N104: Essentials of Nursing Care - Health Safety

N104: Essentials of Nursing Care – Health Safety Study Guide medication is also considered mucosal.  Parenteral: Any medication administration that involves injecting a drug directly into a vein (intravenous), muscle (intramuscular), artery (intra- arterial), abdominal cavity (intraperitoneal), heart (intracardiac, bone intraosseus), or into the fatty tissue beneath the skin (subcutaneous). The speed of absorption varies but is faster than oral administration. This is used when more complete and faster absorption of a drug is needed.  Percutaneous (topical): Medications are absorbed directly through the skin into the blood stream. Some hormone replacements are administered by patches that are absorbed slowly and evenly.  Endotracheal: This is injected into the trachea. The rate of absorption is very rapid. Typically, this route is reserved for emergency medications when an IV cannot be established. • Right time: o A medication order will always show how often the drug must (scheduled) or can (PRN) be given. o Scheduled medication should be given within 30 minutes before or after the scheduled time. o For PRNmedications, the medication should never be given more frequently than ordered. In addition to the five traditional rights of medication administration, five additional "rights" have been identified that will make medication administration safer. The "plus five" rights include: • Right assessment: Is the medication needed? • Right documentation: Document in the patient's chart the name of the medication, dose given, route of administration, and time of administration. Document any effects of the medication. • Right evaluation: What is the patient's reaction to the medication? • Patient's right to education: Teach the patient what the medication is for, effects they should expect, and side effects that might occur. • Patient's right to refuse: The patient always has the right to refuse a medication. The nurse must document each refusal. Tips for Safe Medication Administration • Review the order and make sure you understand exactly what the medication is, how often you need to give the drug, and why the patient will be taking it. Make sure the physician’s order is complete and correct. A complete order consists of the drug’s name, dosage, frequency, and route of administration. If an order is incomplete or unclear, never assume the information. Check with the ordering physician before proceeding. • Read all the prescribing information included with each new drug, checking for possible interactions with medications the patient is already taking, foods to avoid, etc. Patients are often given more than one drug. See drug interactions for each medication and confirm with the patient’s chart if there are any contraindications or special precautions to be made. Patient history on previous anaphylactic reactions should also be noted.

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