Medication Administration in Nursing
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Questions and Answers

What is the difference between a drug's therapeutic effect and a side effect?

A therapeutic effect is the desired effect of a drug, while a side effect is an unintended, usually predictable secondary effect.

Describe two ways drug toxicity can occur.

Drug toxicity can occur due to over-dosage, where the maximum dosage is exceeded, or due to drug accumulation in the blood from impaired metabolism or excretion.

What is the difference between a mild allergic reaction to a drug and a severe reaction?

A mild allergic reaction might manifest as skin rash, itching, or swelling, while a severe reaction, called anaphylactic reaction, can be life-threatening, causing wheezing, shortness of breath, hypotension, and tachycardia.

What type of medication is meant to relieve symptoms of a disease but not cure it?

<p>Palliative drugs are designed to relieve symptoms of a disease but don't affect the disease itself.</p> Signup and view all the answers

Explain the purpose of a substitutive medication.

<p>Substitutive medications replace body fluids or substances that are missing or deficient.</p> Signup and view all the answers

Describe the primary legal document that guides nurses in Hong Kong when it comes to providing safe and competent care, specifically in the area of administering medications.

<p>The primary legal document is the &quot;Code of ethics and professional conduct for Nurses in Hong Kong (NCHK, 2015)&quot;.</p> Signup and view all the answers

What are the five key responsibilities of nurses in Hong Kong related to administering medication, as outlined in the "Nurse Responsibilities for good practice in AOM (NCHK, 2017)"?

<p>The five key responsibilities are: 1. Understanding local policies and practices on AOM, 2. Assessing clients' conditions before administering medication, 3. Administering medication correctly, 4. Ensuring proper use of medication administration devices and disposal of residual medication and devices, 5. Evaluating the client's progress with proper documentation.</p> Signup and view all the answers

Explain the concept of "3 check 5 rights" in relation to safe medication administration, and why it is crucial.

<p>&quot;3 check 5 rights&quot; refers to a strict procedure involving three checks of the medication and ensuring the five rights are followed. It is crucial to prevent medication errors and ensure the right patient receives the right medication, dosage, route, time, and documentation.</p> Signup and view all the answers

What are the potential consequences for a nurse in Hong Kong if they violate the principles and guidelines for safe medication administration outlined in the provided materials?

<p>Violating the principles and guidelines can lead to a range of consequences, including medication errors, inappropriate medication use, and patient harm, potentially resulting in disciplinary actions from the Nursing Council of Hong Kong or legal repercussions.</p> Signup and view all the answers

Identify three factors that can contribute to medication errors, as described in the text provided.

<p>Three factors contributing to medication errors are: non-compliance with the &quot;3 check 5 rights&quot; procedure, improper communication between healthcare professionals and patients, and product mislabeling or packaging issues.</p> Signup and view all the answers

Imagine a scenario where a nurse is administering medication to a patient who has a known allergy to a specific drug. Describe two crucial steps the nurse should take to ensure the patient's safety, based on the information provided in the document.

<ol> <li>The nurse must carefully verify any contraindications for the medication with the patient's allergy history. 2. The nurse should double-check the medication label and the patient's wristband to confirm the correct identity and dosage.</li> </ol> Signup and view all the answers

The document mentions "Look alike & Sound alike" medications as a potential risk factor. Choose one example from the document and explain how a nurse can minimize the risk of administering the wrong medication in such a situation.

<p>One example is Clonazepam and Clobazam. Nurses should double-check the medication label for both the drug name and its dosage form (e.g., tablet vs. liquid) to avoid confusion.</p> Signup and view all the answers

Explain the two-staff rule for administering Dangerous Drugs (DD) as described in the document. Why is this rule essential for patient safety?

<p>Two authorized staff members must be present during the administration of DD, with one staff member verifying the drug and dosage while the other prepares and administers the medication. This rule helps prevent errors and ensures accountability for drug administration.</p> Signup and view all the answers

Explain the concept of "individual patient dispensing" as used in the Drug Supply System described in the document. Describe one benefit of this approach for patient safety.

<p>Individual patient dispensing refers to providing medication specifically labeled with the patient's name and dosage. This method reduces errors by eliminating the chance of administering the wrong medication to the wrong patient.</p> Signup and view all the answers

Explain the "有疑必問" (have doubts, ask questions) approach emphasized in the document. How does this philosophy contribute to drug safety in a hospital setting?

<p>&quot;有疑必問&quot; encourages nurses and other healthcare professionals to clarify any uncertainties or doubts they have regarding medication administration, dosage, or patient status. This proactive approach promotes a culture of safety by minimizing risks and ensuring accurate drug delivery.</p> Signup and view all the answers

Flashcards

Palliative Drug

Relieves symptoms of diseases but does not cure them.

