Henry Ford Pharm test
6 rights of medication administration - CORRECT ANSWER-Right drug
Right dose
Right patient
Right route
Right time
Right documentation
Right Drug - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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: - CORRECT
ANSWER-Drug information
,Patient information
Distraction
Communication
Patient education - CORRECT ANSWER--the names of medications and how to
pronounce them
-what the medications do
-what they look like
-how and when medications should be taken
-possible side effects and food/drug interactions
Who may issue a verbal order? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER-Physician
Registered Nurse
Physician Assistant
Pharmacist
Respiratory Therapist
Verbal orders are not to be used under any circumstances for the prescription of: -
CORRECT ANSWER-antineoplastic agents
Only the following categories of medications are acceptable as range orders: -
CORRECT ANSWER-Opioids and other analgesics
Antitussives
Antiemetics
Antihypertensive's
Antihistamines
Anxiolytics
Penicillin(s) - CORRECT 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.
Tetracyclines - CORRECT 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 - CORRECT 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:
6 rights of medication administration - CORRECT ANSWER-Right drug
Right dose
Right patient
Right route
Right time
Right documentation
Right Drug - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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: - CORRECT
ANSWER-Drug information
,Patient information
Distraction
Communication
Patient education - CORRECT ANSWER--the names of medications and how to
pronounce them
-what the medications do
-what they look like
-how and when medications should be taken
-possible side effects and food/drug interactions
Who may issue a verbal order? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER-Physician
Registered Nurse
Physician Assistant
Pharmacist
Respiratory Therapist
Verbal orders are not to be used under any circumstances for the prescription of: -
CORRECT ANSWER-antineoplastic agents
Only the following categories of medications are acceptable as range orders: -
CORRECT ANSWER-Opioids and other analgesics
Antitussives
Antiemetics
Antihypertensive's
Antihistamines
Anxiolytics
Penicillin(s) - CORRECT 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.
Tetracyclines - CORRECT 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 - CORRECT 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:
