reinforcement and tracking, social skills training using role playing, bereavement counseling to help process grief through reminiscing and removing belongings, biofeedback using biological measures as feedback, relaxation exercises like progressive muscle relaxation and meditation, crisis intervention to assist with coping and prevent future crises, and play therapy to help children cope with loss, illness, and learn self-care skills through play.
Nitrates
Nitrates can cause headaches and reflex tachycardia as side effects. They are contraindicated in those with traumatic head injuries due to increased intracranial pressure or hypersensitivity. Caution should be used in those taking antihypertensives, and those with renal or liver impairment as there may be interactions. Nitrates may interact with beta blockers, calcium channel blockers, diuretics and PDE5 inhibitors causing hypotension. Drinking alcohol may also cause hypotension. If taking nitrates for chest pain, the patient should stop activity, sit or lie down, and not take more than 3 tablets. They should let the tablets dissolve under the tongue for 5 minutes and call 911 if pain is
Prolapse cord
Prolapse cord occurs when the umbilical cord descends through the vagina before delivery of the baby and can cut off blood flow. It is a medical emergency risked by conditions like ruptured membranes, abnormal fetal positioning high in the pelvis, and others. If a patient reports feeling something coming through her vagina and a cord is visualized, the provider should be notified, sterile gloves used to apply pressure to lift the cord off the baby, and the patient repositioned while giving oxygen and IV fluids in preparation for an emergency c-section if needed to save the baby.
Pharmacology causing prolong qt
Several psychiatric medications including ziprasidone, asenapine, paliperidone, and iloperidone as well as TCAs can cause prolongation of the QT interval on electrocardiograms. Additional drugs from other classes such as the antiarrhythmic amiodarone, the antibiotic clarithromycin, and the antianginal ranolazine have also been associated with QT prolongation.
Bariatric discharge teaching
This discharge teaching document outlines the post-bariatric surgery care instructions including a diet progression focused on hydration and vitamin/mineral supplements, wound care, activity limitations, symptom monitoring, emotional support, follow up appointments, and potential future plastic surgery procedures once weight has stabilized.
5 top lesson for nurse olympians
This document provides 5 lessons for nurse Olympians. The first lesson is to do daily checks on stress, emotions, and cultural competence awareness to take care of your mental health. The second lesson is that competence and training are important to provide quality care, so nurses should regularly review materials and procedures. The third lesson is to stay up to date on the latest research, equipment, and specialize when possible to achieve greatness through evidence-based practices that provide safe, competent, and high quality care. The fourth lesson is that no one knows everything, so nurses should not be afraid to look things up or compare themselves to colleagues. The fifth and final lesson is to accept praise humbly and focus on helping others rather than seeking personal
Bisphosphonates
Bisphosphonates including alendronate, ibandronate, risedronate, and zoledronic acid are used to treat osteoporosis. Common side effects are esophagitis, esophageal ulceration, abdominal pain, nausea, diarrhea, constipation, and blurred vision or eye pain. Nursing care instructions are to take the medication first thing in the morning with water on an empty stomach and remain upright for 30 minutes, avoid calcium for 30 minutes after, do weight bearing exercises daily, and notify the provider of swallowing issues. Bone density and serum calcium levels should be monitored regularly.
Rn ostomy care
Ostomy care involves gathering supplies, providing privacy, inspecting and cleaning the stoma and peristomal skin area, measuring and cutting an opening in a skin barrier for the stoma, applying barrier pastes if needed, attaching the skin barrier and pouch, and disposing of used supplies while maintaining hand hygiene.
Mec rn care
Meconium-stained amniotic fluid occurs after 38 weeks of gestation when the fetus passes meconium into the amniotic fluid due to hypoxia. Hypoxia stimulates the vagal nerve, which causes relaxation of the anal sphincter and peristalsis of the fetal gastrointestinal tract. Meconium-stained amniotic fluid can range in color from black to greenish-yellow or brown and may be thin or thick in consistency. Nursing care involves documenting the fluid, notifying the neonatal resuscitation team, gathering equipment, and following the suction protocol to suction the mouth, nose, or below the vocal cords depending on the neonate's respiratory and muscle tone status and heart
Amniotic fluid embolism rn care
An obstetric patient experienced complications including preeclampsia, macrosomia, hydramnios, fetal demise, and an unsuccessful oxytocin administration which resulted in circulatory collapse, coagulation failure, cyanosis, respiratory distress, and cardiac arrest. Emergency interventions were performed including high flow oxygen, IV fluids, intubation, CPR, blood products, and preparations for an emergency cesarean section to treat the life-threatening conditions and stabilize the patient.
