Medication Safety and Administration
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Questions and Answers

What is a key component that must be included in a medication order?

  • Medication name (correct)
  • Patient's medical history
  • Patient's insurance details
  • Provider's office address

What describes the Culture of Safety in a healthcare setting?

  • A system where every error is punished
  • A method to reduce staff workloads
  • A workplace environment that encourages reporting errors (correct)
  • An environment that discourages error reporting

How should a nurse respond if a patient does not have an ID bracelet present?

  • Assume the patient’s identity can be verified by other means
  • Ask the patient for their birth date and proceed
  • Obtain the ID bracelet before administering medication (correct)
  • Administer the medication anyway

Which of the following is NOT a type of medication order?

<p>Timed order (A)</p> Signup and view all the answers

Which factor can affect urination and function?

<p>Fluid intake (B)</p> Signup and view all the answers

Which principle is crucial when administering medications to children?

<p>Use weight-based calculations for dosing (B)</p> Signup and view all the answers

What is a common characteristic of medication errors?

<p>They often stem from time pressure and labeling issues (D)</p> Signup and view all the answers

What is the role of effective communication in preventing medication errors?

<p>It ensures clear understanding of orders and reduces mistakes (B)</p> Signup and view all the answers

Which of the following are included in the 5 Rights of Safe Medication Administration?

<p>Right patient (A), Right documentation (C)</p> Signup and view all the answers

What needle size should be used for an IM injection in a 240 lb adult?

<p>1.5-inch, 22-gauge needle (B)</p> Signup and view all the answers

What is the purpose of a bolus rate in Patient Controlled Analgesia (PCA)?

<p>Patient-controlled dose for additional relief (B)</p> Signup and view all the answers

Which type of insulin is characterized by a peak effect of 4-10 hours?

<p>NPH insulin (D)</p> Signup and view all the answers

What factors should be considered when selecting the needle size for injections?

<p>Patient age, weight, and medication type (B)</p> Signup and view all the answers

What documentation principles should be followed after medication administration?

<p>Note reasons for refusal or missed doses immediately (D)</p> Signup and view all the answers

Which of the following is a common special consideration for administering medication to elderly patients?

<p>They require alternate forms like liquids (C)</p> Signup and view all the answers

In the administration of Heparin, what is the special technique used to prevent bruising?

<p>Add air to the syringe (B)</p> Signup and view all the answers

What adaptations might be needed for medication administration in elderly patients?

<p>Caregiver assistance and smaller doses (A)</p> Signup and view all the answers

What is the maximum volume that can be administered for an IM injection in adults using the ventrogluteal site?

<p>3 cc (A)</p> Signup and view all the answers

Which needle specifications are appropriate for a 9-month-old infant receiving an IM injection?

<p>25-22 gauge, 5/8-1 inch needle (B)</p> Signup and view all the answers

Which route of medication administration involves placing the medication under the tongue?

<p>Sublingual (A)</p> Signup and view all the answers

What type of insulin has a duration of 3-6 hours and a peak time of 2-3 hours?

<p>Regular insulin (D)</p> Signup and view all the answers

What is the purpose of adding air during Heparin administration?

<p>To prevent medication backtracking and bruising (C)</p> Signup and view all the answers

What describes the basal rate in Patient Controlled Analgesia (PCA)?

<p>Steady infusion for continuous pain relief (C)</p> Signup and view all the answers

What is an important principle of documentation following medication administration?

<p>Note only the medications administered, immediately (B)</p> Signup and view all the answers

Which of the following is considered a high-risk medication?

<p>Insulin (A)</p> Signup and view all the answers

Which of the following routes of administration involves delivering medication directly into the bloodstream?

<p>Parenteral (A)</p> Signup and view all the answers

What is the primary goal of a culture of safety in healthcare?

<p>To encourage open communication and reporting of errors (B)</p> Signup and view all the answers

Which of the following is NOT a common component of a medication order?

<p>Patient's date of birth (D)</p> Signup and view all the answers

What should a nurse do if a patient lacks an ID bracelet before medication administration?

<p>Wait to administer medication until an ID bracelet is obtained (C)</p> Signup and view all the answers

Which of the following describes a PRN medication order?

<p>To be given as needed based on patient condition (B)</p> Signup and view all the answers

What method can be employed to prevent medication errors during administration?

<p>Implementing a barcode medication administration system (D)</p> Signup and view all the answers

What factor does NOT typically affect urination and function?

