Podcast
Questions and Answers
A nurse is transcribing a client's prescription onto a paper medication administration record (MAR). Beside medication name, dose, route, and frequency, which of the following information is essential to include?
A nurse is transcribing a client's prescription onto a paper medication administration record (MAR). Beside medication name, dose, route, and frequency, which of the following information is essential to include?
- Pharmacy contact information.
- Client's insurance details.
- Date the prescription was written and its expiration date. (correct)
- The diagnosis for which the medication is prescribed.
A client has multiple allergies listed on their MAR. Which of the following actions should the nurse prioritize when administering medications?
A client has multiple allergies listed on their MAR. Which of the following actions should the nurse prioritize when administering medications?
- Double-check the medication and dosage, but disregard the allergy information if the medication is essential.
- Administer the medication regardless, as allergies are usually mild.
- Verify the client's allergies and potential cross-reactivity with the prescribed medication. (correct)
- Consult with the provider about potentially ordering an antihistamine along with the medication.
A health care facility is transitioning from paper MARs to electronic health records (EHRs) with computerized provider order entry (CPOE). What is the primary advantage of this change?
A health care facility is transitioning from paper MARs to electronic health records (EHRs) with computerized provider order entry (CPOE). What is the primary advantage of this change?
- Increases the time nurses spend on documentation.
- Eliminates the need for nurses to verify medication orders.
- Allows providers to enter prescriptions directly, reducing transcription errors. (correct)
- Requires pharmacists to visit the patient's bedside to verify medication orders.
A nurse is preparing to administer a medication that should be taken with food, according to the MAR. What is the rationale for this instruction?
A nurse is preparing to administer a medication that should be taken with food, according to the MAR. What is the rationale for this instruction?
A nurse discovers that the provider has prescribed a medication that the client is allergic to according to the client's MAR. What should the nurse do first?
A nurse discovers that the provider has prescribed a medication that the client is allergic to according to the client's MAR. What should the nurse do first?
A health care facility adopts a unit-dose system for medication dispensing. How does this system primarily enhance medication safety?
A health care facility adopts a unit-dose system for medication dispensing. How does this system primarily enhance medication safety?
A nurse is preparing to administer a medication from a unit-dose package. What key information should the nurse verify on the package label before administration?
A nurse is preparing to administer a medication from a unit-dose package. What key information should the nurse verify on the package label before administration?
Why is it best practice for liquid medications in a pharmacy bulk system to be dispensed in oral syringes rather than other measuring devices?
Why is it best practice for liquid medications in a pharmacy bulk system to be dispensed in oral syringes rather than other measuring devices?
When reconciling a client's medications, a nurse notes a discrepancy between the documented dosage in the MAR and the dosage strength listed on the pharmacy bulk container label. What action should the nurse take FIRST?
When reconciling a client's medications, a nurse notes a discrepancy between the documented dosage in the MAR and the dosage strength listed on the pharmacy bulk container label. What action should the nurse take FIRST?
A nurse is preparing to restock medications in an automated medication dispensing system (AMDS). Which of the following security measures is most important to maintain the integrity of the system?
A nurse is preparing to restock medications in an automated medication dispensing system (AMDS). Which of the following security measures is most important to maintain the integrity of the system?
A nurse using a bar code system encounters an alert indicating a discrepancy between the medication scanned and the client's wristband. What is the most appropriate nursing action?
A nurse using a bar code system encounters an alert indicating a discrepancy between the medication scanned and the client's wristband. What is the most appropriate nursing action?
A nurse is preparing to administer a scored tablet to a client. What is the primary consideration when handling this type of medication?
A nurse is preparing to administer a scored tablet to a client. What is the primary consideration when handling this type of medication?
A client is prescribed an enteric-coated tablet. What information should the nurse provide to the client regarding its administration?
A client is prescribed an enteric-coated tablet. What information should the nurse provide to the client regarding its administration?
A nurse is teaching a client about sustained-release capsules. Which of the following statements is most important for the nurse to include?