Therapeutic Effect

The desired effect of a drug, known as the primary effect.

Drug Toxicity

Harmful effects from over-dosage or drug accumulation.

Drug Allergy

Immunologic reaction causing antibody production when exposed.

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Five Rights of Medication Administration

Ensures safe medication delivery: right patient, drug, dose, route, time.

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Code of Ethics for Nurses

A set of guidelines for ethical nursing practice by the Nursing Council of Hong Kong.

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AOM Principles

Key principles ensuring safe and effective administration of medications by nurses.

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Nurse Responsibilities in AOM

Duties nurses must follow for good practice in administering medications.

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3 Check 5 Rights

A protocol to ensure correct medication administration involving three checks and five rights.

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Consequences of Medication Errors

Negative outcomes from improper medication use, potentially harming patients.

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Medication Error

Mistakes in prescribing or administering medication, which can be preventable.

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Dangerous Drugs Ordinance 134

Law regulating the manufacture, supply, and administration of dangerous drugs in Hong Kong.

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DDA Storage Guidelines

Protocols for the proper storage and handling of dangerous drugs in a healthcare setting.

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Look alike & Sound alike medications

Medications that appear similar or sound similar, leading to potential errors.

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Two Authorized Staff Rule

Requirement that two authorized staff must be present during the administration of dangerous drugs.

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Study Notes

Principle of Administration of Medications (AOM)

  • AOM is the administration of medications.
  • Learning objectives include defining medication terms, understanding AOM principles (3 check and 5 rights), describing medication routes, calculating dosages, understanding nurse roles, and discussing lab results related to AOM.
  • Types of drugs include palliative (relieve symptoms), curative (cure disease), supportive (support body function), substitutive (replace fluids/substances), chemotherapeutic (destroy malignant cells), and restorative (return body to health).
  • Nurses should know the indications for each medication.

Drug Effects

  • Therapeutic effect is the desired effect of a drug.
  • Primary effect is the reason a drug is prescribed.
  • Side effects are secondary effects, unintended but usually predictable.
  • Adverse effects/reactions are harmful results from drug toxicity or overdosage.
  • Drug accumulation in the blood can occur due to impaired metabolism or excretion.
  • Knowing maximum dosage and patient profiles is important to prevent drug toxicity.

Drug Allergy

  • Drug allergy is an immunologic reaction to a drug.
  • Body produces antibodies when first exposed to a foreign substance (antigen).
  • Mild reactions include skin rash, itching, angioedema, diarrhea, vomiting, rhinitis, and lacrimal tearing.
  • Severe/life-threatening reactions (anaphylactic reaction) include wheezing, dyspnea (shortness of breath), acute hypotension, and tachycardia.
  • Nurses should ask about allergy history and related signs/symptoms.

Supervision & Legal Documents

  • Legal documents like the Code of Conduct and Practice by the Nursing Council of Hong Kong guide nurses in AOM.
  • Supervision, legal documents and compliance with rules and regulations are essential aspects for safe medication administration by nurses.

Nurse Responsibilities in AOM

  • Understanding local policies and practices in AOM.
  • Assessing client conditions before administering.
  • Administering medication correctly.
  • Ensuring proper use of administration devices and disposal of residuals.
  • Evaluating client progress and documenting.
  • Educating clients and caregivers.
  • Reporting medication incidents.
  • Keeping up-to-date knowledge of medications.

Safety Issues in AOM

  • Proper medication storage (e.g., locked drug trolleys).
  • Secure storage of dangerous drugs.
  • Proper medication handling (i.e., following 3 checks and 5 rights).
  • Avoiding reuse of leftover drugs.
  • Monitoring for drug effect and contraindications.
  • Ensuring patient understanding and compliance.

Medication Error

  • Inappropriate medication use results in patient harm.

  • Causes include professional practice issues, health care products, procedures, systems, improper communication, and inadequate education.

  • Examples include non-compliance with 3 checks and 5 rights, improper communication, labeling/packaging errors, and irrelevant education.

  • Errors like not verifying contraindications, look-alike/sound-alike drugs, missed or extra doses, wrong routing, scheduling and patient identification errors.

Medication Order

  • A valid medication order must include: Licensed practitioner information, institution information, doctor's name and signature, patient identity (full name, hospital. or HK ID), drug allergy history, diagnosis, drug name, form, route, strength, dosage instruction, and duration/dosage.

