week 1 meds and oxygen readings.docx

**[Notes for sept 5 ]** TA for lecture: Shawna Lab teacher: Jessica Roloson Can book open access lab to practice skills **Required Readings:** **College of Nurses of Ontario. (2022). *Practice standard: Medication*.** **Competence**: Nurses must demonstrate the necessary knowledge and skil...

**[Notes for sept 5 ]** TA for lecture: Shawna Lab teacher: Jessica Roloson Can book open access lab to practice skills **Required Readings:** **College of Nurses of Ontario. (2022). *Practice standard: Medication*.** **Competence**: Nurses must demonstrate the necessary knowledge and skills to safely administer medications. This includes understanding pharmacology, medication interactions, and proper techniques. **Assessment**: Before administering medication, nurses are required to assess the patient's condition, verify the medication order, and ensure that the medication is appropriate for the patient's current health status. **Medication Administration**: Nurses must follow prescribed procedures for administering medications, including verifying patient identity, dosage, and route. They should also monitor for and document any effects or adverse reactions. **Documentation**: Accurate and timely documentation of medication administration is essential. This includes recording the medication given, the dosage, the time, and any observations related to the patient's response. **Patient Education**: Nurses are responsible for educating patients about their medications, including instructions on how and when to take them, potential side effects, and any necessary precautions. **Ethical and Legal Considerations**: Nurses must adhere to legal and ethical guidelines in medication management, including obtaining informed consent and ensuring the confidentiality of patient information. **Adverse drug reaction:** As defined in the Food and Drug Regulations, a noxious and unintended response to a drug, which occurs at doses normally used or tested for the diagnosis, treatment or prevention of a disease or the modification of an organic function **Adverse reaction:** As defined in the Natural Health Products Regulations, a noxious and unintended response to a natural health product that occurs at any dose used or tested for the diagnosis, treatment or prevention of a disease or for modifying an organic function **Institute for safe medication practices Canada (2020). Opioid diversion in hospitals: A safety concern.** *ISMP Canada Safety Bulletin, 20(*8), 1-5. https://ismpcanada.ca/wp-content/uploads/ISMPCSB2020-i8-Opioid-Diversion.pdf?msclkid=3f11841fd16d11eca2157b20f39c428b  **Opioid Diversion Overview**: - Opioid diversion is a significant safety concern affecting both patients and healthcare providers. - It is a systemic issue, exacerbated by gaps in medication-use systems and insufficient support for healthcare providers.  **Current Situation**: - There has been an increase in controlled substance diversions in Canadian hospitals. - Over 3000 incidents involving lost or stolen controlled substances were reported from 2015 to 2019.  **Causes and Reporting**: - Causes of loss include theft, break-ins, and employee pilferage, with many cases listed as "unexplained." - Diversion can involve tampering with medications and is often difficult to detect and report accurately.  **Impact on Patients and System**: - Diversion poses risks to patient safety, including untreated symptoms and incorrect documentation. - Impaired healthcare providers can jeopardize patient care, and contaminated medications can harm patients. - Diversion can erode public trust and incur significant costs related to investigations and patient care.  **Cultural and Systemic Challenges**: - There is a need to shift from blaming individuals to addressing systemic issues within medication-use systems. - Fear of stigma and job loss may prevent affected providers from seeking help, and colleagues might hesitate to report suspicious behavior.  **Recent Initiatives and Recommendations**: - Guidelines and frameworks have been developed to improve diversion detection and prevention. - Recommendations include establishing multidisciplinary diversion prevention committees and using risk assessment tools. 1. **Peak**: - **Definition**: The highest concentration of a drug in the bloodstream after it has been administered. - **Purpose**: Measuring the peak helps determine if the drug\'s concentration reaches therapeutic levels and ensures that it does not exceed toxic levels. It is typically measured at a specified time after drug administration, depending on the drug\'s pharmacokinetics and intended effects. - **Example**: For antibiotics, a peak level might be measured 1-2 hours after intravenous administration to ensure it reaches a concentration that is effective against the infection. 2. **Trough**: - **Definition**: The lowest concentration of a drug in the bloodstream, just before the next dose is due. - **Purpose**: Measuring the trough helps ensure that the drug\'s concentration does not fall below the level needed to maintain efficacy. It is important for avoiding subtherapeutic levels that could lead to treatment failure. - **Example**: For medications like vancomycin, a trough level might be measured right before the next dose to ensure it remains effective and safe. **In Practice**: - **Timing**: Peak and trough levels are often measured at specific intervals based on the drug\'s dosing schedule and its pharmacokinetics. - **Adjustment**: These measurements help in adjusting dosages to optimize therapeutic effects while minimizing adverse effects and toxicity. - **Monitoring**: They are especially important for drugs with narrow therapeutic windows or those that require precise dosing to avoid complications. **Nursing Skills Online 4.0** - Module 5: Safe Medication Administration - Module 6: Non-parenteral Medication Administration \*\*need to watch feeding tube videos to refresh memory - Module 7: Administration of Parenteral Medications: Injections - Module 8: Administration of Parenteral Medications: Intravenous Medications **Canadian Clinical Skills: Essentials Collection** - Applying a Nasal Cannula or Face Mask - Ensuring Oxygen Safety - Setting Oxygen Flow Rates Know this for exams: Oxygenation NP rule of 4F102 RA: 21% 1L: 24% 2L:28% 3L:32% 4L:36% 5L:40% 6L:44% \*\*4L or greater need to add humidity because its too drying **Week 2 readings**