A nurse is teaching a client about sustained-release capsules. Which of the following statements is most important for the nurse to include?
A client cannot swallow solid medications. What is the nurse's best course of action?
A client cannot swallow solid medications. What is the nurse's best course of action?
A nurse is administering a troche to a client. What instruction should the nurse give to the client for proper administration?
A nurse is administering a troche to a client. What instruction should the nurse give to the client for proper administration?
A nurse is administering a sublingual medication. Where should the nurse instruct the client to place the medication?
A nurse is administering a sublingual medication. Where should the nurse instruct the client to place the medication?
A nurse is administering a buccal medication. What specific instruction should the nurse provide to the client about its administration?
A nurse is administering a buccal medication. What specific instruction should the nurse provide to the client about its administration?
A provider prescribes dexamethasone 6 mg PO every 6 hours. Available is dexamethasone 3 mg tablets. How many tablets should the nurse administer per dose?
A provider prescribes dexamethasone 6 mg PO every 6 hours. Available is dexamethasone 3 mg tablets. How many tablets should the nurse administer per dose?
A provider prescribes digoxin 0.125mg PO daily. Available is digoxin 0.25 mg/tablet. How many tablets should the nurse administer?
A provider prescribes digoxin 0.125mg PO daily. Available is digoxin 0.25 mg/tablet. How many tablets should the nurse administer?
A provider prescribes glipizide 10 mg PO 30 minutes before the client’s morning and evening meal. The amount available is glipizide 5 mg/tablet. How many tablets should the nurse administer?
A provider prescribes glipizide 10 mg PO 30 minutes before the client’s morning and evening meal. The amount available is glipizide 5 mg/tablet. How many tablets should the nurse administer?
A provider prescribes nifedipine 40 mg PO every 8 hours. The amount available is nifedipine 20 mg/capsule. How many capsules should the nurse administer
A provider prescribes nifedipine 40 mg PO every 8 hours. The amount available is nifedipine 20 mg/capsule. How many capsules should the nurse administer
A provider prescribes acyclovir 600 mg PO every 8 hours. Available is acyclovir 300 mg/capsule. How many capsules should the nurse administer?
A provider prescribes acyclovir 600 mg PO every 8 hours. Available is acyclovir 300 mg/capsule. How many capsules should the nurse administer?
A provider prescribes acetaminophen 1000mg PO every 6 hours PRN headache. Available is acetaminophen 500mg/tablet. How many tablets should the nurse administer?
A provider prescribes acetaminophen 1000mg PO every 6 hours PRN headache. Available is acetaminophen 500mg/tablet. How many tablets should the nurse administer?
A client is prescribed spironolactone 100 mg PO daily. Available is spironolactone 50 mg/tablet. How many tablets should the nurse administer?
A client is prescribed spironolactone 100 mg PO daily. Available is spironolactone 50 mg/tablet. How many tablets should the nurse administer?
A provider prescribes buspirone 20 mg PO every 12 hours. Available is buspirone 10 mg/tablet. How many tablets should the nurse administer?
A provider prescribes buspirone 20 mg PO every 12 hours. Available is buspirone 10 mg/tablet. How many tablets should the nurse administer?
A provider prescribes clonidine 300 mcg PO daily at bedtime. Available is clonidine 0.1 mg/tablet. How many tablets should the nurse administer?
A provider prescribes clonidine 300 mcg PO daily at bedtime. Available is clonidine 0.1 mg/tablet. How many tablets should the nurse administer?
A physician prescribes olanzapine 7.5 mg PO daily. Available are olanzapine 2.5 mg tablets. How many tablets should the nurse administer?
A physician prescribes olanzapine 7.5 mg PO daily. Available are olanzapine 2.5 mg tablets. How many tablets should the nurse administer?
A nurse is preparing to administer a liquid medication to a client. Which of the following measuring devices provides the MOST accurate dose?
A nurse is preparing to administer a liquid medication to a client. Which of the following measuring devices provides the MOST accurate dose?
