Nursing Practice: Safe Administration Guidelines, IV Fluids, Antibiotics, And Medication Alerts

Safe Administration Guidelines

Journal 1.1

Safe Administration Guidelines

What is the usual procedure for managing the following:

    A verbal or telephone order?
    A standing order?
    PRN orders?

They are checked for condition specificity. They must be clearly dated, signed by prescriber ,identifies who by qualification may administer the medication, and should be subject to regular review. The patient to receive the drug is included and when to give the medication (B, 2012).

Journal 1.2

1. Please list seven standard routes of medication administration?

Oral route.

Intravenous route.

Intra muscular route.

Subcutaneous route.

Rectal route.

Intradermal route.

Insufflation/Inhalation route (L., 2016).

1. Why should the abbreviation S/C not be used by the medical officer when they mean subcutaneous?

If the letters are interchanged it can mean CS, Caesarian section (L., 2016). This may cause serious confusion and errors.

1. Why should the abbreviation µg not be used in medical orders?

The µ sign may be overlooked and lead to serious medication errors. It should be written in words (B, 2012).

Journal 2.1

You are staff in a first aid center for a 10-kilometre charity run, with the temperature at 36°C and the humidity at 92%, the first aid center is overwhelmed with patients suffering from dehydration and because IV therapy is within your scope of practice, the lead physician instructs you to administer IV fluid to a 34-year-old male who is seriously dehydrated and extremely weak.

After assessing the patient’s airway, breathing, circulation and applying high-flow oxygen to the patient, you proceed to the medical supply area to get the IV fluid.

There you find a variety of fluids, including isotonic, hypertonic, hypotonic, and a refrigerator of colloid solutions.

Please answer the following questions:

1.What type of fluid would you expect the physician to order for this patient?

Isotonic solution (P., 2005).

1. How might the clinical condition of dehydration affect the ability to locate and access a vein for IV therapy?

Dehydration causes collapse of veins and may make them difficult to access (L., 2016). Hence a lot of effort may be needed (L., 2016).

Journal 2.2

What would be some advantages of using access devices? 

They allow medications to be delivered into large veins.

They can be left for long hours.

They are less likely to cause a clot (L., 2016).

Journal 3.1

John Bourke is a 60 year old male who arrives in the emergency department at your health facility. He has a history of Aplastic Anaemia, for which he recently required chemotherapy. On examination he is pale, sweating, hypotensive and febrile. He is diagnosed as having neutropenic sepsis.

Following cannulation for emergency intravenous therapy and orders for the antibiotics Gentamycin and Metronidazole you will be required to attend to the following:

Calculate the correct doses of his intravenous antibiotics

His intravenous fluid order is for 1 litre of Normal Saline 0.9% over 60 minutes via an infusion pump.

He is prescribed 300mg daily of Gentamycin – the vial contains 80mg in 2ml.

He is prescribed 100 mg Metronidazole that has been added to 100mls normal saline to infuse over 20 minutes.

1. How many mls per hour of the IV Normal Saline will you deliver to Mr Bourke?

1L of normal saline is equivalent to 1000ml to be infused over 60 minutes. Hence 1000ml per hour.

1. How many mls of Gentamycin will you administer to Mr Bourke?

1 ampoules has 80mg of Gentamycin. 300mg of the antibiotic can be gotten by using 3 ampoules equal to 240mg plus 60mg of gentamycin found in 0.75ml of the 2ml ampoule.

3.75ml.

1. Calculate the drip rate (dpm) for administering Metronidazole to Mr Bourke using a macro (20dpm) infusion set.

Journal 4.1

What is the purpose of medication alerts?

Medication alerts help avoid and minimise the risks associated with medication poisoning, misuse and overdose cases that may happen in medication use and handling (B, 2012).

Journal 4.2

As an EN/ Div. 2 Nurse in your current workplace, what defines your administration of medications?

The condition of the patient. I.V route is preferred in emergency cases.

The cormobid conditions. This helps determine the safe route.

Patient’s preference. Some patients prefer oral medications.

Age. Infants may need rectal suppositories to help manage their pain conditions e.g rectal Paracetamol suppositories (B, 2012).

Journal 4.3

What does the Therapeutic Goods Act regulate?

Therapeutic Goods Act regulates medicines, medical devices, vaccines, and other biomolecules used clinically for treatment of patients (L., 2016).

Journal 4.4

What does the National Health Act apply to?

The National Health act applies to the regulations and laws that govern the public health and the management and  practice of medical professions.

Journal 5.1

What are three important points you would make to a patient who you are educating about taking a course of oral medication?

Advise the patient to take the medication immediately after food.

Advise the patient to take the medications accordingly on regular interval times.

Advise the patient to take the medication with lots of water (P., 2005).

Journal 5.2

A delayed adverse drug reaction develops in one of your allocated client’s; outline your management of this situation?

Review of the patient’s medication history through asking or looking at the treatment data. Manage the adverse effect accordingly. Report in the reporting tool of pharmacovigilance (PV) the side effect for data reviews by the pharmacy control body (B, 2012).

An acute adverse drug reaction develops in one of your allocated patient’s; outline your management of this situation?

Withdrawing the medication involved and carrying out the necessary pharmacological and non-pharmacological management of the patient to help avert the situation (B, 2012).

Journal 5.3

List the 5 assessments you would attend on a client receiving peripheral therapy.

1. Air way/respiratory system assessment.
2. Blood pressure assessment.
3. Pulse rate assessment.
4. Heart rate assessment.
5. Body temperature assessment(L., 2016).

References

B, K. (2012). Basic and clinical pharmacology. San Francisco: Mc Graw Hill Education.

Kim, E. (2015). Review of medical physiology. San Francisco: Mc Graw Hill Education.

L., L. (2016). Pharmacology and nursing process. Country St Louis: Mosby.

P., S. (2005). Martin’s Physical Pharmacy and Pharmaceutical Sciences: Physical Chemical and Biopharmaceutical Principles in the Pharmaceutical Sciences. Philadelphia: Lippincott Williams & Wilkins .

R., H. ( 2011). Pharmacology (Lippincott Illustrated Reviews Series) 5th Edition (5 ed.). Philadelphia: LWW; 5 edition.