Medication Administration
Medication Administration play a pivotal role in ensuring holistic patient care. Pharmacological expertise is being also important. This section equips you with a deeper understanding of essential nursing practices, including thorough patient assessments, navigating drug delivery systems, and promoting health through effective education. You’ll also explore the importance of safe medication administration, accurate dose estimation, and managing medication records for critical care patients. Finally, we’ll discuss the rehabilitation phase, emphasizing the continuity of care.
By the end of this section, you should know about:
- Assessment
- Drug delivery system
- Health promotion and patient education
- Patient education and safe medication administration
- Critical care and medication orders
- Accurate dose estimation and safe dosing
- Medication administration records
- Rehabilitation of care
Let’s Take a closer look at them
The nursing process is a patient-centered system that guides nurses in providing safe and effective care. It consists of five major steps: analysis, evaluation, planning, implementation, and evaluation. Below is an overview of tests and diagnostic steps as they relate to medication administration, with an emphasis on critical thinking and patient-centered care
Assessment in Medication Administration
The assessment includes gathering comprehensive information about the patient to understand their health status, medication history, and other factors that may affect medication administration
Through the eyes of the patient
It is important to see the situation from the patient’s perspective. Nurses should also consider patients’ preferences, values, and needs, as well as medication concerns. For example, it is important to examine how a patient’s cultural or family beliefs influence attitudes toward medication. Nurses should encourage patients to express their feelings, concerns, and beliefs to ensure safe and appropriate medication administration.
Patient history
It helps determine the need for certain medications by reviewing the patient’s medical and surgical history. For example, patients with diabetes may need insulin, while a thyroidectomy may require thyroid hormone replacement.
Understanding the patient’s history also helps identify potential drug contraindications or side effects. For example, a patient with gastric ulcer may not respond to aspirin because of increased bleeding risk.
Allergies
It is important to list and mention allergens (drug or food). Many products contain food-derived ingredients, such as egg lecithin or soybean oil in propofol, which can be harmful to those with allergies
Nurses should ensure that seizures are clearly documented in the patient’s medical records to facilitate communication within the healthcare team.
Pharmaceuticals in Medication Administration
Nurses should ask patients about all medications, including prescription and prescription medications and herbal supplements. Some important questions are:
How long have you been taking these medications?
What dose are you taking?
Have you experienced side effects or side effects?
Do you have a list of medications?
Nurses should consult reliable resources (e.g., pharmacology textbooks, Physician’s Desk Reference) to understand each medication’s action, purpose, dosage, and nursing implications.
Diet History in Medication Administration
A patient’s eating habits can influence medication schedules. Some medications need to be taken before, during, or after meals. Additionally, dietary restrictions or preferences may affect the timing of medication administration.
Patient’s Perceptual or Coordination Problems
Assessing a patient’s ability to self-administer medications is vital, especially for those with physical limitations (e.g., arthritis making it hard to use syringes). If a patient is unable to administer medications independently, nurses should assess the availability of family or caregivers to help, or consider a home care referral.
Patient’s Current Condition
Assess the patient’s current physical or mental status to determine if they are able to take their medications safely. For example, a patient who is vomiting may not be able to take medications orally, and the healthcare provider should be notified for alternative routes or changes in the treatment plan.
Patient’s Attitude About Medication Use
Understanding a patient’s attitudes toward medications helps identify issues such as medication dependence or reluctance. Some patients may avoid medications for personal, psychological, or cultural reasons. Nurses should listen carefully to understand these attitudes, which can influence medication adherence.
Cultural Aspects of Care in Medication Administration
A patient’s cultural background can affect their approach to medication. Different cultures may have unique health beliefs, such as the preference for herbal remedies over prescribed medications, which could interfere with treatment plans. Nurses must assess cultural beliefs and values, and work with patients to resolve conflicts between cultural practices and prescribed therapies.
Factors Affecting Adherence to Medication Therapy
Factors such as financial difficulties, knowledge gaps, and motivation influence whether a patient follows their prescribed medication regimen. Nurses should assess whether patients understand the purpose of their medications, the importance of adhering to the prescribed schedule, and any challenges they face in taking their medications regularly.
Patient’s Learning Needs
Health literacy is crucial for effective medication administration. Patients need to understand technical information about their medications. Nurses should assess the patient’s ability to comprehend and manage their medication schedule. If a patient struggles to understand their medication instructions, further education and support should be provided.
Nursing diagnosis
Based on the assessment data, nurses can identify actual or potential problems associated with chemotherapy. These disorders can be classified under several nursing diagnoses, e.g.
Anxiety: The patient is worried about taking another medication or possible side effects.