A medication order is received for an elixir. What does the nurse know about this type of liquid medication?
A medication order is received for an elixir. What does the nurse know about this type of liquid medication?
A nurse is preparing to administer a suspension. What action should the nurse take prior to measuring the dose?
A nurse is preparing to administer a suspension. What action should the nurse take prior to measuring the dose?
A medication needs to be administered via an enteral feeding tube. What is the priority action the nurse should take?
A medication needs to be administered via an enteral feeding tube. What is the priority action the nurse should take?
A nurse is preparing to administer valproic acid 750 mg PO every 12 hours. Available is valproic acid oral syrup 250 mg/5 mL. How many mL should the nurse administer per dose?
A nurse is preparing to administer valproic acid 750 mg PO every 12 hours. Available is valproic acid oral syrup 250 mg/5 mL. How many mL should the nurse administer per dose?
A physician prescribes furosemide 75 mg PO daily. Available is furosemide oral solution 10 mg/1 mL. How many mL should the nurse administer?
A physician prescribes furosemide 75 mg PO daily. Available is furosemide oral solution 10 mg/1 mL. How many mL should the nurse administer?
A provider prescribes potassium chloride 60 mEq PO every 12 hours. Available is potassium chloride oral solution 20 mEq/15 mL. How many mL should the nurse administer per dose?
A provider prescribes potassium chloride 60 mEq PO every 12 hours. Available is potassium chloride oral solution 20 mEq/15 mL. How many mL should the nurse administer per dose?
A provider prescribes lamivudine 200 mg PO every 12 hours. Available is lamivudine oral solution 10 mg/mL. How many mL should the nurse administer per dose?
A provider prescribes lamivudine 200 mg PO every 12 hours. Available is lamivudine oral solution 10 mg/mL. How many mL should the nurse administer per dose?
A guardian is instructed to administer pseudoephedrine 20 mg PO every 6 hours to a child. The available pseudoephedrine oral liquid is 20 mg/5 mL. How many mL should the guardian be instructed to give every 6 hours?
A guardian is instructed to administer pseudoephedrine 20 mg PO every 6 hours to a child. The available pseudoephedrine oral liquid is 20 mg/5 mL. How many mL should the guardian be instructed to give every 6 hours?
A provider prescribes cephalexin 375 mg PO every 6 hours. Available is cephalexin oral suspension 125 mg/5 mL. How many mL should the nurse administer per dose?
A provider prescribes cephalexin 375 mg PO every 6 hours. Available is cephalexin oral suspension 125 mg/5 mL. How many mL should the nurse administer per dose?
A provider prescribes phenobarbital 120 mg. Available is phenobarbital elixir 30 mg/5 mL. How many mL should the nurse administer?
A provider prescribes phenobarbital 120 mg. Available is phenobarbital elixir 30 mg/5 mL. How many mL should the nurse administer?
A provider prescribes penicillin V potassium 750 mg PO every 6 hours. Available is penicillin V potassium oral suspension 250 mg/5 mL. How many mL should the nurse administer per dose?
A provider prescribes penicillin V potassium 750 mg PO every 6 hours. Available is penicillin V potassium oral suspension 250 mg/5 mL. How many mL should the nurse administer per dose?
A provider prescribes diphenhydramine 50 mg PO every 6 hours. Available is diphenhydramine oral syrup 12.5 mg/5 mL. How many mL should the nurse administer per dose?
A provider prescribes diphenhydramine 50 mg PO every 6 hours. Available is diphenhydramine oral syrup 12.5 mg/5 mL. How many mL should the nurse administer per dose?
A provider prescribes phenytoin 375 mg PO daily. Available is phenytoin oral suspension 125 mg/5 mL. How many mL should the nurse administer?
A provider prescribes phenytoin 375 mg PO daily. Available is phenytoin oral suspension 125 mg/5 mL. How many mL should the nurse administer?
A nurse is preparing to transcribe medication orders onto a paper MAR. Besides the medication name and dosage, which of the following details must be included to ensure accurate medication administration?
