Henry Ford Pharm test
6 rights of medication administration - answer Right drug
Right dose
Right patient
Right route
Right time
Right documentation
Right Drug - answer Proper identification of the ordered drug is required. Check medication
against the physicians order form. As a Registered Nurse, you have the responsibility before
administering any medication, to ensure that the dose and drug is appropriate for the patient. You
also have the responsibility to clarify orders, which are unclear or seem inappropriate for the
clinical condition of the patient.
Right Dose - answer The RN is responsible for checking the dosage of the drug, doing the
appropriate calculations or conversions, and knowing the usual dosage.
Right Patient - answer Proper identification of the patient is required before medication is
administered. HFHS acceptable method for confirming identification consists of checking the
patients first and last name and medical record number (MRN) on the identification band with
the name and MRN on the Medication Administration Record (MAR).
Right Route - answer Route of administration should be part of the physicians order. The RN is
responsible for preparing and administering medications correctly by consulting the
accompanying instructions from the pharmacy or drug company.
Right Time - answer The RN is responsible for administering medications according to
scheduled times if that is how the order is written. Instructing patients on the timing of self-
administered drugs at home is also an important function for nurses. Instruct using exact times
such as "take at 8:00 in the morning with food and 5:00 in the evening with food" rather than
"take at meal times" since meal times can vary with different cultural groups.
Right Documentation - answer The RN is responsible for documenting the administration of the
prescribed medication with the information required in the appropriate location such as the
Medication Administration Record (MAR) within the Electronic Health Record.
In addition to the 6 rights there are some additional steps which include: - answer Drug
information
Patient information
Distraction
Communication
Patient education - answer -the names of medications and how to pronounce them
-what the medications do
-what they look like
,Henry Ford Pharm test
-how and when medications should be taken
-possible side effects and food/drug interactions
Who may issue a verbal order? - answer -Licensed independent provider (MD, DO, NP, or DDS)
-Other licensed healthcare professional (physician assistant) as a delegated act of a licensed
independent prescriber
When is a verbal order used? - answer -true emergencies
-when issuing a written or electronic order is no feasible (e.g. during sterile procedures)
Who is permitted to receive a verbal order? - answer Physician
Registered Nurse
Physician Assistant
Pharmacist
Respiratory Therapist
Verbal orders are not to be used under any circumstances for the prescription of: - answer
antineoplastic agents
Only the following categories of medications are acceptable as range orders: - answer Opioids
and other analgesics
Antitussives
Antiemetics
Antihypertensive's
Antihistamines
Anxiolytics
Penicillin(s) - answer Amoxicillin, ampicillin, augmentin, nafcillin sodium, pipercillin sodium,
penicillin G (aqueous), penicillin VK, trimox, unasyn
Indications: penicillins are antibiotics used to treat many different types of infections, such as
tonsillitis, pneumonia, ear infections, bronchitis, urinary tract infections, gonorrhea, and
infections of the skin, just to name a few.
Serious Adverse Effects: Anaphylaxis, neutropenia, leukopenia, thrombocytopenia,
hepatotoxicity
Nursing Considerations: Give with a full glass of water on empty stomach and do not give with
acidic fruit juice - it decompresses PCN
Patient Education:
-Seek emergency medical treatment if they experience signs and symptoms of an allergic
reaction such as: shortness of breath, hives, swelling of the lips, face or tongue, rash or fainting.
-Contact your physician if they experience severe or bloody diarrhea and abdominal cramping if
being discharged on penicillin.
-Penicillin may decrease the effectiveness of birth control pills and a second method of birth
control while taking penicillin may be necessary to ensure protecting unintentional pregnancy.
, Henry Ford Pharm test
Tetracyclines - answer Doxycycline(vibramycin), Minocycline, and tetracycline
Indications: tetracyclines are antibiotics that are used for different types of bacterial infections
including urinary tract infections, acne, gonorrhea, and chlamydia
Serious Adverse Reactions: Neutropenia, thrombocytopenia, hepatotoxicity, superinfection,
hemolytic anemia, anaphylaxis.
