HLTENN007 Diploma of Nursing: Administering and Monitoring Medicines

This HLTENN007 assignment solution addresses key aspects of administering and monitoring medicines, including the nurse's role, medication schedules, routes of administration, pharmacodynamics, pharmacokinetics, polypharmacy, and the first-pass effect. It covers drug transportation, bioavailability, receptor types, and essential rights of medication administration. The assignment also provides detailed information on various routes of drug delivery, such as oral, sublingual, buccal, inhaled, and injected, along with specific examples. Furthermore, it includes a scenario-based assessment requiring the selection of appropriate pain medication, considering potential drug interactions. This document offers comprehensive insights into safe and effective medication practices for nursing students; additional resources can be found on Desklib.

0Running head: NURSING
Nursing
Name of the Student
Name of University
Author’s note

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Table of Contents
Assessment Task 1...........................................................................................................................2
Questioning..................................................................................................................................2
Assessment 2.................................................................................................................................19
Scenario 1:.................................................................................................................................19
Scenario 2:.................................................................................................................................20
Scenario 3:.................................................................................................................................21
References......................................................................................................................................22

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Assessment Task 1
Questioning
1.
Nurse must be registered (Nursing and Midwifery Board of Australia, 2017)
2.
Nurses are aware about the medication dosage, their use and side-effects (Nursing and
Midwifery Board of Australia, 2017)
3.
Schedule 2: Pharmacy medicine
Schedule 3: Pharmacist only in medicine
Schedule 4: Pescription only in medicine
Schedule 8: Controlled drug
(Australian Government Depart of Health, 2017)
4.
Name Handled Administered Stored
Capsules Out of direct sunlight Orally Room-temperature
Drops Out of the reach of
children
Internally (nasal or eye
drops)
Room temperature or
4 degree centigrade

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Inhalants Out of the reach of
children
Internal via mouth Room temperature,
away from light
Liquid medication Out of the reach of
children. Liquid
antibiotic requires
expert handling
Orally (cough syrup or
liver tonics)
Intravenously
(antibiotics)
Cough syrup or liver
tonics: room
temperature
Liquid antibiotic: 0 to
4 degree Centigrade
Lotion or creams Away from sunlight
and children
Locally or externally,
over skin
Room temperature
Ointments Away from sunlight
and children
Locally or externally,
over skin
Room temperature
Patches Strict hand hygiene
required
Locally or externally,
over skin
Room temperature
Powder Away from sunlight
and children
Locally or externally,
over skin
Room temperature
Tablets Away from sunlight in
an air tight manner
inside glass bottles
Orally Room temperature
Wafers Away from the reach
of children. Does not
require expert
handling
Orally. Majority are
mouth dissolved and do
not require water
Room temperature
Suppositories Suppositories should Through the rectum Cool and dark place

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not be handled long
with hands as it can
melt
(Source: Shargel, Andrew & Wu-Pong, 2015)
5.
Pharmacodynamics: Branch of pharmacology that deals with the mechanism of action of drugs
and subsequent effect on the body
Pharmacokinetics: A branch of pharmacology that deals with the kinetics of drug mechanism
inside the body
Pharmaco-therapeutics: It is a branch of pharmacology that deals with the study of therapeutic
usage of drugs and is possible effects
(Shargel, Andrew & Wu-Pong, 2015)
6.
Polypharmacy: Use of multiple or numerous combination of medication by a patient is known as
polypharmacy. The concept of polypharmmacy is mostly common among the elderly people
especially the people with intellectual disabilities. Polypaharmacy leads to adverse drug reactions
along with the generation of antibiotic resistance (Shargel, Andrew & Wu-Pong, 2015).
7.

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First Pass Effect: It is a phenomenon of drug metabolism where the concentration of the
administered drug is significantly reduced before it reaches to the systemic circulation. This loss
of concentration of drug occurs via absorption effect coming from liver and the gut wall. First
Pass Effect is also known as First Pass Metabolism. This loss of concentration of drugs via the
heaptic system or the gut tissue is termed as excretion (Shargel, Andrew & Wu-Pong, 2015).
Example: Nitroglycerine, Morphine, marijuana, propranolol.
8.
The duration of action of a drug is known as its half-life. Half-life of the drug is
calculated by means of how quickly a drug is eliminated from blood plasma. More is the half-life
less is the dosage. The half-life of the drug varies with the mode of drug administration life
intravenous, intramuscular, parenteral and orally. Based on the required of the drug dosage or its
half-life, the mode of administration is determined (Shargel, Andrew & Wu-Pong, 2015).
9.
Transportation of drug inside the body can take place via two ways, active transport and
passive transport.
Passive transport
Passive diffusion Pore transport Ion-pair transport Facilitated or
receptor
medicated
diffusion
Active transport