A nurse is preparing to transcribe medication orders onto a paper MAR. Besides the medication name and dosage, which of the following details must be included to ensure accurate medication administration?
When reviewing a client's medication orders, the nurse notices a discrepancy between the prescribed dose and the typical dosage range for the medication. What is the most appropriate action for the nurse to take?
When reviewing a client's medication orders, the nurse notices a discrepancy between the prescribed dose and the typical dosage range for the medication. What is the most appropriate action for the nurse to take?
A client's MAR indicates that a particular medication should be administered on an empty stomach. What physiological factor is most important to consider when adhering to this instruction?
A client's MAR indicates that a particular medication should be administered on an empty stomach. What physiological factor is most important to consider when adhering to this instruction?
A nurse notices that a client's allergy bracelet lists 'sulfa drugs' as an allergy, but a newly prescribed medication contains a sulfonamide component not explicitly listed. What action should the nurse prioritize?
A nurse notices that a client's allergy bracelet lists 'sulfa drugs' as an allergy, but a newly prescribed medication contains a sulfonamide component not explicitly listed. What action should the nurse prioritize?
What is the primary reason for using a unit-dose system in medication dispensing?
What is the primary reason for using a unit-dose system in medication dispensing?
A nurse is preparing to administer medication from a unit-dose package that does not have a bar code. Besides the medication name and expiration date, what other piece of information is critical to verify on the label before administration?
A nurse is preparing to administer medication from a unit-dose package that does not have a bar code. Besides the medication name and expiration date, what other piece of information is critical to verify on the label before administration?
Why is it a recommended best practice for liquid medications in a pharmacy bulk system to be dispensed in oral syringes rather than medicine cups?
Why is it a recommended best practice for liquid medications in a pharmacy bulk system to be dispensed in oral syringes rather than medicine cups?
While reconciling a client's medications, a nurse discovers that the dosage listed on the pharmacy bulk container label does not match the documented dosage in the MAR. After verifying the discrepancy, what is the nurse's next action?
While reconciling a client's medications, a nurse discovers that the dosage listed on the pharmacy bulk container label does not match the documented dosage in the MAR. After verifying the discrepancy, what is the nurse's next action?
A nurse is assigned to restock medications in an automated medication dispensing system (AMDS). What procedural step is most important to prevent unauthorized access and diversion?
A nurse is assigned to restock medications in an automated medication dispensing system (AMDS). What procedural step is most important to prevent unauthorized access and diversion?
A nurse scans a medication using a bar code system, and an alert indicates a potential interaction with another medication the client is taking. What is the nurse’s priority action based on this information?
A nurse scans a medication using a bar code system, and an alert indicates a potential interaction with another medication the client is taking. What is the nurse’s priority action based on this information?
A nurse is about to administer a scored tablet. What assessment should the nurse make before dividing the tablet?
A nurse is about to administer a scored tablet. What assessment should the nurse make before dividing the tablet?
A client is prescribed an enteric-coated tablet. What instruction should the nurse emphasize to the client regarding its administration?
A client is prescribed an enteric-coated tablet. What instruction should the nurse emphasize to the client regarding its administration?
What key information should a nurse provide to a client about taking sustained-release capsules?
What key information should a nurse provide to a client about taking sustained-release capsules?
A client reports difficulty swallowing solid medications. What should the nurse do first to address this problem?
A client reports difficulty swallowing solid medications. What should the nurse do first to address this problem?
A nurse is preparing to administer a troche to a client. What specific instruction should the nurse provide to the client?
A nurse is preparing to administer a troche to a client. What specific instruction should the nurse provide to the client?
Where should the nurse instruct a client to place a sublingual medication for optimal absorption?
Where should the nurse instruct a client to place a sublingual medication for optimal absorption?
A nurse is administering a buccal medication. What instruction is most important to give the client?
A nurse is administering a buccal medication. What instruction is most important to give the client?
