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Nursing Process and Medication Admin.: Assessment |
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blood pressure,platelets,blood sugar |
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knowledge defecit; low adherence |
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being prepared;planning where to give the medication,do you have the right needle?Syringe? |
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did I get an adverse effect or the therapuetic effect? Do I need to go back and do some more teaching?Do I need to consult a physician? |
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medications given with a needle or via the respiratory tract |
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Parts of a Medication Order |
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full name of client date and time of the order written name of the drug being administered dosage and frequency of administration route of administration signature of person writing the order |
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Types of Medication Orders: Stat |
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needs to be done immediately;only given the medication once,the pharmacist has 15min to give this order |
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one time orders;needs to be given w/in a 60min. time frame |
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order sets;give us the ability to treat the patient w/out the permission of the doctor b/c it's already given |
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as needed orders;the RN gives her judgement on when to administer the medication |
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orders the physician gives you verbally,only given in emergent situations,students can't take these; verify what you hear |
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orders given over the phone student's can't take these; verify what you hear |
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descriptive info about the client date prescription was written the Rx symbol Medication name,dosage, and strength Route of admission despensing instructions for the pharmacist direction for the administration to be given to the client refill prescribers signature |
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manual way to chart giving medications |
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Administering Medications |
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identify the client inform the client administer the drug provide adjunctive intervention as indicated record the drug administered evaluate the client's response to the drug |
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What is the medication action? Why is the client taking the medication? Is it a safe dose? What are the nursing implications? Side/Adverse effects? |
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when dispensing for the Pyxis/Check exp.date after obtaining the dose at bedside before administration |
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Ten "Rights" of Accurate Medication Admin. |
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Definition
right medication, right dose, right time, right route, right client (after you come out of client's room) right client education, right documentation, right to refuse, right to assessment, right evaluation |
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Types of Syringes: hypodermic |
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Definition
comes in 2,2.5,3 and 5ml sizes |
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orange,only used for insulin; measured in units |
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small and precise measurements; 15 degree angle |
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has a tip that requires the needle to be twisted into it to avoid accidental removal of the needle |
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the cartridge slides into syrnge barrel,turns,and locks at needle ends; the plunger then screws into cartridge end-used for narcotics |
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slanted part of the tip of the needle; go with bevel up into the skin |
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a glass container usually designed to hold a single dose of a drug |
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a small glass bottle with a sealed rubber cap; after the top is removed,you should not touch,keep it as sterile as pssible by cleaning the bottle with friction |
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the technique of adding a diluent to a powdered drug to prepare it for administration |
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mixing clear before cloudy; inject air into both vials; then go back an pull up solution; don't mix insulins in the vials ony in the syringe |
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Administering Meds: Intradermal Injections |
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Definition
upper chest wall, back on top of the scapula, lower arm; going right into dermis at a 15 degree angle bevels up and you're wearing gloves, inject medication and pull out at the same angle (1ml syringe;#25-27 gauge,1/4-5/8 needle) |
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(3mL syringe,#25 gauge needle or smaller, 3/8-5/8inch long) no aspiration; 1/2-1mL includes insulin,heparin,epigin upper thigh belly upper gluteal muscles sides of upper arms, back,halfway down the scapula given at a 45-90 degree angle |
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darting mechanism;choices begins on what you're given,how much you are given the size of the client,and which muscle you will use (3-5ml,1 1/2 and #20-23 gauge) |
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•give solutions that are thick and viscous, (ex. Penicillin for STIs) used for adults and children with well developed gluteal muscles; good for children under 3 b/c they walk; palpate the posterior superior iliac spine, then draw an imaginary line to the greater trochanter of the femur; this line is lateral to and parallel to the sciatic nerve. The injection site is lateral and superior to this line.(take butt cheek and divide it into four quadrant, give it in the upper outer corner) |
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pull down on the skin around the area |
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you need gloves never let the vial touch the patient create a pocket by pulling down on the eye place solution in the pocket,keep your finger in place |
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pull pinna upward and backward-straightens ear canal cotton is not needed unless specifically ordered |
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get patient to get head back over the edge of the bed may want to rotate the patient's head to get into the correct sinus |
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administering vaginal instillations |
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follow directions person has to stay laying down insert 8-10cm, creams 5cm- patient needs to lay down for 10min |
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inserting rectal suppository |
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patient is in the Sims position insert the suppository through the sphincter 4cm given to patients that can't take things by mouth stored in the refrigerator lubricate before it goes in |
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