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Symport (co-transport) Anti-port (counter transport)
(Source: Newton, Hickey & Brant, 2016)
10.
Bioavailability: One of the principal pharmacokinetic properties of a drug is belong under a sub-
category of absorption. It is defined as the fraction of administered drug dose of unchanged drug
form reaches systemic circulation Newton, Hickey & Brant, 2016).
Oral Dosage form (decreasing order to bioavailbility)
Solution
Suspension
Capsule
Tablet
Coated Tablet
(Source: Newton, Hickey & Brant, 2016)
11.
Receptors are membrane bound macromolecular protein that helps in the transportation
of drugs towards the effector molecules.
Types of receptors:
Type 1: Ligand gates ion channels
Type 2: G-protein coupled receptors

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Type 3: Kinase linked receptors
Type 4: Nuclear receptors,
Agonist: Agonists are the drug which when binds with is receptors cause receptor
activation.
Antagonist: Antagonists are the drugs which when binds with the receptors cause
receptor deactivation.
(Perry, Potter & Ostendorf, 2015)
12.
 Drug toxicology: It is used to measure the toxic effect of drugs inside the body.
 Anaphylactic reaction: Life threatening allergic reactions that belong under type 1
hypersensitivity reaction. Adverse reaction: The negative effects of drugs
 Contraindications: It is specific situation or a condition of the body where a particular
drug or a procedure or surgery cannot be used as it may prove to be harmful for the
person.
 Precautions: The measures taken in order to avoid any adverse reactions prior to drug
administration.
 Side-effects: Therapeutic adverse effect of a drug
(Perry, Potter & Ostendorf, 2015)
13.

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8 rights of medication administration
1. Right medication (drug, medication, medicines)
 Checking medication level
 Checking the order
2. Right dose
 Confirming appropriateness of the dose
 Checking the medication order
3. Right route
 Checking order and appropriateness of the route administration route
 Checking the last route of administration of last dose
4. Right time
 Frequency or ordered medication
 Checking the prescribed time of medication administration
5. Right person
 Asking patient to identify himself
 Use of two identifiers
6. Right expiration date
7. Right to refuse
 Documentation of refusal
8. Right prescription (documentation)
 Using proper method of recording the medical records
(Perry, Potter & Ostendorf, 2015)

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14
 Oral: Through mouth;
 Sublingual: placing drug under tongue; cardiovascular drugs
 Buccal: Placing drug in between gums; psychiatric drug
 Dry Powder inhalers: breath through inhaler via mouth; asthmatic medication
 Metered dose inhalers: short burst of aerosolized medicine via inhalation; respiratory disease
(asthma)
 Nebulisers: inhaled directly into lungs; pneumonia
 Oxygen therapy: Administered via nasal canulla; Chronic obstructive pulmonary disease
 Subcutaneous injections: Beneath the skin; insulin
 Intramuscular injections: Inside the muscle; Tetanus
 Z – track injections: type of intramuscular injection, used to prevent leakage t the mediciane in
the subcutaneous layer.; used in elderly patient with decreased muscle mass
 Enteral administration - percutaneous gastrostomy (peg) as well as nasogastric tubes:
gastrointestinal tract; Liquid medications: elixirs and suspensions
 Intranasal, including nebulised medications: via nose: nebulizers
 Ocular: topical administration of medicine via eyes (subconjunctival, intravitreal, retrobulbar,
intracameral)

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 Rectal: Rectum as a route of administration; Glycerine suppository
 Sub-cutaneous injection using pre-loaded syringes or pens: beneath the skin; clexane (low
molecular weight heparine)
 Topical, including transdermal: application over body surface, skin ointment for allergy
 Vaginal: Antifungal (cloritmazole)
 Ventrolateral injection technique: type of intramuscular injection at the junction between spine
and hair region on the ventrolateral aspect of the hedgehog's flank
(Perry, Potter & Ostendorf, 2015)
15.
Paracetamol
Chemical name: n-(4-hydroxyphenyl)ethanamide
Trade name: Capol
Generic name: Paracetamol
(Perry, Potter & Ostendorf, 2015)
16.