A provider prescribes prednisone 30 mg PO daily. Available are prednisone 10 mg tablets. How many tablets should the nurse administer per dose?
A provider prescribes prednisone 30 mg PO daily. Available are prednisone 10 mg tablets. How many tablets should the nurse administer per dose?
A provider prescribes levothyroxine 75 mcg PO daily. Available are levothyroxine 25 mcg tablets. How many tablets should the nurse administer?
A provider prescribes levothyroxine 75 mcg PO daily. Available are levothyroxine 25 mcg tablets. How many tablets should the nurse administer?
A provider prescribes metoprolol 50 mg PO twice daily. Available are metoprolol 25 mg tablets. How many tablets should the nurse administer per dose?
A provider prescribes metoprolol 50 mg PO twice daily. Available are metoprolol 25 mg tablets. How many tablets should the nurse administer per dose?
A provider prescribes amoxicillin 500 mg PO every 8 hours. Available are amoxicillin 250 mg capsules. How many capsules should the nurse administer?
A provider prescribes amoxicillin 500 mg PO every 8 hours. Available are amoxicillin 250 mg capsules. How many capsules should the nurse administer?
A provider prescribes ciprofloxacin 400 mg PO every 12 hours. Available are ciprofloxacin 200 mg tablets. How many tablets should the nurse administer?
A provider prescribes ciprofloxacin 400 mg PO every 12 hours. Available are ciprofloxacin 200 mg tablets. How many tablets should the nurse administer?
A provider prescribes ibuprofen 800 mg PO every 8 hours PRN pain. Available are ibuprofen 200 mg tablets. How many tablets should the nurse administer?
A provider prescribes ibuprofen 800 mg PO every 8 hours PRN pain. Available are ibuprofen 200 mg tablets. How many tablets should the nurse administer?
A client is prescribed furosemide 40 mg PO daily. Available are furosemide 20 mg tablets. How many tablets should the nurse administer?
A client is prescribed furosemide 40 mg PO daily. Available are furosemide 20 mg tablets. How many tablets should the nurse administer?
A provider prescribes sertraline 75 mg PO daily. Available are sertraline 25 mg tablets. How many tablets should the nurse administer?
A provider prescribes sertraline 75 mg PO daily. Available are sertraline 25 mg tablets. How many tablets should the nurse administer?
A provider prescribes lorazepam 1.5 mg PO daily at bedtime. Available are lorazepam 0.5 mg tablets. How many tablets should the nurse administer?
A provider prescribes lorazepam 1.5 mg PO daily at bedtime. Available are lorazepam 0.5 mg tablets. How many tablets should the nurse administer?
A physician prescribes risperidone 3 mg PO daily. Available are risperidone 1 mg tablets. How many tablets should the nurse administer?
A physician prescribes risperidone 3 mg PO daily. Available are risperidone 1 mg tablets. How many tablets should the nurse administer?
What characteristic defines an elixir as a liquid medication?
What characteristic defines an elixir as a liquid medication?
Why is it important to shake a suspension before administration?
Why is it important to shake a suspension before administration?
A nurse is preparing to administer medication through an enteral feeding tube. What is the primary reason to use liquid medication instead of crushed tablets?
A nurse is preparing to administer medication through an enteral feeding tube. What is the primary reason to use liquid medication instead of crushed tablets?
A nurse is preparing to administer divalproex sodium 625 mg PO every 12 hours. Available is divalproex sodium oral syrup 250 mg/5 mL. How many mL should the nurse administer per dose?
A nurse is preparing to administer divalproex sodium 625 mg PO every 12 hours. Available is divalproex sodium oral syrup 250 mg/5 mL. How many mL should the nurse administer per dose?
A physician prescribes metoprolol 25 mg PO daily. Available is metoprolol oral solution 5 mg/1 mL. How many mL should the nurse administer?
A physician prescribes metoprolol 25 mg PO daily. Available is metoprolol oral solution 5 mg/1 mL. How many mL should the nurse administer?
