NUR 155 EXAM FOUR STUDY GUIDE
MEDICATION: CHAPTER 35
Nurses are the last ditch effort to make sure we harm our patient
Administering/reviewing/supervising medications is one of the most error-prone tasks you do in
your career.
Nurses can not delegate the administering of medication or patient teaching to a UAP.
Make sure you take your time while you are administering medication.
If you make a mistake, monitor your patient, DO NOT administer anything else unless standing
order or code situation
Once patient is stable, call the HCP. Document what you administered (not what was ordered).
DO NOT say you made a mistake in the chart. Do an incident report on your mistake.
Med errors are the 8th leading cause of death in the US (44% of errors during med
administration)
Nurses need to know how nursing practice acts in their areas and define and limit their
functions, and be able to recognize the limits od their own function and skill.
Nurses are responsible for their own action regardless if a written order or not.
- Example- if the wrong dose is on the order, and the nurse administers it anyways
without calling the healthcare provider, they will be liable and held legally
responsible for any repercussions.
- If you receive an order that you think is incorrect, verify with the healthcare
provider!
NATIONAL PATIENT SAFETNATIONAL PATIENT SAFETY GOALS FOR MED ADMINISTRATION:
You must have at least 2 identifiers for to clarify you have the correct patient. NAME, DOB,
MEDICAL RECORD NUMBER
Improve the effectiveness of communication among caregivers
- Record and read back complete orders and lab results
- Standardize abbreviations, acronyms, symbols, and dose designation.
Watch out for look alike, sound alike medications and triple check the med order to prevent
errors
, Other legal aspects of med administration:
- Controlled substances must be kept in a locked drawer, cupboard, med cart, or PIXUS
- Controlled substances must be verified by two nurses
- If the medication of a controlled substance is refused, it must be wasted by two
nurses.
Types of orders:
- Standing- part of a protocol- ex- if a MI, give nitro, etc.
- Written- on a legal order sheet or EMR screen
- Verbal- ONLY GIVEN TO RN- repeat and read back to confirm, then write it. Signed by
nurse and then signed by doctor at a later time
- Stat and ASAP- one time only, as soon as humanly possible- ex- CAT scan for
suspected appendicitis.
- Single does (1x)- one time only
- PRN- as needed remember: give Tylenol for pain if only prescribed for fever
- Routine- regularly scheduled usually by pharmacy services)
Components of a medication order:
- Client name
- Date and time of order
- Name of drug being administered
- Dosage of the drug
- Frequency of the administration
o Routine- one time only, STAT, PRN, twice daily, daily, etc.
- Route of administration- PO, IM, SQ, IV, PR (rectum), vagianlly, buccal, nasal, IH
(inhalation),
- Signature
Transcription- transfer from the order to the MAR. can be transcribed by unit clerk, or RN. The
RN is to check the MAR against medication order in clients chart to assure accuracy. Once
completed, the nurse puts the date, times, and initials on the order.
If a patient brings their own meds from home, you must call the doctor to get an order for it.
Depending on the facility, the nurse takes the meds and it is stored in the pharmacy until the
patient is discharged.
Before you give the patient a med, you must look up he drug information, and make sure that
there are no contraindications. Verify the action, indication, normal dosage range and route,
adverse effects, contraindications, drug interactions, nursing considerations.
- Ex. Drug interactions- run antibiotics independently so you know what your patient is
reacting to. Cant run at the same time even if they are compatible. Drug interactions
can occur anytime from a few minutes to two weeks after administration.
- Do this contraindication check with your patient before you even pull the med to
make sure theirs no toxicity, etc.
MEDICATION: CHAPTER 35
Nurses are the last ditch effort to make sure we harm our patient
Administering/reviewing/supervising medications is one of the most error-prone tasks you do in
your career.
Nurses can not delegate the administering of medication or patient teaching to a UAP.
Make sure you take your time while you are administering medication.
If you make a mistake, monitor your patient, DO NOT administer anything else unless standing
order or code situation
Once patient is stable, call the HCP. Document what you administered (not what was ordered).
DO NOT say you made a mistake in the chart. Do an incident report on your mistake.
Med errors are the 8th leading cause of death in the US (44% of errors during med
administration)
Nurses need to know how nursing practice acts in their areas and define and limit their
functions, and be able to recognize the limits od their own function and skill.
Nurses are responsible for their own action regardless if a written order or not.
- Example- if the wrong dose is on the order, and the nurse administers it anyways
without calling the healthcare provider, they will be liable and held legally
responsible for any repercussions.
- If you receive an order that you think is incorrect, verify with the healthcare
provider!
NATIONAL PATIENT SAFETNATIONAL PATIENT SAFETY GOALS FOR MED ADMINISTRATION:
You must have at least 2 identifiers for to clarify you have the correct patient. NAME, DOB,
MEDICAL RECORD NUMBER
Improve the effectiveness of communication among caregivers
- Record and read back complete orders and lab results
- Standardize abbreviations, acronyms, symbols, and dose designation.
Watch out for look alike, sound alike medications and triple check the med order to prevent
errors
, Other legal aspects of med administration:
- Controlled substances must be kept in a locked drawer, cupboard, med cart, or PIXUS
- Controlled substances must be verified by two nurses
- If the medication of a controlled substance is refused, it must be wasted by two
nurses.
Types of orders:
- Standing- part of a protocol- ex- if a MI, give nitro, etc.
- Written- on a legal order sheet or EMR screen
- Verbal- ONLY GIVEN TO RN- repeat and read back to confirm, then write it. Signed by
nurse and then signed by doctor at a later time
- Stat and ASAP- one time only, as soon as humanly possible- ex- CAT scan for
suspected appendicitis.
- Single does (1x)- one time only
- PRN- as needed remember: give Tylenol for pain if only prescribed for fever
- Routine- regularly scheduled usually by pharmacy services)
Components of a medication order:
- Client name
- Date and time of order
- Name of drug being administered
- Dosage of the drug
- Frequency of the administration
o Routine- one time only, STAT, PRN, twice daily, daily, etc.
- Route of administration- PO, IM, SQ, IV, PR (rectum), vagianlly, buccal, nasal, IH
(inhalation),
- Signature
Transcription- transfer from the order to the MAR. can be transcribed by unit clerk, or RN. The
RN is to check the MAR against medication order in clients chart to assure accuracy. Once
completed, the nurse puts the date, times, and initials on the order.
If a patient brings their own meds from home, you must call the doctor to get an order for it.
Depending on the facility, the nurse takes the meds and it is stored in the pharmacy until the
patient is discharged.
Before you give the patient a med, you must look up he drug information, and make sure that
there are no contraindications. Verify the action, indication, normal dosage range and route,
adverse effects, contraindications, drug interactions, nursing considerations.
- Ex. Drug interactions- run antibiotics independently so you know what your patient is
reacting to. Cant run at the same time even if they are compatible. Drug interactions
can occur anytime from a few minutes to two weeks after administration.
- Do this contraindication check with your patient before you even pull the med to
make sure theirs no toxicity, etc.
