Medication Administration (Grade A)

Summary:

The note discusses different aspects of medication administration in healthcare, including drug preparations, routes of administration, factors affecting medication absorption and effects, medication errors, documentation requirements, and the 6 rights of medication administration. The passages emphasize the importance of proper preparation, administration, and documentation and highlight potential risks such as distractions, ambiguous drug names, and abbreviations. The passages also provide guidelines on handling various scenarios that may arise during medication administration.

Excerpt:

Medication Administration

• Drug classifications
  ○ Effect on the body system
  ○ Chemical composition
  ○ Clinical indication or therapeutic action
  ■ Why is this prescribed, helps you end up evaluating for therapeutic reaction to see if the medication worked
• Mechanisms of drug actions
  ○ Drug-receptor interaction –
  ■ Drug interacts with one or more cellular structures to alter the function
  ○ Drug-enzyme interaction–
  ■ Combines with enzymes to achieve the desired effect
  ○ Acting on the cell membrane or altering the cellular environment
• Pharmacokinetics
  ○ Absorption
  ■ Drug is transferred from the site of entry into the bloodstream
  ○ Distribution
  ■ Drug is distributed throughout the body
  ■ ex) pumping is poor
  ○ Metabolism
  ■ Drug is broken down into an inactive form
  ■ ex) if a person has liver dysfunction
  ○ Excretion
  ■ Drug is excreted from the body
  ■ ex) if a person has kidney problems
  ■ May need to take cautionary measures depending on the drug (ex–chemo)
• Factors affecting drug absorption
  ○ Route of admin.
  ○ Lipid solubility
  ○ pH
  ○ Blood flow
  ○ Local conditions at the site of admin.
  ■ Think more topically
  ■ ex) ear drops cannot absorb in because of purulent fluid in the ear
  ■ ex) broken skin leading to drug going into the subcutaneous tissue
  ○ Drug dosage
• Medication effects
  ○ Therapeutic- expected response (go back to nursing process)
  ○ Side effects- predictable and unavoidable, harmless or may cause injury
  ○ Adverse drug effects (ADEs): unintended, undesirable, unpredictable responses (may be severe)
  ■ Iatrogenic disease
  ■ Allergic effects
  ■ Toxic effects
  ● Problems with ADME
  ■ Drug interactions
  ■ Most commonly n/v and rash!!! (allergy or actual side effect?)