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Pharmacology doh safe dose
- 1. Pharmacology Dose Over Have
- 2. Safe Dose • Legal responsibilities • Six rights • Nursing process • Components of medication prescription • Minimize medication errors • Atraumatic care to pedicatrics • Risk for adverse medication reactions
- 3. DOH: Safe Dose • Responsibilities: • Preparing • Administering • Evaluating client response • Developing and maintaining an up-to-date knowledge base • Skill competency • Knowledge of acceptable practice • Accuracy of med orders • Reporting all medication errors • Safeguarding and storing medications
- 4. DOH: Safe Dose • 6 rights • Client • Med • Route • Time • Dose • Documentation
- 5. DOH: Safe Dose • Types of Medication Prescriptions: • Routine • Standard • Single • One time • PRN • Stat
- 6. DOH: Safe Dose • Types of Medication Prescriptions: • May or may not have termination date • Without a specified termination date, the order will be in effect until it’s discontinued or client discharged • opioids, and antibiotics must be reordered within a specified amount of time or will automatically be discontinued
- 7. DOH: Safe Dose • Components of Medication Prescription: • Client name • Date of order • Time of order • Name of medication • Dosage • Route • Time and frequency • Signature of prescribing provider
- 8. DOH: Safe Dose • Medication errors: • Wrong medication or IV fluid • Incorrect dose or IV rate • Wrong client, route, or time • Administration of known allergic medication • Omission of dose • Incorrect discontinuation of medication or IV fluid
- 9. DOH: Safe Dose • Nursing Process: Assessment • Client’s condition relevant to med administration • Preadmission HR, BP etc. • Omit or delay doses as indicated by condition • Identify allergies • Determine if the medication prescription is complete • Interpret medication prescription accurately • Question provider if the prescription is unclear or seems inappropriate for the client’s condition
- 10. DOH: Safe Dose • Nursing Process: Planning • Calculate & measure doses accurately • Be sure the medication is the correct strength • Verify high alert medication with a colleague • Avoid distractions during medication preparation
- 11. DOH: Safe Dose • Nursing Process: Implementation • 6 right • Only administer what YOU have prepared • Follow correct procedure for all routs • Use verbal orders for only emergencies • Follow agency policy for telephone orders • Follow laws & regulations when administering controlled substances • Omit or delay a dose if client question size of dose or appearance of medication
- 12. DOH: Safe Dose • Errors: • Assess client for any signs of an adverse reaction • Notify the client’s provider and the supervisor • Document the event, along with the action taken in response to the event to treat or prevent adverse reactions • Document the event on an incident report according to agency policy • Evaluate the cause of the error in order to prevent a reoccurrence
- 13. DOH: Safe Dose • Nursing Process: Evaluation • Client response • Document and report appropriately • Side & adverse effects; document and report appropriately • Report all errors & take corrective measures immediately
- 14. DOH: Safe Dose • Tools for Safe Practices • Abbreviation (error prone) • Tall Man Letters • High Alert Medication List • Universal guideline: always use leading zeros before a decimal, but never trailing
- 15. DOH: Safe Dose • Atraumatic Care: • Therapeutic care in setting and thru the use of interventions that eliminates or minimizes the psychological and physical distress experienced by children and their families
- 16. DOH: Safe Dose • Atraumatic Care: Preventing Physical Stressors • Educate on environment, diagnosis, treatments • Use non-threatening models (dolls) • Make environment less threatening “safe areas” • Keep a neutral thermal environment • Explain all noises, including alarms • Close doors to room when possible to allow privacy • Allow rest periods between invasive procedures • Allow transitional items at bedside (blankets, dolls, etc.)