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After completing this unit, you should be able to: Describe rules and responsibilities regarding drug administration and the initial preparation for the drug administration, list the rights of drug administration, recognize the correct equipment to use for administering medications,...
CHAPTER 53 Medication Administration © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-2 Learning Outcomes 53.1 Describe rules and responsibilities regarding drug administration and the initial preparation for the drug administration 53.2 List the rights of drug administration 53.3 Recognize the correct equipment to use for administering medications © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-3 Learning Outcomes 53.4 Carry out the procedures for administering oral medications 53.5 Carry out procedures for administering parenteral medications 53.6 Carry out procedures for administering parenteral medications by other routes © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-4 Learning Outcomes 53.7 Relate special considerations required for medication administration to pediatric, geriatric, and pregnant patients 53.8 Outline patient education information related to medications 53.9 Implement accurate and complete documentation of medications © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-5 Introduction • Drug administration – Given correctly ~ restores health – Given incorrectly ~ condition can worsen • Medical assistant must – Understand fundamentals of drug administration – Know your scope of practice © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-6 Preparing to Administer a Drug • For common drugs know – Uses – Contraindications – Interactions – Adverse effects • Be alert to any change in patient’s condition that could affect drug therapy © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-7 Preparing to Administer a Drug (cont.) • Drug and drug allergies – Keep an accurate medication list in the patient record – Ask about drug allergies at every appointment © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-8 Preparing to Administer a Drug (cont.) • Administration site – Check site of administration – Be sure there are no contradictions to using the site © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-9 Preparing to Administer a Drug (cont.) • Patient condition – Assess overall condition – Review drug list – Be sure dose is appropriate • Patient consent form – Answer questions – Have signed before administering injection © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-10 General Rules for Drug Administration • Give only drugs the doctor orders • Wash your hands – Prepare in a well-lit area – Focus on task – Avoid distractions © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-46 Patient Education about Medications (cont.) • Drug-drug interactions – Types • • • • Effects may be increased Effects may be decreased One drug may be increased by another Lead to adverse reactions – Check patient drug use – Patient education © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-47 Patient Education about Medications (cont.) • Food-drug interactions – Alter the therapeutic effect – Interfere with body’s use of nutrients – Patient education • Be specific about foods to avoid and when • Explain what to expect if interaction occurs • Describe what to © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-48 Patient Education about Medications (cont.) • Adverse effects – May be mild to life-threatening – Elderly or patient with kidney and liver disease ~ more susceptible – Patient education • Take as instructed • Recognition of significant adverse effects • Report to physician © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-49 Patient Education about Medications (cont.) • Complete medication list – Prescription and OTC drugs – Supplements and herbals – Past and present use of recreational drugs and alcohol – Patient education • Tell all of their doctors about their medications • Keep an up-to-date list with dosages © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-50 Patient Education about Medications (cont.) • Patient compliance – patient education – How and when to take each drug – How long to take each drug – How to identify possible adverse effects © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-51 Patient Education about Medications (cont.) • Patient compliance – patient education – What to with old medication – How to store drugs – When to call the doctor © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-52 Apply Your Knowledge What should you instruct the patient about regarding drug administration? ANSWER: The patient should be taught how to read the prescription label, drug-drug and drug-food interactions, adverse effects, and how to take the drug correctly Bravo! © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-53 Charting Medications • Entries – accurate • Be consistent with charting methods used • Tips – Have the right chart, document in right place – Chart directly from physician’s order – Be specific – Do not leave gaps or skip lines © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-54 Charting Medications (cont.) • Tips (cont.) – Correct errors in proper manner – Do not use ditto marks – Write neatly; enter carefully in EHR – Use approved abbreviations and symbols – If unsure, ask supervisor © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-55 Apply Your Knowledge When charting that you gave the patient a subcutaneous injection, you wrote intravenously by mistake What should you do? ANSWER: If you make an error, not erase it Draw a line through intravenously The mistake should still be visible, so not black it out Initial it and then chart “subcut” IMPRESSIVE ! © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-56 In Summary 53.1 Before administering a medication, you should check the patient for allergies and also evaluate any drugdrug interactions You should check all injection sites for abnormalities Additionally, you should be aware of the patient’s condition and have the patient sign a consent form if necessary 53.2 The rights of drug administration include the right patient, right drug, right dose, right route, right time, right documentation, right reason, right to know, right to refuse, and right technique © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-57 In Summary (cont.) 53.3 Drugs may be administered for either local or systemic effects Table 53-2 outlines the many drug administration routes 53.4 Oral medications typically are swallowed and absorbed through the digestive tract Sublingual medications go under the tongue, and buccal medications go between the cheek and gum 53.5 The three most common injection routes are ID, subcut, and IM IV is less frequently used in a medical office All injections are given using aseptic technique © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-58 In Summary (cont.) 53.6 Other medication routes include inhalants (respiratory), topical (including transdermal), urethral, vaginal, and rectal 53.7 Certain special considerations must be made when caring for pediatric, pregnant, and breastfeeding patients Pediatric patients require extreme care when calculating doses Checking medications given to pregnant and breastfeeding patients for possible adverse effects is essential © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-59 In Summary (cont.) 53.8 Patients should be educated about why, when, and how they should take medications This includes instruction to ensure patient compliance Patients should also be instructed about the dangers of medication combinations, the importance of reporting an adverse effect, and maintaining a complete medication list 53.9 Documentation of medication administered should occur immediately after the given and should include the name, date, time, medication administered, dose, route, location, lot #, and how the patient tolerated it © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 53-60 End of Chapter 53 Words are the most powerful drug used by mankind ~Rudyard Kipling © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part ... whole or part 53- 3 Learning Outcomes 53. 4 Carry out the procedures for administering oral medications 53. 5 Carry out procedures for administering parenteral medications 53. 6 Carry out procedures. . .53- 2 Learning Outcomes 53. 1 Describe rules and responsibilities regarding drug administration and the initial preparation for the drug administration 53. 2 List the rights of drug administration. .. website, in whole or part 53- 4 Learning Outcomes 53. 7 Relate special considerations required for medication administration to pediatric, geriatric, and pregnant patients 53. 8 Outline patient education