<p>Color of clothing (D)</p> Signup and view all the answers

When it comes to medication administration, what is considered a best practice for documentation?

<p>Using electronic systems to log medications post-administration (C)</p> Signup and view all the answers

Which of the following statements regarding insulin administration is incorrect?

<p>Insulin can only be administered via syringe. (C)</p> Signup and view all the answers

What is a significant risk associated with not double-checking medications during administration?

<p>Increased likelihood of medication errors (B)</p> Signup and view all the answers

Which type of catheter is most commonly used for long-term urinary drainage?

<p>Foley catheter (A)</p> Signup and view all the answers

What is the required needle size for subcutaneous heparin administration?

<p>½-5/8 inch, 25-30 gauge needle (C)</p> Signup and view all the answers

When administering an IM injection to an infant, which site is preferred?

<p>Vastus lateralis (C)</p> Signup and view all the answers

Which type of insulin has a duration of 10-16 hours?

<p>NPH insulin (A)</p> Signup and view all the answers

Which of the following is NOT one of the 5 Rights of Safe Medication Administration?

<p>Right health insurance (D)</p> Signup and view all the answers

What is the maximum volume that can be administered via IM injection in the ventrogluteal site for adults?

<p>3 cc (A)</p> Signup and view all the answers

What type of medications are insulin and heparin classified as?

<p>High-risk medications (B)</p> Signup and view all the answers

What should be done immediately after administering medication?

<p>Document the administration (C)</p> Signup and view all the answers

What type of medication administration involves placing the medication in the buccal pouch?

<p>Buccal (C)</p> Signup and view all the answers

In Patient Controlled Analgesia (PCA), what is the purpose of the basal rate?

<p>Delivers a steady infusion of medication (D)</p> Signup and view all the answers

For a 240 lb adult, which needle specification is appropriate for administering an IM injection?

<p>1.5 inch, 22-gauge needle (D)</p> Signup and view all the answers

What is one of the critical components that must be included in any medication order?

<p>Provider's signature (C)</p> Signup and view all the answers

Which principle best describes the concept of a culture of safety in healthcare?

<p>Encouraging error reporting to improve safety without fear of punishment. (A)</p> Signup and view all the answers

What should a nurse do if a patient has no ID bracelet available before administering medication?

<p>Wait for someone to bring the ID bracelet before administering. (C)</p> Signup and view all the answers

What type of medication order allows administration of a drug only as needed?

<p>PRN order (B)</p> Signup and view all the answers

Which of the following factors is essential to consider when preventing medication errors?

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What is the main feature of a workplace culture of safety in healthcare?

<p>Promotes reporting of errors without penalty (D)</p> Signup and view all the answers

Which of the following is an essential part of a medication order?

<p>Medication name (B)</p> Signup and view all the answers

What must a nurse do if a patient does not possess an ID bracelet during medication administration?

<p>Wait until an ID bracelet is obtained (B)</p> Signup and view all the answers

What best describes a single/one-time medication order?

<p>Given only once as needed (D)</p> Signup and view all the answers

Which of the following is NOT typically considered a factor affecting urination?

<p>Dietary fiber (B)</p> Signup and view all the answers

In terms of medication errors, which situation exemplifies an error in labeling?

<p>A medication bottle with no label at all (B)</p> Signup and view all the answers

What should be included in a safety protocol for medication administration?

<p>Encourage staff to report any uncertainties (C)</p> Signup and view all the answers

Which type of catheter is primarily utilized for short-term urinary drainage?

<p>Intermittent catheter (A)</p> Signup and view all the answers

What technique is essential to minimize bruising when administering Heparin?

<p>Injecting quickly without aspiration (B)</p> Signup and view all the answers

What is the primary goal of implementing barcode medication administration?

<p>To confirm patient identity and medication accuracy (A)</p> Signup and view all the answers

Flashcards

Medication Error Prevention

Strategies to avoid mistakes in medication administration.

Medication Order Components

Essential parts of a valid medication order (name, dose, route, frequency, purpose, signature).

Culture of Safety

Workplace environment encouraging error reporting without punishment.

Barcode Medication Administration

Using barcodes to scan patient and medication for verification.

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Medication Errors

Mistakes in medication processes like wrong dose, patient, or time.

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Types of Medication Orders

Different types of orders like routine, PRN, standing, single, etc.

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5 Rights of Medication Administration

Essential guidelines for safe medication administration (patient, medication, dose, route, time).