A provider prescribes abacavir 300 mg PO every 12 hours. Available is abacavir oral solution 20 mg/mL. How many mL should the nurse administer per dose?
A provider prescribes abacavir 300 mg PO every 12 hours. Available is abacavir oral solution 20 mg/mL. How many mL should the nurse administer per dose?
A parent is instructed to administer amoxicillin 250 mg PO every 8 hours to a child. The available amoxicillin oral suspension is 250 mg/5 mL. How many mL should the parent be instructed to give every 8 hours?
A parent is instructed to administer amoxicillin 250 mg PO every 8 hours to a child. The available amoxicillin oral suspension is 250 mg/5 mL. How many mL should the parent be instructed to give every 8 hours?
A provider prescribes cefdinir 180 mg PO every 12 hours. Available is cefdinir oral suspension 125 mg/5 mL. How many mL should the nurse administer per dose?
A provider prescribes cefdinir 180 mg PO every 12 hours. Available is cefdinir oral suspension 125 mg/5 mL. How many mL should the nurse administer per dose?
A nurse is preparing to administer phenobarbital 80 mg. Available is phenobarbital elixir 20 mg/5 mL. How many mL should the nurse administer?
A nurse is preparing to administer phenobarbital 80 mg. Available is phenobarbital elixir 20 mg/5 mL. How many mL should the nurse administer?
A provider prescribes penicillin VK 375 mg PO every 6 hours. Available is penicillin VK oral solution 125 mg/5 mL. How many mL should the nurse administer per dose?
A provider prescribes penicillin VK 375 mg PO every 6 hours. Available is penicillin VK oral solution 125 mg/5 mL. How many mL should the nurse administer per dose?
A nurse is preparing to administer medications using a medication cart. Which practice is most appropriate for maintaining medication security?
A nurse is preparing to administer medications using a medication cart. Which practice is most appropriate for maintaining medication security?
A medication order reads: 'Administer 1/2 tablet PO daily.' The pharmacy sends a unit-dose package containing one scored tablet. What is the most appropriate nursing action?
A medication order reads: 'Administer 1/2 tablet PO daily.' The pharmacy sends a unit-dose package containing one scored tablet. What is the most appropriate nursing action?
A nurse is caring for a client who has a nasogastric tube. The provider orders a medication in tablet form. What should the nurse do first?
A nurse is caring for a client who has a nasogastric tube. The provider orders a medication in tablet form. What should the nurse do first?
A nurse is teaching a client how to take a buccal medication. What instructions should the nurse include to ensure proper administration?
A nurse is teaching a client how to take a buccal medication. What instructions should the nurse include to ensure proper administration?
A nurse is preparing to administer a liquid medication from a pharmacy bulk container. What is the preferred method for dispensing the medication?
A nurse is preparing to administer a liquid medication from a pharmacy bulk container. What is the preferred method for dispensing the medication?
A nurse notes that a client's electronic MAR displays duplicate orders for the same medication, with different frequencies. What should the nurse do?
A nurse notes that a client's electronic MAR displays duplicate orders for the same medication, with different frequencies. What should the nurse do?
A nurse is preparing to administer a suspension to a client. Which of the following actions is most important?
A nurse is preparing to administer a suspension to a client. Which of the following actions is most important?
A client refuses to take a medication, stating they have never taken it before and are concerned about side effects. The medication is listed on the MAR. What is the nurse's priority action?
A client refuses to take a medication, stating they have never taken it before and are concerned about side effects. The medication is listed on the MAR. What is the nurse's priority action?
A provider prescribes amoxicillin 275 mg PO every 8 hours. Available is amoxicillin oral suspension 125 mg/5 mL. How many mL should the nurse administer per dose?
A provider prescribes amoxicillin 275 mg PO every 8 hours. Available is amoxicillin oral suspension 125 mg/5 mL. How many mL should the nurse administer per dose?
A nurse is teaching a client about self-administration of oral medications at home. What is the most important instruction related to accurate dosing?