How Nurses Facilitate Medication throughout the Process

  • Confirming medication orders with the doctor if there is doubt.
  • Requesting drug supplies from the pharmacy.
  • Maintaining appropriate medication storage and management.
  • Administering medications correctly (e.g., following 3 checks and 5 rights).

Hospital Authority Standard Drug Formulary

  • Implemented since 2005.
  • Standardizes policies on drug safety, efficacy, and utilization.
  • Categorizes drugs into: General drugs, Special Drugs, Self-financed items (SFIs) with safety net, and SFIs without safety net.

Drug Supply System

  • Ward Stock - bulk stock of commonly used drugs, with weekly refills by pharmacist, and varies among specialties based on ward nature.
  • Individual patient dispensing - individually supplied labelled medication, with 3-5 day supply (acute setting).

Dispensing, Prescription and Administration

  • Pharmacists dispense drugs according to prescriptions.
  • Nurses administer drugs based on the prescription.
  • Patient verbalizes or identifies medical treatment issues.

Medication Safety Precautions

  • Scan patient wristbands before dispensing medication.
  • Confirm patient identification with open-ended questions (e.g., "What is your name?").
  • Always check patient bracelet to prevent dispensing errors.
  • Cross-check medication packages/sheets/prescriptions with patient's identification details (e.g., patient name/hospital number.
  • Report any mistakes or discrepancies.

Drug Names

  • Chemical name: precise chemical composition description.
  • Generic name: Assigned by the first drug developer; often derived from the chemical name.
  • Trade/brand name: Name selected by the selling drug company; can vary among manufacturers.

Look-Alike, Sound-Alike Drugs

  • Look-alike/sound-alike drugs must have different locations in storage and dispensing.
  • Current dispensing procedures need reinforcing with accurate drug identification.

Drug Form/Preparation & Drug Action

  • Drug forms include tablet, capsule, suspension, syrup, ointment, cream, spray; appropriate administration methods.
  • Determining correct prescription and absence of contraindications/drug side effects, reactions or interactions (NPO or infection site).

Dosage Calculation

  • Correct calculation of dosages for various drug forms of different types of medications ensures safety for both adults and children.

Medication Scheduling

  • Schedule procedures are dependent on organisational policy and patient suitability.
  • Refer to physician about order and administration times as relevant.
  • Use abbreviations correctly.

Parenteral Medication Administration

  • Parenteral medication refers to administration outside the gastrointestinal tract (e.g., IV, IM, ID, and subcutaneous).
  • Important details about each route of administration can be found elsewhere in the notes.

Other

  • 3 Checks for right medication, documentation and storage.
  • Always check patient history.

References

  • Relevant articles and books referenced in the presentation.

Topical Skin Medications

  • Preparations for topical use include powders, suspension-based lotions, creams, ointments, pastes, oil-based lotions, aerosol sprays, and transdermal patches.

Transdermal Patches

  • Examples: Androderm (testosterone), Evra (combined hormonal), Nitro-Dur (nitroglycerin).

Topical Creams & Ointments

  • Examples: Voltaren Emulgel, Hydrocortisone Valerate Cream, Silver Sulfadiazine Cream, Zinc Oxide Ointment, and Doxepin Hydrochloride Cream.

Ophthalmic Medications

  • Use appropriate technique during eye drop/ointment use.

Otic Medications

  • Warm the medication to body temperature before administration and ensure proper ear tissue care is followed.

Nasal Medications

  • Self-administration with upright positioning; proper nasal spray technique for drug administration in patient; avoid sharing medicine.

Inhaled Medications

  • Effective administration techniques for MDI, DPI and Nebulizers as appropriate for patient needs.

Sharing Interpretation on Lab Results (AOM)

  • Nurses appropriately share and interpret lab results related to medication responses.

Therapeutic Drug Monitoring (TDM)

  • TDM optimizes clinical outcomes and minimizes toxicity from treatment with drugs like Vancomycin and Phenytoin by monitoring blood levels.

Other Parenteral Medications

  • Administration of medications outside the gastrointestinal system.
  • Methods include intradermal (ID), subcutaneous (SC), intramuscular (IM), and intravenous (IV) injections.

Over-the-Counter (OTC) Medications

  • OTC medications do not usually require a prescription and are sold in retail shops.

Additional notes

  • Use provided reference materials when necessary.

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NUR1013 Principle of Medication Administration PDF

Description

This quiz tests your knowledge on the principles of medication administration in nursing, specifically in the context of Hong Kong. You will explore critical concepts such as drug effects, toxicity, legal responsibilities, and safe practices. Understanding these principles is essential for providing competent and safe care as a nurse.

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