medication administration. automated medication administration equipment pyxis suremed medserve

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  • Slide 1
  • Medication Administration
  • Slide 2
  • Automated Medication Administration Equipment Pyxis SureMed MedServe
  • Slide 3
  • Essential Components of a Medication Order Clients Name Medical Record Number, Room/Bed # Date & time of order Name of Medication Dosage of Medication Route Frequency of administration MDs signature
  • Slide 4
  • Six Rights of Medication Administration Right Patient (check name band, ask client their name) Right Medication Right Dose Right Route Right Time (frequency) Right Documentation * Clients also have the right to refuse (say no) to medication
  • Slide 5
  • The Nurses Responsibility for Medication Administration Assess whether the client can tolerate the meds Administer meds accurately & timely Monitor for side-effects Know contraindications Client teaching Practice the Six Rights(stressed in clinical) Evaluation (effectiveness & client response)
  • Slide 6
  • Types of Oral Medications Tablets Capsules Sublingual Buccal Elixirs Enteric Coated
  • Slide 7
  • Precise & Safe Medication Administration
  • Slide 8
  • Rectal Medications Provide for privacy Explain procedure to client Place client in Sims position Apply clean gloves Lubricate tip, round end inserted first Encourage client to relax, deep breathe Insert past sphincter, towards umbilicus Have client remain on side at least five mins. (hold buttocks together etc.)
  • Slide 9
  • Rectal Medication Administration
  • Slide 10
  • Ophthalmic Medications Place HOB down or low Fowlers Provide Kleenex for client Have client look towards ceiling Instill meds in conjunctiva (if gtts) If ointment, apply ribbon from inner to outer canthus Know od, os, ou routes
  • Slide 11
  • Topical & Inhalation Medications Ointments (absorbed via mucous membranes, skin) Inserted (vaginal) Instilled (ear/nose gtts) Lotions Sprays (nasal) Pastes (absorbed through skin) Inhalation (nebulized treatments, MDI)
  • Slide 12
  • Topical Ointments
  • Slide 13
  • Otic Medications
  • Slide 14
  • MDI Medications
  • Slide 15
  • Medications via NGT/EFT Determine whether med comes in elixir form Crush all except for EC meds and mix with water or other liquid medications Stop feedings, clamp tube, apply syringe, unclamp tube, flush tube with approx. 30cc water Clamp tube, remove syringe, pull plunger from barrel, reattach barrel, pour meds through barrel Add water as necessary to keep things flowing smoothly After all meds have been given, flush with 30cc water, clamp tube, remove syringe, start feedings
  • Slide 16
  • Slide 17
  • Documentation Always record: Date, time & your initials or signature, title (R. Otten, SN,CSUF ) Medication, route (site) and actual time given Reason why med was omitted (ie. refused) Clients response to the medication
  • Slide 18
  • Medication Administration Records (MARs)
  • Slide 19
  • Nursing Considerations for Injection Sites Assess for adequate tissue & muscle availability/client body wt. Assess where previous injections have been administered Assess client restrictions Assess for quantity & quality of medication to be administered
  • Slide 20
  • Parts of a Needle & Syringe Syringe: Barrel Plunger Tip Needle: Bevel Shaft Hub
  • Slide 21
  • Types of Syringes
  • Slide 22
  • Tips of Syringes Luer-Lok Non Luer-Lok
  • Slide 23
  • Pre-Filled Systems
  • Slide 24
  • Assembling the Device
  • Slide 25
  • Scoop Method
  • Slide 26
  • Safety Devices
  • Slide 27
  • Needless Systems
  • Slide 28
  • Three Types of Injections Intradermal - Injected into dermal skin layers (Allergy tests, PPDs, etc.) Subcutaneous - Injected into subcutaneous tissues (Heparin, Insulin) Intramuscular - Injected into deep muscles (narcotic analgesics, iron)
  • Slide 29
  • Intradermal Injections Given in small doses (i.e.. 0.1cc) Common sites include: RFA, LFA Use 1cc syringe with 26-27 gauge needle, 1/4 - 5/8 inch long Administer with needle at 5-15 degree angle with bevel of needle up Check for bleb or wheal Document site in medication book/nurses notes
  • Slide 30
  • Intradermal Injections
  • Slide 31
  • Subcutaneous Injections Given in doses of 0.5cc - 1.5 cc Common sites include: deltoid, abdomen Deltoid landmarks: Find Acromium Process and go 4 to 6 finger-lengths below Rotate sites to minimize tissue damage Use Insulin/TB syringe for these meds For other SQ meds use 1-3 cc syringe, 25-27 gauge needle, 3/8-5/8 inch length Insert needle 45-90 degrees
  • Slide 32
  • Deltoid Injections
  • Slide 33
  • Vastus Lateralis Injections Site well-developed in both adults & children, lacks major blood vessels/nerves Landmark: Find Greater Trochanter & Knee, divide thigh up into three equal quadrants with hand, middle 1/3 is the site for injection (lateral aspect). Good for clients with position restrictions
  • Slide 34
  • Intramuscular Injections
  • Slide 35
  • Vastus Lateralis
  • Slide 36
  • Dorsogluteal Injections Rarely used due to Sciatic nerve risk Less accessible than other sites (i.e. requires side-lying or turned further) Landmark: Find Greater Trochanter & Iliac Crest, draw quadrants and administer in upper two quadrants
  • Slide 37
  • Dorsogluteal Injections
  • Slide 38
  • What other site is used for IMs?
  • Slide 39
  • Ventrogluteal Good for deep injections Away from blood vessels and nerves Z-track Thick, viscous meds Antibiotics Large volume Irritating
  • Slide 40
  • What if when giving an IM injection, the aspirate comes back with blood. What is the correct procedure and why?
  • Slide 41
  • Preparing NPH & Regular Insulin Swab tops of both vials Inject desired units of air into NPH vial, remove needle and then inject desired units of air into Regular vial Invert Regular vial and withdraw desired units of insulin (no bubbles) Insert needle into NPH vial, invert and withdraw desired units of insulin
  • Slide 42
  • Regular & NPH Insulins
  • Slide 43
  • Mixing Insulins NPH Insulin Regular Insulin
  • Slide 44
  • Remember !!! If an IM injection requires the administration of > 3cc of medication, divide the medication up into two equal doses and administer in different sites.
  • Slide 45
  • Remember !!! Always double-check Insulin & Heparin amounts/doses with another licensed person (RN/LVN/INSTRUCTOR)

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