1. Review medication administration-errors, six rights
Medication administration-errors- Any preventable adverse drug event involving inappropriate
medication used by a patient or health care professional; it may or may not cause the patient
harm
Six Rights: Right drug, right dose, right time, right route, right patient, right documentation
2. Review types of Treatment, empiric, prophylactic palliative etc
Acute therapy- Involves more intensive drug treatment and is implemented in the acutely ill or
critically ill (Ex. Intensive chemotherapy for patient with newly diagnosed cancer, vasopressors
to maintain blood pressure, volume expanders for patient in shock)
Maintenance therapy- prevents the progression of a disease or condition. (Ex. Maintains the
patient’s blood pressure, oral contraceptives for birth control)
Supplemental therapy- aka replacement therapy supplies the body with a substance needed
to maintain normal function. (ex. Administration of insulin for patient w/ diabetes, iron to
patient w/ iron-deficiency anemia
Palliative therapy- to make a patient as comfortable as possible, focuses om providing patients
with relief from symptoms, pain, and stress of a serious illness. Goal is to improve quality of
life for both the patient and family. (Ex. Used when curative therapy has failed, High-dosage of
opioid analgesics to relieve pain in the final stages of cancer)
Supportive therapy- maintains the integrity of body functions while the patient is recovering
from illness or trauma. (ex. Provision of fluids and electrolytes to prevent dehydration in a
patient who is vomiting and has diarrhea, administration of fluids or blood products to a
patient who has lost blood during a surgery)
Prophylactic therapy- drug therapy provided to prevent illness or other undesirable outcome
during planned events. (use of preoperative antibiotic therapy for surgical procedures,
disease-specific vaccines for indvs. traveling to geographic areas where a given disease is
known to be endemic.
Empiric therapy- based on clinicals probabilities, involves drug administration when a certain
pathologic condition has a high likelihood of occurrence based on a patients initial presenting
symptoms.
3. Review age related drug administration
Infants
• while maintaining safe and secure positioning of the infant (w/ parent holding,
rocking, cuddling, soothing), perform the procedure (ex. Injection) safely and swiftly
• Allow self-comforting measures as age-appropriate (ex. Use of pacifier, fingers in
mouth, self-movement)
Toddlers
• Offer a brief, concrete explanation of the procedure but with realistic expectations of
the child’s actual understanding of the info. Parents, caregivers, or other legal
guardians must be part pf the process. Hold the child securely while administering the
medication.
• Accept aggressive behavior as a healthy response, but only within reasonable limits.
• Provide comfort measure immediately after the procedure (touching, holding)
, • Help the child understand the treatment and his or her feelings through puppet play or
play with stuffed animals or hospital equipment such as empty needleless syringes
• Provide for healthy ways to release aggression such as age-appropriate supervised
playtime
Preschoolers
• Offer a brief, concrete explanation of the procedure at the patient’s level and with a
parent or caregiver present
• Provide comfort measure after the procedure (ex. Touching, holding)
• Identify and accept aggressive behavior responses, and provide age-appropriate
outlets
• Make use of magical thinking (using ointments or “special medicines” to make
discomfort go away)
• Note that the role of the parent in providing comfort and understanding is very
important
School-age children
• Explain the procedure, allowing for some control over body and situation
• Provide comfort measures
• Explore feelings and concepts through the use of therapeutic play. Art may be used to
help the patient express fears. Use of age-appropriate books and realistic hospital
equipment may also be helpful
• Provide age-appropriate activities for releasing aggression and anger
• Set age-appropriate behavior limits (ex. Okay to cry or scream, but not bite)
• Use the opportunity to teach about the relationship between receiving medication
and body function and structure (ex. What a seizure is and how medication helps
prevent the seizure)
• Offer the complete picture (need to take medication, relax w/ deep breaths;
medication will help prevent pain)
Adolescents
• Prepare the patient in advance for the procedure but without scare tactics
• Allow for expression in a way that does not cause losing face, such as giving the
adolescent time alone after the procedure (ex. once a seizure is controlled) and giving
the adolescent time to discuss his or her feelings.
• Explore w/ the adolescent any current concepts of self, hospitalization, and illness, and
correct any misconceptions
• Encourage self-expression, individuality, and self-care
• Encourage participation in procedures as appropriate
4. Review your drug categories in pregnancy and classifications
Pregnancy safety categories
Category A- Studies indicate no risk in the human fetus