Prescription/medication:
The medication orders are written on form designed specially for physician’s order which is part of patient’s permanent record.
Safe practice dictates that nurse should follow only a written order, because a written order by physician is least likely to result in misunderstanding the errors.
Under certain circumstances, such as emergency, a verbal order from the physician may be given to the registered nurse .in most of the setting student nurses are not allowed to carry verbal orders.
Types of order :
· There are several types of order that a physician may write .
· A standing order is carried out as specified until it is cancelled by another order.
· Many physicians whose practices are limited to a particular clinical area have a specified set of written order for all their hospitalized patients. These are also referred as standing orders.
· The physician may write p.r.n. order (as needed ) for medication. The patient receives medication when it is requested or needed.
· Another type of order is called a single order; that is the directive is carried out only once, at a time specified by the physician.
· Medication to be administered immediately before surgery is an example of a single order.
· A stat order also is a single order but it is carried out immediately .
· A stat order for epinephrine would be carried out immediately for a patient who I experiencing an anaphylactic drug reaction.
Parts of the Medication order :
The medication order consists of seven parts :
1. Patient’s name .
2. Date and time of the order written.
3. Name of the drug to be administered .
4. Dosage of the drug.
5. Route by which drug to be administered.
6. Frequency of administration of the drug.
7. Signature of physician writing the order
(d) Safety in Administering medications :
1.Regarding label :
1. Give medication only from clear labeled container.
2. Poisonous drug should label as “poison” in red ink.
3. Select the right drug from the cupboard. Follow three checks.
4.Pour liquid medication from the bottle from the opposite side of the label.
5. Never administer medications from unmarked bottle/ container.
2. Regarding measuring medicines :
1. Hold medicine bottle in right hand and open the cork or lid with left hand.
2. Always use a calibrated measure in order to measure the accurate dose.
3.Avoid conversation or any thing that prevents or diverts the concentration on the task in hand.
4. Shake the fluid medication before pouring in to the ounce glass.
5. hold ounce glass on the eye level and place thumb nail of the hand holding the glass at the high on the glass to which medicine is to be poured.
6.wipe the mouth of bottle before recapping the bottle.
3.Regarding administration :
1. Observe five Rights.
2. Give medicine if there is written and signed order only.
3.Verbal orders should be accepted only in emergency.
4.Do ‘no use’ drugs that differ in color, odor or consistency,
5. Never give more than one drug at a time unless they are ordered.
6. Know minimum and maximum dos for the medication being given.
7. Always identify the right patient before giving medication by calling patient with his name.
8. Stay with patient unless he has taken the medication. The drug should not be left with patient.
9.An error with medication should be reported immediately to the nurse in charge.
10. Never give medication in dark or dim light.
11.Never allow one patient to carry medication to anther patient.
4.Regarding recording the drug :
1.Record if an ordered medication is refused or if it cannot be administered.
2.Record each dose of medication soon after it is administrated.
3.use standard abbreviation in recording medications.
4.Record only those medicines which you have administered.
5. Record effects, usually any unusual effects.
6. Never record any medication as “given” before it has been given to the patient.
5.Abbreviation used in medication :
· OD –once in a day.
· BD-Twice in a day
· TID-Tree time in a day.
· QID-Four time in a day.
· Q4h-Every 4 hourly
· Q8H-Evry 8 hourly.
· Q12H-Every 12 hours.
(e) Medication Errors : A medication error is “a failure in the treatment process that leads to, or has the potential to leads to, harm to the patient”
It is the administration of drug :
· Which is given not according to the order.
· Is administered as per the order but is unsafe or inappropriate for the client.
· When documentation a client’s chart does not reflect that a medication was administered as ordered.
· Medication was given ,but no charted.
· Administering of I.V. medication at the wrong rate
· Administrating medication in wrong dose.
· Administering medication at the wrong time.
· Administering the wrong medication
· Charting medication that was not given
· Administering substitution medication.
· Failure of given a medication within the prescribed time interval
· Giving a medication by the wrong route.
· Incorrect preparation of drug by a incorrect route.
· Administering medication to the wrong client.
· Giving a drug that has deteriorated.
When a medication error occurs, it must be documented exactly as it has occurred.
3. DRUGS FORMS : Drug are available in many forms or preparations.
The following are the list of pharmaceutical preparation of drugs:
1.Oral preparations :
Capsule : Powdered drugs or liquids within a gelatic container.
Elixir : Solution containing alcohol, sugar and water may or may not have active
Emulsion : Suspension with oil base.
Lozengs (tache) : Tablet held in mouth to b dissolved and its combination of drugs and some sugar or
soothing material which relieves the tingling sensation at the back of throat and stop a
cough.
Powder : A finally grinded drug or drugs frequently mixed with liquid before administration.
Spansule : A drug made in capsule in such a way that there is a slow release of its contents and
provided effect over a long period
Suspensions : Medication in liquid form which must be shaken before administration because it separates.
Syrup
Syrup : An aqueous solution of sugar often used to disguise unpleasant taste of drugs and smooth i
irritated membrane.
Tablet : Compressed hard disk of powdered medication, may be scarred for easy breaking. This may
Be scarred for easy breaking. This may be sugar coated or have fine coting as cohesion.
Tincture : Alcoholic or hydro alcoholic solution prepared from the drugs derived from plants.
Aqueous solution : One or more drugs dissolved in water.
Extract : Concentrated preparation of drug from vegetables or animal generally used to
preserve a drug for using a medication.
Pill : single dose units made by mixing the powder drugs with a liquid such as syrup and
rolling the mixture into round or oval shape. It is replaced today by tablets and capsules.
2. Topical preparations :
Cream : Non –greasy, semisolid preparations for topical applications.
Gel/Jelly : clear semisolid, substance that liquefies when applied to skin.
Lotion : Emollient liquid may be clear solutions or suspensions which are applied to the skin
Ointment : Drug combined with oil base or drug in petroleum(Vaseline).
Paste : Preparation like an ointment for external use, frequently thick a stiff, penetrates the
skin less than ointments.
Suppository : Medicines contained within a gelatinous base, when dissolved at body temperature slowly release the drug.
Spirits : A concentrated alcohol solutions of a volatile substance also known as essence.
Waters : Saturated solution of volatile oils.
Plaster : Solid preparation used as a counter irritant or as an adhesive used externally.
Transdermal patch : Medicine in a patch, when applied to the skin, permits gradually, control absorption.
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