Ineffective healthcare: A patient may struggle to adhere to complex medications.
Lack of knowledge: A patient may not understand the understanding of how to manage their chemotherapy, including appropriate administration and possible side effects.
Non-adherence: For financial and psychological reasons, the patient may not adhere to the prescribed medication.
Difficulty swallowing: Conditions such as depression or anorexia can make it difficult for patients to swallow antibiotics.
Weak memory: A patient with cognitive issues may have difficulty remembering to take medication on time.
Caregiver Role Stress: Family members or caregivers may experience stress or strain while supporting the patient’s medication regimen.
For example, if a patient struggles with complex medication use, the nursing assessment of a complex treatment regimen may utilize ineffective health care and then the nurse becomes a resource intervene aimed at facilitating medication administration and provide appropriate patient education.
Drug delivery system in Medication Administration
Effective regulation is essential for safe medicines. Nurses must coordinate care activities to ensure safe and accurate medication administration, avoiding rush that often leads to errors. The use of no-interference zones (NIZs) is recommended to minimize distractions and distractions during formulation. These areas are designated areas around medication carts or dispensing areas, which are not allowed to interrupt, to help nurses stay focused when administering medications
To set goals and priorities in Medication Administration
Establishing clear goals and outcomes for medication administration helps ensure patient safety and improves timeliness. For example, a nurse might set a goal that a newly diagnosed type 2 diabetic would safely self-administer medication prior to discharge. The primary outcome will be that patient will demonstrate understanding of medication preferences and contraindications, know how to treat hypoglycemia, and be able to control blood glucose levels Nurses should also provide priority medications is prioritized based on the patient’s assessment. Pain medication should be given first if the patient is in pain, and blood pressure medication should be given before any other medication if blood pressure is elevated.
Teamwork and collaboration in Medication Administration
Collaboration is essential to ensure effective drug delivery. Nurses should work with the patient’s family caregivers to reinforce medication regimens and support patient compliance with prescribed medications upon discharge. Nurses collaborate with health care providers, physicians, and case managers to address barriers such as high drug costs. For patients with literacy difficulties or difficulty understanding medication instructions, it is important to include community resources such as medical interpreters or public health departments to ensure that patients have access to instructions which is appropriate
Health promotion and patient education
Nurses play an important role in promoting health by helping patients manage their medications. It is important to understand the influence of health beliefs, socioeconomic factors, and attitudes on the willingness to follow treatment plans for illness. Nurses educate patients and families about the benefits of medications and instruct them on how to take them correctly. Particular emphasis will be placed on tailoring education to individual patient needs, particularly in cases where cultural beliefs, language barriers, or financial constraints may affect compliance. For example, patients with low vision may need a blind prescription or a special syringe to help with accurate administration.
Patient education and safe medication administration
Patient education is important in the prevention of medication errors. Nurses should use clear language to explain medication purpose, dosage, timing, and side effects. Techniques such as Teach Back, in which patients repeat instructions in their own words, help determine if they have understood the information. For patients requiring insulin and other injectable medications, nurses can demonstrate appropriate methods for injection preparation and administration. In some cases, nurses teach family caregivers how to administer injections if the patient is unable to do so on their own. Specially designed equipment, such as syringes with extended markers, may be necessary for patients with low vision.
Critical care and medication orders
It is the responsibility of nurses to ensure the safe and effective administration of medication in critical medical situations. This starts with ensuring that prescriptions are clear, readable, and complete. If an order is unclear or incomplete, nurses should clarify it with the health care provider before proceeding. Accurate medication ordering includes information such as the patient’s full name, medication name, dosage, route of administration, timing and frequency Nurses also use a Medication Administration Record (MAR). ) or Electronic MAR (eMAR) is used to track medications, ensuring that the right medication is administered at the right time
Accurate dose estimation and safe dosing
It dose calculation and measurement are important components of safe drug delivery. Nurses should use calibrated measuring devices when preparing liquid medications and adhere to a protocol to minimize error. If there is any uncertainty in calculating a dose, nurses should consult with another nurse or the healthcare provider to verify accuracy. Correct administration also includes verifying the patient’s identity using at least two patient identifiers, performing necessary assessments (such as checking the heart rate before administering antidysrhythmic medications), and monitoring the patient’s response, especially with new medications.
Medication administration records
After administering medications, nurses should immediately document the information in accordance with agency policies. This includes noting the name of the medication, dosage, route of administration, and timing. Any missing quantities, rejections, or changes due to tests or procedures should also be recorded, along with the reason for the missing quantities. Effective communication with health care providers is essential during medication loss to ensure patient safety and medication control.