Nursing Considerations:
-effectiveness reduced with antacids, iron salts and foods high in calcium
-give 1 hour before meals or 2 hours after meals
-give with a full glass of water. adequate water should be taken with each dose to prevent
irritation of the esophagus
Patient Education:
-warn to stay out of the sun, photosensitivity manifested by exaggerated sunburn
-Do not use tetracyclines during tooth development, i.e., last trimester of pregnancy, neonatal
period, and childhood until age 8- may cause permanent discoloration of teeth and may inhibit
fetal skeletal growth.
-Do not take dairy products, iron supplements, multivitamins, calcium supplements, antacids or
laxatives within 2 hours of taking tetracyclines. These products may reduce the effectiveness of
tetracyclines.
-Throw away any unused tetracycline when it expires or when it is no longer needed. Do not take
any tetracyclines after the expiration date printed on the label. Expired tetracyclines can cause a
dangerous syndrome resulting in damage to the kidneys.
-Stop taking the tetracycline and seem emergency medical attention if the patient experiences
serious side effects such as an allergic reaction, severe headache, vision changes or confusion,
liver damage, bleeding or bruising, or severe fatigue.
-Inform doctor if any less serious side effects occur including nausea, vomiting, increased
sensitivity of the skin to sunlight, swollen tongue, or yeast infection.
Aminoglycosides - answer Amikacin, Gentamycin (Garamycin), Streptomycin, Tobramycin
Indications: Aminoglycosides are antibiotics used to treat many different infections including
serious infections. Infections such as cirrhosis, gonorrhea, pneumonia, septicemia, and urinary
tract infections may be treated with aminoglycosides.
Serious Adverse Reactions: Nephrotoxicity, ototoxicity, agranulocytosis, thrombocytopenia,
neurotoxicity.
Nursing Considerations:
-Nephrotoxicity is a serious side effect of aminoglycosides. If these side effects are present, the
physician must be contacted before administering this medication. Risk increases in patient with
poor renal function and the elderly. Monitor patient's BUN, creatinine, increase/decrease in
frequency of urination, and increased thirst for signs of nephrotoxicity. Nephrotoxicity is limited
if given for less than 5 days.
-Monitor patient for signs of ototoxicity. This may include tinnitus, hearing impairment, and
vestibular symptoms such as dizziness, nystigmus, vertigo, and ataxia.
Patient Education:
6 rights of medication administration - answer Right drug
Right dose
Right patient
Right route
Right time
Right documentation
Right Drug - answer Proper identification of the ordered drug is required. Check medication
against the physicians order form. As a Registered Nurse, you have the responsibility before
administering any medication, to ensure that the dose and drug is appropriate for the patient. You
also have the responsibility to clarify orders, which are unclear or seem inappropriate for the
clinical condition of the patient.
Right Dose - answer The RN is responsible for checking the dosage of the drug, doing the
appropriate calculations or conversions, and knowing the usual dosage.
Right Patient - answer Proper identification of the patient is required before medication is
administered. HFHS acceptable method for confirming identification consists of checking the
patients first and last name and medical record number (MRN) on the identification band with
the name and MRN on the Medication Administration Record (MAR).
Right Route - answer Route of administration should be part of the physicians order. The RN is
responsible for preparing and administering medications correctly by consulting the
accompanying instructions from the pharmacy or drug company.
Right Time - answer The RN is responsible for administering medications according to
scheduled times if that is how the order is written. Instructing patients on the timing of self-
administered drugs at home is also an important function for nurses. Instruct using exact times
such as "take at 8:00 in the morning with food and 5:00 in the evening with food" rather than
"take at meal times" since meal times can vary with different cultural groups.
Right Documentation - answer The RN is responsible for documenting the administration of the
prescribed medication with the information required in the appropriate location such as the
Medication Administration Record (MAR) within the Electronic Health Record.
