Transcript Chapter 36
Chapter 36 Calculation of Medication Dosage and Medication Administration Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Legal and Ethical Implications of Medication Administration • Laws vary from state to state • Thorough knowledge of medications administered to patient • Ethical considerations – Using drugs for personal benefit – Proper authorization Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Legal and Ethical Implications of Medication Administration • The medication order – Given by provider • The prescription – Written legal document that gives directions for compounding, dispensing, and administering medication to patient – Eight parts Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Legal and Ethical Implications of Medication Administration • The prescription – Two types of medicines • Prescription • Over-the-counter (OTC) – Prescriptions for controlled substances – Approved prescription abbreviations and symbols Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculation of Drug Dosages • Understanding ratio – Ratio expressed as a quotient – Ratio expressed as a fraction – Ratio expressed as a decimal • Understanding proportion – Means and extremes – Solving for X Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculation of Drug Dosages • Weights and measures – Metric system guidelines – The seven common metric prefixes • • • • • • • MicroMilliCentiDeciDekaHectoKilo- Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculation of Drug Dosages • Weights and measures – Fundamental units – Household measurements – Metric system conversion • Proportional method for converting metric equivalents • Moving the decimal in the correct direction Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Medications Measured in Units • How to calculate unit dosages – Proportional method – Formula method • Insulin – Individualized needs and treatment Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Medications Measured in Units • Types of diabetes – – – – Type I insulin-dependent diabetes mellitus Type II noninsulin-dependent diabetes mellitus Type III gestational diabetes Type IV other types of diabetes Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Medications Measured in Units • Importance of exact dosage • Precautions to observe when administering insulin • Expressing the weight of medication • Expressing the volume of medication Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculating Adult Dosages • The proportional method • The formula method Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculating Children’s Dosages • Young’s, Clark’s, and Fried’s rules replaced by more exact methods • By body surface area (BSA) – Nomogram – Used for infants and children up to 12 years of age Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculating Children’s Dosages • By kilogram of body weight – Mathematical process – Proportional method Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Medications • The “Six Rights” of proper drug administration Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Medications Click Here to play the video Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Medications • Medication errors – When a medication error occurs – Standard procedure for reporting errors Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Medications • Patient assessment – – – – Age Physical condition Body size Gender • Muscular build • Skin texture • Injection sites to avoid Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Oral Medications • Equipment and supplies for oral medications Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Parenteral Medications • Parenteral routes – Subcutaneous – Intramuscular – Intradermal • Multiple dose form • Unit dose forms Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Parenteral Medications • Hazards associated with parenteral medications • Reasons for parenteral route selection – Rapid response time to medication – Accuracy of dosage – Need to concentrate medication in specific body part or area Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Parenteral Medications • Reasons for parenteral route selection – Inability to administer orally because medication is destroyed by gastric juices or patient is incapable of taking medication orally – Liquid or powder form – Expressed in terms of volume – Ordered in terms of weight and volume Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parenteral Equipment and Supplies • Syringes – Disposable syringes – Non-disposable syringes – Combination disposable and non-disposable cartridgeinjection syringes Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parenteral Equipment and Supplies Click Here to play the video Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parts of a Syringe Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parts of a Needle Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parenteral Equipment and Supplies • Safe disposal of needles and syringes – Sharps containers – Needlesticks Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parenteral Equipment and Supplies Click Here to play the video Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Principles of Intravenous Therapy • Patient needs and conditions • Patient safety • Types of solutions • Legal aspects Basic IV Administration Set >> Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Site Selection for Injections Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Injection Angles Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Site Selection and Injection Angle • Marking the correct site for intramuscular injection – – – – Dorsogluteal site Ventrogluteal site Deltoid muscle Vastus lateralis site Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Basic Guidelines for Administration of Injections • Withdrawing medication – Withdrawing medication from a vial – Withdrawing medication from an ampule • Reconstituting a powder medication Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Basic Guidelines for Administration of Injections • Administering subcutaneous, intramuscular, and intradermal injections Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Basic Guidelines for Administration of Injections Click Here to play the video Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Z-track Method of Intramuscular Injection • Given to avoid irritation to subcutaneous tissues – Imferon is an example of a medication given by this route • Pull skin to side before inserting needle Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Z-track Method of Intramuscular Injection Click Here to play the video Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Allergenic Extracts • MAs may administer allergenic extracts – Always follow guidelines – Have emergency supplies on hand • Allergic reactions – Observe the patient for 20-30 minutes after administration Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Inhaled Medications • Inhalation therapy – Inhaler may be used to administer medication to the lungs • Implications for patient care Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Inhaled Medications • Administration of oxygen – – – – Hypoxemia Oxygen tanks Dosage Methods of oxygen delivery • Oxygen safety precautions Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.