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Missing ID Bracelet

Do not administer medication without an ID bracelet.

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Insulin Types

Different types of insulin are classified by their onset, peak and duration of action. Regular is short-acting and NPH is intermediate-acting.

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Proper Needle Size

Select the right needle size for the medication, patient, and injection site. For a 240lb adult, use a 1.5-inch, 22-gauge needle for a ventrogluteal injection. For infants, use a 25-22 gauge, 5/8-1 inch needle for vastus lateralis injection.

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Insulin Order Error

Insulin orders MUST specify the time and route of administration. Examples include '5 U of regular insulin SQ with breakfast'.

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High-Risk Medications

Medications requiring special care due to their potential for serious side effects. Examples include insulin, heparin, narcotics, and potassium.

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PCA: Bolus vs Basal

PCA (Patient-Controlled Analgesia) has two components: Basal rate and Bolus rate.

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IM Injection Sites

Preferred sites for adults: Ventrogluteal (max 3cc). Preferred site for infants and children: Vastus lateralis (0.5-1 ml)

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Heparin Administration

When administering heparin subcutaneously, add air to the syringe to prevent back-tracking and bruising.

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Documentation Principles

Record only the medications you administer, immediately. This includes any refusals, missed doses, therapeutic effects, and adverse effects.

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What are medication errors?

Mistakes made during medication administration, like wrong dosage, patient, or time. These errors can occur due to unclear orders, labeling issues, misidentification of the patient, incomplete delivery, time pressure, etc.

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How to prevent medication errors?

Implement measures like using computerized Physician Order Entry systems, barcode scanning, clear communication, and interprofessional education (IPE) simulation.

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RaDonda Vaught Case

The case of RaDonda Vaught highlights the importance of a safety culture and the risks when standard safety practices are overlooked. The nurse failed to double-check a drug order resulting in patient harm.

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What are the essential parts of a medication order?

Medication name, dosage, route, frequency, purpose, and provider signature.

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Routine Order

A medication order that is given at regular intervals.

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PRN Order

Given only as needed, based on patient assessment.

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Standing Order

A set of orders for routine care, executed until a specific date or cancellation.

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Single/One-Time Order

A medication ordered to be given only once at a specific time.

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Titration Order

The dose of medication is adjusted based on patient response.

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Right Patient

Verifying the identity of the person receiving medication, ensuring it's the intended patient.

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Right Medication

Ensuring the prescribed medication matches the label and order, preventing accidental substitutions.

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Right Dose

Administering the exact amount of medication prescribed, avoiding overdosing or underdosing.

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Right Route

Delivering medication via the correct pathway, like oral, IV, or injection, for effective absorption.

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Right Time

Administering medication according to the prescribed schedule, maximizing its effectiveness.

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Right Documentation

Recording medication administration promptly and accurately in the patient's chart.

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Special Considerations for Elderly

Adjusting medication administration for older adults, who may require smaller doses, alternate forms, and caregiver assistance.

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Special Considerations for Children

Adjusting medication administration for children, who may require smaller doses, alternate forms, and caregiver assistance.

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Insulin Types: Regular

Short-acting insulin with a rapid onset, peak, and duration, typically used for mealtime coverage.

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Insulin Types: NPH

Intermediate-acting insulin with a slower onset, peak, and longer duration, often used for basal coverage.

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Regular Insulin

Short-acting insulin that starts working quickly, peaks in a few hours, and lasts for several hours.

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NPH Insulin

Intermediate-acting insulin that starts working slowly, peaks later, and lasts longer.

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What is a culture of safety?

A workplace where reporting errors is encouraged without fear of punishment, aiming to improve patient safety.

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What are the components of a medication order?

A complete medication order includes: medication name, dosage, route, frequency, purpose, and provider signature.

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What are special considerations for children in medication administration?

Children often require smaller doses, alternative formulations, and may need help from caregivers during medication administration.

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What are special considerations for elderly in medication administration?

Elderly patients may require smaller doses, alternate forms of medication, and might need caregiver assistance due to possible swallowing difficulties.

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What is the purpose of barcode medication administration?

Barcode medication administration uses scanners to verify the patient, medication, dose, time, and route, reducing errors.

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What should you do if a patient is missing their ID bracelet?

If a patient doesn't have an ID bracelet, do not administer medication until one is obtained.

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What is the importance of a culture of safety?

It encourages open communication and the reporting of errors without fear of punishment, leading to improved patient safety.

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How can medication errors be prevented?