A nurse is teaching a client about self-administration of oral medications at home. What is the most important instruction related to accurate dosing?
Flashcards
Medication Administration Record (MAR)
Medication Administration Record (MAR)
A document with a client's medications, dosage, route, and administration times.
Electronic Health Record (EHR)
Electronic Health Record (EHR)
A system where providers enter prescriptions directly into a client's medical record.
Transcribe
Transcribe
To make a written copy of a prescription order.
Prescription
Prescription
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Unit-dose
Unit-dose
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Pharmacy bulk system
Pharmacy bulk system
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Controlled substance
Controlled substance
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Multi-dose
Multi-dose
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Solution
Solution
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Automated Dispensing System (AMDS)
Automated Dispensing System (AMDS)
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Biometric identification
Biometric identification
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Tablet
Tablet
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Scored tablet
Scored tablet
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Enteric-coated tablet
Enteric-coated tablet
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Troche
Troche
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Capsule
Capsule
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Sustained-release capsule
Sustained-release capsule
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Caplet
Caplet
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Sublingual
Sublingual
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Buccal
Buccal
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Elixir
Elixir
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Syrup
Syrup
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Suspension
Suspension
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Solution
Solution
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Study Notes
- The module provides an overview of the medication administration record and its use, the unit-dose system of medication dispensing, and medication storage and distribution in healthcare facilities
Medication Administration Record (MAR)
- A MAR is a document containing a client’s prescribed medications, dosage, route, administration times, and other relevant details, such as start and end times or specific parameters for administration
- Electronic health records (EHRs) and computerized provider order entry (CPOE) are standard in acute care facilities
- Nurses may need to transcribe prescriptions onto a paper MAR, ensuring to include the medication name, dose, route, frequency, date, and expiration
- MARs contain client's identifying information, current date, prescription details, and medication administration times
- Instructions such as whether a medication should be taken with food are included in the MAR
Medication Dispensing
- Several healthcare professionals are responsible for medication administration
- The provider writes the medication prescription
- A pharmacist or pharmacy technician prepares and distributes the medications
- A nurse administers the medication
- Administering medication requires nursing knowledge, clinical judgment, and clinical skills
Unit-Dose System
- Each dose of medication is individually packaged and labeled with the medication name and expiration date
- Some packages include a bar code for point-of-care medication systems
- Packages contain tablets, capsules, troches, suppositories, or pre-measured liquid medication
- Pharmacists can create unit-dose packages from bulk supplies if not available from the manufacturer
- The medication label includes form, concentration, directions, total dose, storage information, and expiration date
Pharmacy Bulk System
- A labeled container holds multiple medication doses
- Liquid medications should be dispensed in oral syringes to ensure accurate dosing
Liquid Medication Label Information
- Includes generic and brand names, intended use, total volume, concentration, directions for use, storage information, and expiration date
- Not all labels include the medication's intended use
Medication Storage Areas
- Facilities use medication carts, rooms, locked cabinets, and automated dispensing systems to store medications
Medication Carts
- Medications are in unit-dose packaging with each client's medications stored in individual drawers, labeled with the client’s name
- Some carts have a bar code scanner to verify accuracy
- Pharmacists or technicians fill drawers with a 24-hr supply
- Medication carts should be locked when not in use, requiring a key or passcode to unlock
Medical Cabinets
- Some facilities have individual medication cabinets in client rooms for all medications except controlled substances
Medication Rooms
- Stock medications, multi-dose medications, emergency medications, IV solutions, and medication supplies are stored in medication rooms
- Access to rooms is restricted by passcode or key
