NR 224 Exam 3 Study Guide: Medication Administration and Patient Care

1. The Six Rights of Medication Administration

• Right Dose: Ensure the correct dosage of the medication is administered as per the prescription.
• Right Patient: Verify the patient’s identity using at least two identifiers (e.g., name and date of birth) before administering any medication.
• Right Route: Administer the medication via the correct route (e.g., oral, intravenous, intramuscular).
• Right Time: Administer the medication at the prescribed time. Some medications must be given at specific intervals or times for maximum efficacy.
• Right Documentation: Accurately document the medication administration immediately after giving the medication to avoid errors.
• Patient Rights and Right to Refuse: Patients have the right to refuse medication. If a patient refuses, it is important to explain the importance of the medication and the potential consequences of not taking it, while respecting their autonomy.

2. Understanding Medication Names

• Chemical Name: Provides the exact description of the medication’s composition. Example: N-acetyl-para-aminophenol.
• Generic Name: Assigned by the manufacturer who first develops the drug and is listed in the U.S. Pharmacopeia. Example: Acetaminophen.
• Trade Name: Also known as the brand or proprietary name. This is the name under which a manufacturer markets the medication. Example: Tylenol.

3. Patient Use of Herbal Supplements

• Patients must inform healthcare providers about any herbal supplements they are taking, as these can interact with prescribed medications, potentially altering their effectiveness or causing adverse effects.

4. Types of Medication Orders

• Standing Orders: Pre-written orders for a specific condition that can be carried out until the physician cancels them or the prescribed number of days elapses.
• PRN Orders: “As needed” orders that allow medication administration based on the patient’s condition, such as pain relief.
• One-Time Orders: A medication order that is executed once at a specific time.
• STAT Orders: Immediate medication orders that need to be executed as soon as possible.
• Now Orders: Orders that should be administered within an hour or as soon as possible, but not as urgent as STAT.

5. Handling Medication Administration Issues

• If It Is Too Soon to Give PRN Pain Meds: Consider non-pharmacological pain management techniques, such as repositioning, ice/heat application, or relaxation techniques.
• If a Standing Order Has Expired: Contact the physician to obtain a new order to continue the medication if necessary.
• If a Physician’s Order Is Incorrect, Illegible, or Missing Information: Always call the physician to clarify or verify the order. Never guess or assume what the order should be.

6. Instilling Ear Drops

• For Adults: Pull the pinna up and back before instilling drops to straighten the ear canal (ages 3 and up).
• For Children: Pull the pinna down and back to straighten the ear canal. Use sterile solutions, and ensure the drops are at room temperature. You may place a cotton ball in the ear, but do not push it in.

7. Eye Drops Administration

• Instill eye drops in the conjunctival sac (the white part of the eye). Avoid touching the tip of the dropper to the patient’s eye to maintain sterility. Ensure the drops are at the appropriate temperature. Do not use eye drops from one patient on another.

8. Care of an Artificial Eye

• Proper cleaning and handling are essential to prevent infection and ensure comfort. Follow the specific care instructions provided by the healthcare provider.

9. Physician Orders and Medication Administration

• If an Order Is Written Incorrectly or Illegibly: Contact the physician for clarification or correction before administering the medication.
• Changing the Timing of Medications: You can adjust the timing for PRN or once-daily medications if necessary, but this should be done within the guidelines provided and documented properly.

10. Roles in Medication Administration

• Prescriber (Doctor, Nurse Practitioner, Physician Assistant): Responsible for writing medication orders, which can be done by hand, electronically, or verbally in emergency situations.
• Registered Nurse (RN): Administers medications and ensures the “Six Rights” of medication administration are followed.
• Pharmacist: Prepares and dispenses medications based on the prescriber’s orders, ensuring the correct medication and dosage are provided.

11. Medication Calculations

• Be proficient in calculating medication dosages, including conversions between units (e.g., mg to g, mL to L). Practice problems related to dosage calculations and conversions are critical for success in medication administration.

12. Reasons for Medication Refusal and Patient Education

• Patients may refuse medications for various reasons, including fear of side effects, lack of understanding of the medication’s purpose, or distrust in the medication. To assist in changing their minds:
  • Educate the Patient: Explain the importance of the medication, how it works, and what could happen if they do not take it.
  • Address Concerns: Listen to the patient’s reasons for refusal and address any misconceptions or fears they may have.