Using systems like computerized physician order entry, barcode scanning, clear communication, and simulation training can help prevent medication errors.

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Study Notes

Medication

  • Culture of safety: A workplace environment that promotes reporting errors to improve safety without punitive measures.
  • Medication Errors: Errors in medication orders, unclear labeling, client misidentification, incomplete deliveries, and time pressures.
  • Preventing Medication Errors: Use Physician Order Entry (POE) systems, barcode scanning, effective communication, and IPE (interprofessional education) simulation.
  • Barcode Medication Administration: The nurse scans the patient's ID bracelet and the medication to confirm the correct patient, drug, dose, time, and route. If no ID bracelet is present, do not administer the medication until one is obtained.
  • Medication Order Components: Medication name, dosage, route, frequency, purpose, and provider signature.
  • Types of Orders: Routine, PRN, standing orders, single/one-time, titration, and verbal orders.
  • Safe Medication Administration (5 Rights +1): Right patient, medication, dose, route, time, and documentation.
  • Special Considerations for Elderly and Children: May require alternate forms (liquids over pills), smaller doses, and caregiver assistance.

Elimination

  • Qualities of normal urine: Volume (250-400ml per void; minimally 30ml/hour), daily production (1200-1500cc for adults; 500-600cc for newborns), light yellow, clear, and odorless.
  • Factors affecting urination and function: Fluid intake, hypovolemia, nutrition, and medications (e.g., diuretics, alcohol, caffeine).
  • Altered urinary function terms: Dysuria (painful urination), polyuria (>2500-3000ml in 24 hours), oliguria (<500ml in 24 hours), anuria (<100ml in 24 hours), urgency and frequency, nocturia (nighttime urination), hematuria (blood in urine), and pyuria (pus in urine).
  • Incontinence Types: Stress incontinence(increased abdominal pressure), functional incontinence (inability to reach the bathroom), and total incontinence (continuous leakage).
  • Diagnostics:
    • Specific Gravity: Measures urine concentration (1.010-1.025).
    • Reagent Strips: Tests for glucose, proteins, and ketones.
    • Urinalysis: A common diagnostic method.
    • Urine Culture & Sensitivity (C&S): identifies microorganisms.
    • Health Promotion: Increase fluid intake, proper wiping technique, Kegel exercises.
  • Types of catheters: Straight, triple lumen, Foley (Indwelling).
  • Indications for catheters: Inability to void, accurate measurements, bladder irrigation, and terminally ill patients.

Bowel

  • Factors Affecting Bowel Function: Diet (fiber, lactose, gluten), medications, fluid intake, hemorrhoids.
  • Bowel Alterations: Constipation, fecal impaction, diarrhea, incontinence, and abdominal distension (bloating). Conditions like Crohn's disease.
  • Stool Sample Tests: Culture, O&P (ova and parasites), Occult blood test.
  • GI Diagnostic Tests: Upper GI (Barium swallow), Lower GI (Barium enema), ERCP, Endoscopy.
  • Colonoscopy: Recommended for individuals over 50 or with family history of polyps, bleeding, or ulcers.
  • Enema Types: Small volume (oil, or water at 150cc), Large volume (1000cc for adults), return flow (for gas relief, 300-500cc as needed).
  • Fecal Diversions and Ostomy Care: Ileal conduit, Continent Urostomy, types of colostomies (ascending, descending, sigmoid, and transverse), ostomy/stoma care.

Additional

  • Intravenous (IV) and Subcutaneous (SQ) Medication Considerations: Use proper needle sizes based on medication type and patient age/weight, and proper hygiene measures (gloves).
  • Documentation Principles: Record medications immediately and document reasons for refusal or missed doses.
  • Urinary System Anatomy: Kidneys, ureters, bladder, urethra.
  • Urinary Catheters and Procedures: Types of Catheters (Single, Triple Lumen, Foley/Indwelling).
  • Dialysis (Overview): Peritoneal Dialysis, Hemodialysis, Access types.
  • Bowel Elimination: Factors affecting bowel function, bowel alterations, stool sample tests, diagnostic tests, colonoscopy, types of enema.
  • AV fistulas and grafts: types, time to maturity.
  • Venous catheters: types, usages.

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Description

This quiz covers the essential concepts of medication safety, focusing on preventing medication errors through effective communication and technology like barcode scanning. It also includes components of medication orders and types of medication orders. Test your knowledge on the protocols for safe medication administration, including the 5 Rights +1.

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