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Name of
medicine
Name of
medicine
Rationa
le of
adminis
tration
Route
of
adminis
tration
Mode of action Side-effects Nursin
g
interve
ntion
BETA-
BLOCKERS
Mepindolo
l
Used to
treat
glaucom
a
Oral beta-adrenergic
blocking agents
Dizziness
Regular
check-
up of
blood
pressur
e
CALCIUM
CHANNEL
BLOCKERS
Diltiazem High
blood
pressure
Oral Relaxation of
smooth muscle
Headache
Regular
check-
up of
blood
pressur
e
ANTI-
HYPERTENS
IVE
Hyperte
nsion
Oral Diuretics (water
pills)
diarrhoea Regular
check-
up of
blood
pressur

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e
DIURETICS hydrochlor
othiazide
Help
kidney
to get rid
of extra-
water
Oral Blocks
reabsorption of
sodium in
nephron
Low sodium
level
Maintai
n
electrol
yte
balance
ANTI-
CHOLESTO
R
simvastatin
(Zocor)
Harmful
effect of
cholester
ol
Oral Blocks
cholesterol
absorption
Stomach ache Easy to
digest
diet
ANTI-
CLOTHING
warfarin used to
prevent
blood
clots
oral Reduction in the
production of
blood clotting
factor
severe
bruising
Prevent
ion of
wounds
SEDATIVES clonazepa
m
(Klonopin)
Helps to
induce
sleep
oral enhancement of
gamma-
aminobutyrate
(GABA)-
mediated mecha
nisms in the
CNS
constipation Monito
ring of
sleep
ANTIDEPRE
SSANTS
amoxapine Helps to
prevent
oral Selective
serotonin
nausea Monito
ring

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depressi
on
reuptake
inhibitors
(SSRI)
psychot
ic
action
ANTIPSYCH
OTICS
aripiprazol
e (Abilify)
Preventi
on of
psychosi
s
oral blockage of
dopamine
D2 receptors in
the
dopaminergic
pathways brain
nausea Monito
ring of
mental
conditi
on via
counsel
ling
ANTIBIOTIC
S
penicillin Preventi
on of
bacterial
infection
Oral or
intraven
ous
Bactericidal
works via
disruption
bacterial cell
membrane
(gram negative)
Multi-drug
resistance
Monito
ring the
bacteria
l load
in
blood
VITAMINS/
MINERALS
Vitamin
B12
Preventi
on of
pernicio
us
anaemia
oral Water soluble
vitamin, mix
directly with
blood
Vitamin
overdose
(staining of
teeth)
Monito
ring
vitamin
and
mineral
levels
in

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blood
ANTI-
REFLUX
esomepraz
ole
(Nexium)
Preventi
on of
acid
reflux
Oral
suspensi
on
Proton-pump
inhibitor
constipation Regular
and
periodi
c intake
of food
ANTI-
EMETICS
Cyclizine Preventi
on of
vomiting
and
nausea
oral H1 histamine
receptor
antagonists
gastrointestina
l disturbanc
Regular
and
periodi
c intake
of food
ORAL
HYPOGLAC
EMICS
Sulfonylur
eas –
glimepirid
Anti-
diabetic
medicati
on
oral Stimulates
insulin secretion
from pancreatic
beta cells
Weight gain Monito
ring
blood
glucose
level
APERIENCE
S
laxative induce
bowel
moveme
nts
oral Competitive
antagonist at
opioid receptors
constipation Intake
of
liquid
food
INHALED
MEDICATIO
NS
Inhalers
(salbutamo
l)
Treatme
nt of
COPD
nasal relaxation of
bronchial
smooth muscles
Headache Guidin
g
patient

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to take
inhaler
ANALGESIC
S
Codeine
(nonsteroid
al anti-
inflammat
ory drugs
(NSAIDs)
Pain
relief
oral Inhibition of the
synthesis of
prostaglandins
Drowsiness Regulat
ing
proper
dose
RESPIRATO
RY
MEDICATIO
NS
Bronchodil
ators
Treatme
nt of
asthma
oral relaxation of
bronchial
smooth muscles
Headache Checki
ng
partial
pressur
e of
oxygen
ANTI-
INFLAMAT
ORY
aspirin Fever
and mild
pain
oral Inhibits the
synthesis of
prostaglandins
and
thromboxanes
black, bloody,
or tarry stools
Regulat
ing
proper
dose
ANESTETIC
S
Ketamine Mainten
ance of
anaesthe
sia
intraven
ous
Blockage of
NMDA (N-
methyl-D-
aspartate)
blurred vision Checki
ng the
conscio
usness

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receptors of the
patient
and
other
cardiac
conditi
on
before
applicat
ion of
medicin
e
ANTI-VIRAL Rapivab
(peramivir)
Viral
fever
Intra-
venous
Inhibit viral
replication
Renal
impairment
Not
suitable
for
patients
with
renal
impair
ment
OPHTALMIC ofloxacin Bacterial
infection
of eyes
Eye
drop
bactericidal dizziness Guidin
g the
patients

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after
giving
medicat
ion
while
sufferin
g from
blurred
vission
ANTI-
PARKINSON
S
Dopamine
agonists
Treatme
nt of
Parkinso
n
disease
oral activates dopam
ine receptors
Hallucinations Checki
ng the
hand
tremor
if any
ANTI-
EPILEPTIC
benzodiaze
pines
Treatme
nt if
seizures
oral Modifying
neurotransmitter
gamma-
aminobutyric
acid (GABA)
Development
of habit of
medicine
Protect
patient
from
injury
coming
from
seizures
CONTRACE
PTIVE
Elinest Preventi
on of
oral nhibition of
ovulation
changes in
vaginal
Birth
control

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MEDICATIO
NS
pregnan
cy
bleeding
(Source: Perry, Potter & Ostendorf, 2015; Kizior & Hodgson, 2017)

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Assessment 2
Scenario 1:
As the patient has been suffering from 6 by 10 pain scale which reflects a moderate to
severe pain the patient will need a functional or target it pain medication. Although the patient
had been taking metoclopramide which can have severe drug interactions Side Effects if any
narcotic pain medication is taken. Has the patient will need to take a non narcotic pain
medication such as toradol (Chen et al., 2011).
Oxycodone is opoid based analgesic and it is orally administered usually. It is mainly
administered with HCl solution and mm is needed to be very carefully measured by the
Healthcare professionals before administering it to the patient. The patient will show significant
indications of pain relief and it can be measured through the facial pain scale measurement tools.
Along with that some non pharmacological pain medication techniques can also be administered
to the patient to help relieve the pain (Elvir-Lazo & White, 2010).
Paracetamol belongs to the class of analgesics. Can be stored at room temperature.
Oxycodon belongs to the opoid. Should be stored at temperature within 68 to 77F.
Metoclopramide is a dopamine-2 receptor antagonist. Should be stored in a temperatire within 68
to 77 F.
The drugs need to be administered with the right drug : mediation ratio, in this case as I
have faced shortage I would ask the doctor to prescribe another medication of the same

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composition or i will reduce the amount of mediation stock so that the ratio of drug and
mediation remains the same and administer to the patient at extreme urgency.
Scenario 2:
It has to be mentioned that cellulitis is a very common bacterial infection but there are
many side effects associated with the disease. Not taking the medication for the patient has many
implications and there are various complications that can occur if the cellulitis is not managed
and prevented by the treatment. Not taking the medication can delete the infection spreading
throughout the body and entering lymph nodes and bloodstream. This can cause blood infection,
bone infection, inflamed lymph vessels, and even tissue death for the patient (Kilburn et al.,
2014).
Patient education plays a major role in motivating and providing the patience to fall in
line with the treatment plants and provide can send to their progress of the treatment. In this case
the patient has stopped taking medication because he was not feeling well and he was feeling
depressed. In such cases engaging the patient in ICU therapeutic conversation encouraging him
to understand the severity of the Healthcare adversity is going through and how he can control
his progress by cooperating with the treatment plan can help. Hence I will attempt to interact
with the patient (Karppelin et al., 2010).
As the patient is allergic to penicillin, and amoxicillin belongs to the penicillin class of
drugs, the nursing professional will lead to discuss with the Iron if amoxicillin can be replaced
by any non penicillin antibiotic as taking amoxicillin can be harmful for the patient (Kilburn et
al., 2014).

