Assessment 2: Medication Administration, Safety, and Documentation

This assignment, titled "Assessment 2," delves into the critical aspects of medication administration. It begins by outlining the procedures for handling verbal and telephone orders, emphasizing the importance of accurate documentation, repetition of orders, and countersigning by authorized prescribers. The assessment then examines standing and PRN (as needed) orders, detailing their initiation criteria, documentation requirements, and the role of certified staff. The assignment further explores various routes of drug administration (oral, sublingual, intravenous, etc.) and highlights potential errors, such as confusion between similar abbreviations. The assessment covers intravenous fluid administration, including hypertonic solutions, and discusses how to calculate flow rates. Patient safety is a central theme, emphasizing the importance of the seven rights of medication administration and the role of regulatory bodies like the TGA. The assignment addresses adverse drug reactions, management strategies, and the assessment of patients' fluid and electrolyte needs. References to relevant research papers support the discussion, providing a comprehensive overview of safe and effective medication practices.

Running head: ASSESSMENT 2 1
Assessment 2
Name
Institution
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ASSESSMENT 2 2
ASSESSMENT 2
1.1
A verbal or telephone order?
1. An authorized prescriber identifies, specifies the name of the patient and then communicates the order
2. The receiver:
 Documents the order instantly on prescriber form including time and date, authorized name of
prescriber, and pager number or service, name, statues and signature of receiver
 Repeats the order back to authorized prescriber including the:
a. Name of patient
b. Name of drug and spelling of drug to avoid any error due to sound alike drugs
c. Dosage, pronouncing it in single digit (e.g. 15 mg is read as one five)
d. Route
e. Frequency (e.g. 3 times daily and not TID)
 Requests indication for medication to help in error avoidance
 Questions the authorized prescriber in case there is any uncertainty about the order
3. The authorized prescriber has to countersign order with twenty-four hours (or as soon as feasible) after
communicating it.
A standing order?
It is only initiated when patients meet criteria highlighted in orders. It must be co-signed after initiated with
exemption of vaccination orders.
PRN orders?
The PRN medication order is administered only by the certified staff once he has reviewed the following:
1. Verifying PRN order: based on DPH regulations. The PRN orders have to encompass particular target
symptoms alongside instructions for utilization. Target symptoms have to be the ones which certified staff is
able to observe without the need for a clinical assessment. PRN orders might never be ordered for a diagnosis.
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ASSESSMENT 2 3
Where PRN orders are not clear, pharmacist has to be consulted.
2. Administration of PRN medications-documentation: The PR medications have to be documented on the
MAR back including the reasons provide as well as effectiveness. Notation of the observation of staff of the
PRN medication effectiveness have to be highlighted, accurately denoting describe symptom described.
3. For individual learning to self-medicate: A certified staff has to always note if the consumer requested the
PRN medication and the reason highlighted (Mitragotri, Burke & Langer, 2014). This will further be
documented on MAR, alongside how the staff observed the presentation of the individual. Teaching as well as
education for the individual learning to self-medicate must encompass self-identification of symptoms targeted
the order medication will treat.
1.2
a.
 Oral administration
 Sublingual
 Rectal administration
 Topical administration
 Parental administration
 Intravenous injection
 Intramuscular
 Subcutaneous (Mignani, El Kazzouli, Bousmina & Majoral, 2013)
b.
The S.C is mistaken as SL for sublingual or “5 every” and hence write “Sub-Q”, “subQ”, or “subcutaneously”
c. It should not be used since the potential problem of being mistaken for mg (milligrams) leading to one
thousand-fold dosing overdose and hence recommended preferred term is “m cg”.
2.1
1.
Hypertonic solution
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ASSESSMENT 2 4
2.
The peripheral vein may not be found due to severe hypovolaemia
2.2
The access device like a needle could be introduced into femoral vein where it has be held strongly in place and
hence can be identified effortlessly by its pulsation. This will allow a large amount of fluid to be infused very
fast.
3.1
1.
Volume (ml) X drop factor (gtts / ml)
---------------------------------------------
time (min)
= gtts / min
(flow rate)
=1000X15/60=250
2. 100X15/20=75
3. 250/75=3.3
4.1
This gives significant safety info to healthcare practitioners and services and serve to guarantee learnings
appropriate to improving safe utilization of medicines might be shared across health system in an active way.
4.2
 The seven “rights” of medication administration (right-client, -dose, -time, -route, -reason, and -
documentation)
 Whether I have notation
 Whether I have finished intravenous medication administration education
4.3
TGA regulates therapeutic goods including vaccines, medicine prescription, sunscreens, minerals, vitamins,
medical devices, blood, and blood products.
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ASSESSMENT 2 5
4.4
The Act applies to the provision of pharmaceutical, sickness as well as hospital benefits, alongside of medical
as well as dental services.
5.1
I will tell him on steps or procedure
I will tell him how to document medication administration
I will tell him duration it takes for oral medication to take effect
Journal 5.2
1. I will manage this by discontinuing the offending medication. I will give alternative medication with
unlinked chemical structures if available. I will monitor the clinical consequences of medication halt or
substitution closely for a period of 2 weeks (Kardaun et al. 2013).
2. I will use all the above steps in above question but use systemic corticosteroids to speed recovery in acute
case of drug reaction. I will use topical corticosteroids alongside oral antihistamines to enhance dermatologic
symptoms (Perin et al. 2017).
5.3
Assess if patient is hypovolemic for:
 capillary
 heart rate
 national early warning
 passive leg raising
 respiratory rate
 Systolic blood pressure
Assess likely of patient fluid and electrolyte requirements from history, clinical exam, present medications,
clinical monitoring and lab investigations
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ASSESSMENT 2 6
References
Kardaun, S. H., Sekula, P., Valeyrie‐Allanore, L., Liss, Y., Chu, C. Y., Creamer, D., ... & Roujeau, J. C. (2013).
Drug reaction with eosinophilia and systemic symptoms (DRESS): an original multisystem adverse drug
reaction. Results from the prospective RegiSCAR study. British Journal of Dermatology, 169(5), 1071-
1080.
Mignani, S., El Kazzouli, S., Bousmina, M., & Majoral, J. P. (2013). Expand classical drug administration ways
by emerging routes using dendrimer drug delivery systems: a concise overview. Advanced drug delivery
reviews, 65(10), 1316-1330.
Mitragotri, S., Burke, P. A., & Langer, R. (2014). Overcoming the challenges in administering
biopharmaceuticals: formulation and delivery strategies. Nature reviews Drug discovery, 13(9), 655-
672.
Perin, E. C., Murphy, M. P., March, K. L., Bolli, R., Loughran, J., Yang, P. C., ... & Traverse, J. H. (2017).
Evaluation of Cell Therapy on Exercise Performance and Limb Perfusion in Peripheral Artery Disease.
Circulation, 135(15), 1417-1428.
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