Rehabilitation of care
Point-of-care medications can vary depending on the patient’s activity. In some cases patients need the full support of the nurse with medication management, in other cases family caregivers or patients can manage medications themselves. Regardless of the setting, nurses should educate patients and families on proper medication administration, the risks of abuse, and the importance of following prescribed procedures though ensure that prescribed medications receive desired treatment.
Infants and children
Developmental needs should be considered when prescribing medications for infants and children, as medication use may be quite different from adults. In pediatric settings, prevalidation of the pediatric dose is often a routine procedure for another provider to ensure accuracy and safety. Parental involvement is also important, as they can often provide valuable assistance in determining how best to administer their medications to the child. Generally, when the parent administers the medication under the supervision of the nurse, the child’s stress is reduced.
Using supportive care to promote cooperation is important, especially when the child is expected to participate in their treatment. Use simple, clear language when explaining the process to the child. Avoid lengthy explanations that can increase anxiety, especially before painful procedures such as injections. Give the child options such as “Would you like to take your pill with water or water?”. whenever possible. This empowers the child and can reduce resistance. However, it is important not to give the opportunity to refuse the medication. Praise and rewards such as stars or tokens should be given after taking the drug to positively reinforce the behavior.
Advice on dosing:
Oral medications: Water is generally softer and safer for children to swallow than antibiotics. Use a dropper for babies, and straws in older children often help swallow pills. When mixing medicines, always use a small amount of water or food to allow the child to take the entire amount. Avoid mixing chemicals with your child’s favorite foods or liquids to prevent later rejection. Plastic, disposable oral syringes are the most accurate fluid dosing devices, especially in volumes less than 10 mL.
Injections: Administer intramuscular (IM) injections and choose appropriate sites, as infants and young children have undeveloped muscles Ensure that a second nurse is available to help control the child if needed, when the parent should be there to comfort the child, not distract the child with conversation, toys or bubbles Perception of pain can be reduced. Lidocaine ointment can be applied to the injection site before reducing the pain experienced.
Older Adults
Older adults also require special considerations when administering medications due to physiological changes related to aging and the presence of other factors, such as behavioral and economic influences. Individuals who are older may have altered metabolism and kidney function, making them more sensitive to certain medications, particularly those that affect the central nervous system.
Safety in Medication Administration for Older Adults
Medication Review: It is important to frequently review an older patient’s medication history, including over-the-counter medications, and consult with the healthcare provider to simplify the medication regimen if possible. This helps avoid polypharmacy, which is common among older adults.
Clear Instructions and Memory Aids: Instructions should be kept simple and easy to understand. Nurses should provide memory aids, such as medication calendars or schedules, to help older patients keep track of their medications. Written information about medications should be printed in large enough text for the patient to see.
Assess Functional Status: Nurses should assess the patient’s functional status to determine if they require assistance in taking medications. This is especially important for older adults with limited dexterity, cognitive impairments, or physical disabilities.
Sensitivity to Medications: Older adults may experience increased sensitivity to medications, particularly those affecting the central nervous system, such as sedatives or antipsychotics. Nurses should closely monitor their responses to medications and anticipate possible dosage adjustments.
Difficulty Swallowing Medications: Some older adults have difficulty swallowing tablets or capsules. If this is the case, the nurse should ask the healthcare provider to consider liquid medications. Alternatively, patients can be instructed to place the medication on the front of the tongue and swallow with water to help it reach the back of the throat. If problems persist, the medication may be taken with a small amount of semisolid food, such as applesauce, to aid in swallowing.
More on Safety in Medication Administration
Polypharmacy refers to the use of multiple medications, including those that may be inappropriate or even unnecessary, or instances of medication inconsistency with diagnoses often occur when patients take the same medication for the same condition or mix medications the nutrient supply. Polypharmacy is common in older adults due to chronic health issues, but can affect children and those with mental illness. Risks include increased adverse reactions and drug interactions. To minimize these risks, health care providers should communicate frequently and facilitate medication use.
Drug administration assessment is an important nursing activity that requires assessment, analysis, and application of pharmacological knowledge. The goal is for patients to respond appropriately to chemotherapy and manage their own care. Nurses should engage patients in the assessment process, ensure they understand their medication regimen and identify barriers to adherence (eg, cost, lack of knowledge).
Assess patient outcomes by comparing expected outcomes with actual outcomes through physiological outcomes (e.g., blood pressure) and behavioral responses (e.g., pain); do Nurses use tools such as rating scales and patient feedback to assess medication effectiveness. For example, to ensure that patients understand their medications or to disclose proper administration techniques. These tests ensure safe and effective medication use.
Polypharmacy: The use of multiple medications by a patient, often common in older adults or those with multiple chronic conditions.