In addition to the 6 rights there are some additional steps which include: - answer Drug
information
Patient information
Distraction
Communication
Patient education - answer -the names of medications and how to pronounce them
-what the medications do
-what they look like
,Henry Ford Pharm test
-how and when medications should be taken
-possible side effects and food/drug interactions
Who may issue a verbal order? - answer -Licensed independent provider (MD, DO, NP, or DDS)
-Other licensed healthcare professional (physician assistant) as a delegated act of a licensed
independent prescriber
When is a verbal order used? - answer -true emergencies
-when issuing a written or electronic order is no feasible (e.g. during sterile procedures)
Who is permitted to receive a verbal order? - answer Physician
Registered Nurse
Physician Assistant
Pharmacist
Respiratory Therapist
Verbal orders are not to be used under any circumstances for the prescription of: - answer
antineoplastic agents
Only the following categories of medications are acceptable as range orders: - answer Opioids
and other analgesics
Antitussives
Antiemetics
Antihypertensive's
Antihistamines
Anxiolytics
Penicillin(s) - answer Amoxicillin, ampicillin, augmentin, nafcillin sodium, pipercillin sodium,
penicillin G (aqueous), penicillin VK, trimox, unasyn
Indications: penicillins are antibiotics used to treat many different types of infections, such as
tonsillitis, pneumonia, ear infections, bronchitis, urinary tract infections, gonorrhea, and
infections of the skin, just to name a few.
Serious Adverse Effects: Anaphylaxis, neutropenia, leukopenia, thrombocytopenia,
hepatotoxicity
Nursing Considerations: Give with a full glass of water on empty stomach and do not give with
acidic fruit juice - it decompresses PCN
Patient Education:
-Seek emergency medical treatment if they experience signs and symptoms of an allergic
reaction such as: shortness of breath, hives, swelling of the lips, face or tongue, rash or fainting.
-Contact your physician if they experience severe or bloody diarrhea and abdominal cramping if
being discharged on penicillin.
-Penicillin may decrease the effectiveness of birth control pills and a second method of birth
control while taking penicillin may be necessary to ensure protecting unintentional pregnancy.
, Henry Ford Pharm test
Tetracyclines - answer Doxycycline(vibramycin), Minocycline, and tetracycline
Indications: tetracyclines are antibiotics that are used for different types of bacterial infections
including urinary tract infections, acne, gonorrhea, and chlamydia
Serious Adverse Reactions: Neutropenia, thrombocytopenia, hepatotoxicity, superinfection,
hemolytic anemia, anaphylaxis.
Nursing Considerations:
-effectiveness reduced with antacids, iron salts and foods high in calcium
-give 1 hour before meals or 2 hours after meals
-give with a full glass of water. adequate water should be taken with each dose to prevent
irritation of the esophagus
Patient Education:
-warn to stay out of the sun, photosensitivity manifested by exaggerated sunburn
-Do not use tetracyclines during tooth development, i.e., last trimester of pregnancy, neonatal
period, and childhood until age 8- may cause permanent discoloration of teeth and may inhibit
fetal skeletal growth.
-Do not take dairy products, iron supplements, multivitamins, calcium supplements, antacids or
laxatives within 2 hours of taking tetracyclines. These products may reduce the effectiveness of
tetracyclines.
-Throw away any unused tetracycline when it expires or when it is no longer needed. Do not take
any tetracyclines after the expiration date printed on the label. Expired tetracyclines can cause a
dangerous syndrome resulting in damage to the kidneys.
-Stop taking the tetracycline and seem emergency medical attention if the patient experiences
serious side effects such as an allergic reaction, severe headache, vision changes or confusion,
liver damage, bleeding or bruising, or severe fatigue.
-Inform doctor if any less serious side effects occur including nausea, vomiting, increased
sensitivity of the skin to sunlight, swollen tongue, or yeast infection.
Aminoglycosides - answer Amikacin, Gentamycin (Garamycin), Streptomycin, Tobramycin
Indications: Aminoglycosides are antibiotics used to treat many different infections including
serious infections. Infections such as cirrhosis, gonorrhea, pneumonia, septicemia, and urinary
tract infections may be treated with aminoglycosides.
Serious Adverse Reactions: Nephrotoxicity, ototoxicity, agranulocytosis, thrombocytopenia,
neurotoxicity.
Nursing Considerations:
-Nephrotoxicity is a serious side effect of aminoglycosides. If these side effects are present, the
physician must be contacted before administering this medication. Risk increases in patient with
poor renal function and the elderly. Monitor patient's BUN, creatinine, increase/decrease in
frequency of urination, and increased thirst for signs of nephrotoxicity. Nephrotoxicity is limited
if given for less than 5 days.
-Monitor patient for signs of ototoxicity. This may include tinnitus, hearing impairment, and
vestibular symptoms such as dizziness, nystigmus, vertigo, and ataxia.
Patient Education:
