copyright © 2011 delmar, cengage learning. all rights reserved. chapter 30 medication...

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Chapter 30

Medication Administration


Drug Standards and Legislation

• Standards:– Ensure uniformity

– Predict effects

– United States Pharmacopeia (USP)

– National Formulary (NF)

(continued)


Drug Standards and Legislation

• Federal legislation:– Pure Food and Drug Act of 1906

• USP and NF establish drug standards

• State and local legislation

• Health care institution regulations


Pharmacokinetics

• Absorption

• Distribution

• Metabolism

• Excretion


Drug Nomenclature

• Chemical name– Precise description of composition

• Generic name– Given by U.S. Adopted Names Council

• Trade or brand name– Given by pharmaceutical companies

– Used during marketing


Drug Action

• Pharmacology– Medication management

– Classification

(continued)


Drug Action

• Pharmacology– Preparation and route

• Oral

• Parenteral

• Topical

• Inhalants

• Intraocular route


Drug Interaction

• Effect of one drug on another

• Deliberate combining

• Not all drug combinations therapeutic


Side Effects and Adverse Reactions

• Side effects– Mild

– Predictable

– Nontherapeutic

• Adverse reactions– Unexpected

– Potentially hazardous

(continued)


Side Effects and Adverse Reactions

• Food and drug interactions– Drug effects on nutritional status

– Food effects on drug absorption

– Food effects on drug utilization


Factors Influencing Drug Action

• Genetics

• Age

• Height

• Weight

• Physical conditions

• Mental conditions


Professional Roles in Medication Administration

• Health care providers– Orders

– Administration of drugs

– Teaching

– Observation

(continued)


Professional Roles in Medication Administration

• Types of orders:– Stat

– Single-dose

– Standing

– PRN• As needed

• Parts of drug order


Systems of Weight and Measure

• Metric

• Apothecary

• Household


Approximate Dose Equivalents

• Converting units of weight and volume– Measurement conversions within metric system

– Measurement conversions between systems

• Drug dose calculations– Pediatric dosages


Safe Drug Administration

• Guidelines for medication:– Right drug

– Right dose

– Right client

– Right route

– Right time

(continued)



• Document:– Critical element

– Only after client has taken drug

• Drug supply and storage– Unit dose form

– Stock supplied drugs

– Narcotics and controlled substances

(continued)



• Drug abuse– Addiction

• Physiological or psychological dependence on substance or behavior

(continued)



• Drug abuse– Dependence

• Reliance on or need to take drug

• Physiological

• Psychological


Medication Compliance

• Compliance– Taking medication as prescribed

– Improved through client understanding

• Noncompliance– Inconsistent use as prescribed

– Self-adjusted dosing or scheduling


Legal Aspects of Administering Medications

• Questioning medication order– Responsible

– Accountable

• Preventing medication errors


Medication Administration and the Nursing Process

• Assessment– Medical history

– Drug history• Allergies

• Prescription drugs

• Over-the-counter drugs

• Complementary therapy– Herbal supplements

(continued)



• Assessment– Biographical data

– Cultural diversity

– Lifestyle and beliefs

– Sensory and cognitive status

– Physical exam

– Diagnostic and laboratory data

(continued)



• Diagnosis– NANDA statements

• Deficient knowledge

• Ineffective health maintenance

• Impaired physical mobility

• Disturbed sensory perception

• Readiness for enhanced knowledge

(continued)



• Planning and outcome identification– NOC for medication administration:

• Knowledge– Medication

• Medication response

• Self-care– Nonparenteral medication

(continued)



• Implementation– Assessment

– Administration

– Teaching

(continued)



• Implementation– Oral medication administration

• Most common route– Gag reflex

– Consciousness

– Nausea or vomiting

• Medication administration– Sublingual and buccal

(continued)



• Implementation– Enteral medication administration

• Delivery through gastrointestinal tube

• Equipment

• Risk for aspiration

(continued)



• Implementation– Parenteral medication administration

• Routes– Intradermal

– Subcutaneous

– Intramuscular

– Intravenous

(continued)



• Implementation– Parenteral medication administration

• Equipment– Syringes

– Needles

– Ampules and vials

• Angle of injection

(continued)



• Implementation– Intradermal medication administration

• Purposes

• Slow absorption

• Small quantity of solution

• Procedure

(continued)



• Implementation– Subcutaneous medication administration

• Purposes– Heparin

– Insulin

• Sites

• Procedure

(continued)



• Implementation– Intramuscular medication administration

• Purposes

• Sites

• Procedure– Z-track injection

(continued)



• Implementation– Intravenous medication administration

• Purposes

(continued)



• Implementation– Intravenous medication administration

• Procedure– Infusion pump

– Adding drugs to volume-control administration set

– Administering by intermittent infusion

– Intermittent infusion devices

– Administering intravenous push medications

(continued)



• Implementation– Topical medication administration

• Eye

• Ear

• Nasal

• Rectal

• Vaginal

(continued)



• Evaluation– Ongoing responsibility of nurse

• Client’s response to medications

• Changes in client’s condition

• Client’s ability to self-manage

copyright © 2011 delmar, cengage learning. all rights reserved. chapter 30 medication...

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