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| Five plus five rights of drug administration.. |
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| Right client, drug, dose, time, route |
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| Right documentation, assessment, education, evaluation, right to refuse |
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| Factors affecting Drug Response |
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Clinical Factors
Administration
Psychokinetic
Pharmacodynamic |
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| Four components of pharmacokinetics play role in drug action |
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| absorption, distribution, metabolism, excretion, age. |
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| Factors that modify drug response |
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| weight, toxicity, pharmacogenetics, route (IV fastest), time, emotional factors, preexisting disease, tolerance, cumulative effect, drug-drug interaction, food-drug interaction |
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| drug metabolized slower due to the build up |
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Medication Administration:
Preparation |
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| washing hands, checking orders, diets, label X3, and allergies |
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| Administration of Medication: |
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| verify patient name and ID band, knowledge of medication and proper administration. |
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| includes proper documentation on medication record, chart if needed on other forms such as a diabetic flow sheet. |
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| Enteric coated cannot be crushed, sub-lingual under tongue, bucally between the cheek, liquids are measured at the bottom of the meniscus. |
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| patches such as hormones or nitroglycerin. provide a more consistent blood level, remember gloves must be worn for administration of all topical medications. |
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| administered by exposing the conjuctival sac and placing the drop in the center of the sac, not on the eye directly. |
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| ear pulled down and back in children under 3 and up and back for all others |
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| head back and often tilting to reach the frontal sinus |
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| Medication with a spacer, (inhalation) |
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| spacer allows more medications to reach the lung. |
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| allergy testing, tuberculin testing, 26-27 gauge needle bevel up 10-15 degree angle and a visual wheal. |
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| non-irritating and water soluble drugs, 25-27 in the fat pads at a 45 or sometimes a 90 degree angle |
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| necessary for subcutaneous injection with the exception of heparin injection. |
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| Intramuscular administration |
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| rapid systemic response, often used with irritating drugs, 20-23 at a 90 degree angle. Z track requires replacement of the needle after withdrawing the medication and prior to administration. |
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| IM Injection site for infants |
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| deltoid muscle, vastus lateralis, gluetus maximus |
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| safety needles, pca, emla, insulin pen, portable syringe infusion |
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| Assessment (diagnosis) planning, intervention and evaluation |
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subjective and objective
History, medications otc, herbals, allergies, labs, environment |
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| Goal setting, client centered, acceptable, measurable, realistic and shared with the other members of the health care team. |
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| Patient education, general, self-administration, diet and side effects. |
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| continuous and based upon completion of goals |
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