Automated Medication Dispensing Systems (AMDS)
- Medication storage machines control dispensing, including controlled substances
- Nurses use a personal password or biometric identification for access
- Nurses select the client’s name, medication, dosage, and route, and the system dispenses the medication
- The AMDS can link medication administration and the nurse to the client’s electronic medical record
- Advantages of AMDS include adherence to controlled substance regulations, reduced medication errors/costs, and improved documentation
- Nurses should only retrieve one client’s medications at a time, even if the systems are limited
Barcode System
- A handheld scanner is used to scan the client’s ID wristband and the medication label
- The system will alert the nurse to any discrepancies between the scanned medication and the client information
Solid Medication Forms
- Tablet: Medication compressed into a disk-like shape
- Scored tablets are easier to divide, but unscored tablets should not be divided
- Enteric-coated tablet: Coated to prevent dissolution until it reaches the small intestine, preventing stomach irritation
- Troche (Lozenges): Flat, round tablet designed to be dissolved in the mouth
- Capsule: Medication encased in a gelatin container
- Sustained-release capsules contain medication in coated beads for release over 12-24 hours
- Caplet: A cross between a capsule and a tablet, often easier to swallow
Routes for Administering Solid Oral Medications
- Primarily swallowed, liquid preparations should be used if possible
- Some tablets can be crushed and mixed with fluid or soft food if liquid is unavailable
- Do not crush delayed-release, long-acting, enteric-coated medications, capsules, or medications irritating to mucous membranes
- Consult a drug reference or pharmacist before crushing or splitting medications
- Troches should be dissolved in the mouth without prior eating or drinking for 5 minutes, or after until fully dissolved
- Sublingual and buccal medications can have local or systemic effects
- When administering sublingual and buccal medications, instruct clients not to chew or swallow the medication and not eat or drink anything until the medication has fully dissolved
Sublingual Medications
- Placed under the tongue and kept in place until fully dissolved
- Absorbed directly into the bloodstream, leading to faster action
Buccal Medications
- Placed between the cheek and gum, allowing the medication to dissolve
- Alternating sides with each dose prevents mucosal irritation
Calculating Solid Dosages
- Nurses must ensure the correct dose is dispensed and administered, involving mathematical calculations and conversions between metric and household systems
Liquid Medications
- Liquid oral medications are prescribed in micrograms, milligrams, grams, and milliequivalents
- Use calibrated measuring devices (dosing spoons, medication cups, oral syringes, calibrated medication droppers)
- Do not use household teaspoons and tablespoons due to varying sizes and potential inaccuracy
Liquid Medication Forms
- Elixir: Contains water, alcohol, sweetener, and medication
- Syrup: Contains water, concentrated sugar, and medication
- Suspension: Contains small, fine particles of medication that do not fully dissolve; shake or stir before use
- Solution: Medication dissolved in water or 0.9% sodium chloride
Enteral Feeding Tube Medication Administration
- EFTs are used to deliver nutrition and medications to clients unable to take them orally
- Use liquid medication to avoid tube clogging
- If crushing is necessary, consult with a healthcare provider and pharmacist
- Do not mix medications into feeding infusions
- Follow orders and policies regarding fluid flushes before, between, and after medication administration
Measuring Devices
- Use a medicine cup for doses of 5 to 30 mL
- Use medicine spoons calibrated in 1 to 10 mL increments
- Always use a calibrated oral syringe, dropper, or medicine spoon for doses less than 5 mL
Health care facilities use MARs to document information
- Clients’ identifying information
- Current date
- Prescription information
- Time of medication administration
- Instructions for administering medications
Medications can be stored in secure locations
- Medication cabinets in individual client rooms
- Medication rooms
- Automated dispensing systems
Oral medications
- Come in solid or liquid forms
- Solid medications: tablets, troches, capsules, and caplets
- Some medications are to be dissolved in the mouth under the tongue, on the tongue, or in the cheek
- Liquid medications: elixirs, syrups, suspensions, and solutions
- Administer liquid forms using medicine cups, calibrated oral syringes, droppers, or medicine spoons
Dosage
- Dosage for oral medications can be calculated using desired over have, dimensional analysis, or ratio and proportion methods
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Description
This module provides an overview of the medication administration record (MAR) and its use. It also covers the unit-dose system of medication dispensing as well as medication storage and distribution in healthcare facilities. Instructions such as whether a medication should be taken with food are included in the MAR.