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Scenario 3:
Diabetes is concerned with high blood sugar levels and can lead to many health
complexities like coronary heart diseases, renal diseases, and hypertension. The patient will need
to keep your body weight and BMI in control. The various ways that the patient can maintain
healthy weight is with regular exercise, low fat diet, and regular checkups. The medications
include alpha glucosidase inhibitor, biguanides, dopamine antagonists, DPP4 inhibitors, incretin
mimetics, and thiazolidinediones. As the blood glucose levels of the patient is very high insulin
will be included in the medication plan for the patient, the patient funny to be very careful about
the tools and the injection sites. Rotating injection site will help in avoiding an infection or
soreness. The dietary plan of for the patient will include high carbohydrate and fibres. 50% of his
meals will need to include green vegetables. Along with that one fourth of his meal choice
should include starch based foods and the rest must include milk and fruits. Occasionally he
might indulge in lean meat like chicken or fish, but the amount has to be very limited. The
patient family has to be involved in the plan in case of hyperglycemia attacks in which case the
patient must be administered 15 grams of carbohydrate, preferably sugars. The risk factors
include low blood glucose, weaknesses, fatigue, and diabetic foot ulcers. The patient will need to
consult with cardiac specialist and dietitian for better management of the disease (Inzucchi et al.,
2012).
Gentamycin can be prescribed to the patient for conjunctivitis. Although the precautions
include allergic reactions, and can even cause temporary blurred vision. It can be stored in room
temperature within 15 to 30 degree Celsius (Ley et al., 2014).

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Yes, as the blood glucose is much higher than the normal levels, I will administer insulin
and I will administer 15 units of insulin, preferably Actrapid (Inzucchi et al., 2012).
References
Chen, W. H., Liu, K., Tan, P. H., & Chia, Y. Y. (2011). Effects of postoperative background
PCA morphine infusion on pain management and related side effects in patients
undergoing abdominal hysterectomy. Journal of clinical Anesthesia, 23(2), 124-129.
Elvir-Lazo, O. L., & White, P. F. (2010). The role of multimodal analgesia in pain management
after ambulatory surgery. Current Opinion in Anesthesiology, 23(6), 697-703.
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., ... &
Matthews, D. R. (2012). Management of hyperglycaemia in type 2 diabetes: a patient-
centered approach. Position statement of the American Diabetes Association (ADA) and
the European Association for the Study of Diabetes (EASD). Diabetologia, 55(6), 1577-
1596.
Karppelin, M., Siljander, T., Vuopio‐Varkila, J., Kere, J., Huhtala, H., Vuento, R., ... & Syrjänen,
J. (2010). Factors predisposing to acute and recurrent bacterial non‐necrotizing cellulitis
in hospitalized patients: a prospective case–control study. Clinical Microbiology and
Infection, 16(6), 729-734.
Kilburn, S. A., Featherstone, P., Higgins, B., Brindle, R., & Severs, M. (2014). Interventions for
cellulitis and erysipelas. Cochrane Database Syst Rev2010, 16.
Kizior, R. J., & Hodgson, B. B. (2017). Saunders Nursing Drug Handbook 2018-E-Book.
Elsevier Health Sciences.

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Ley, S.H., Hamdy, O., Mohan, V. and Hu, F.B., 2014. Prevention and management of type 2
diabetes: dietary components and nutritional strategies. The Lancet, 383(9933), pp.1999-
2007.
Newton, S., Hickey, M., & Brant, J. (2016). Mosby's Oncology Nursing Advisor E-Book: A
Comprehensive Guide to Clinical Practice. Elsevier Health Sciences.
Nursing and Midwifery Board of Australia - Home. (2017). Nursingmidwiferyboard.gov.au.
Retrieved 15 February 2018, from http://www.nursingmidwiferyboard.gov.au/
Perry, A. G., Potter, P. A., & Ostendorf, W. (2015). Nursing Interventions & Clinical Skills-E-
Book. Elsevier Health Sciences.
Satoskar, R. S., Rege, N., & Bhandarkar, S. D. (2015). Pharmacology and
Pharmacotherapeutics-E-Book. Elsevier Health Sciences.
Scheduling basics. (2017). Therapeutic Goods Administration (TGA). Retrieved 15 February
2018, from https://www.tga.gov.au/scheduling-basics
Shargel, L., Andrew, B. C., & Wu-Pong, S. (2015). Applied biopharmaceutics &
pharmacokinetics (pp. 119-120). McGraw-Hill Medical Publishing Division.