5 Written Questions
5 Matching Questions
- individual prescription order system
- The right dose
- summary sheet
- Medication errors
- standards of care
- a gives the patient's name, address, date of birth, attending physician, gender, marital status, allergies, nearest relative, occupation and empooyer, insurance carrier and other payment arrangments, religious preference, date and time of admission to the hospital, previous hospital admissions and admitting problem or diagnosis.
- b a drug is given to wrong pt; wrong drug is given; wrong route; wrong dose; wrong time; wrong rate of administration; drug that is contraindicated given; drug given to pt that has known allergy; unordered or unsage med is given; given with an incompatible substance; protocals for reporting errors differ between institutions
- c meds are dispensed from the pharmacy upon receipt of a prescription or drug order for an ind patient. Pharmacy sends supply of med ina bottle or box for patient, may hold 3-5 day supply. Meds are stored in med cabinet at nurse's station, med is removed as needed. ADVANTAGES: Review of prescription by nurse and pharmacist so greater patient safety; less chance for deterioration or expiration; easier inventory control; less chance for misuse by others; easier to charge patient; med is available for stat or prn usage. DISADVANTAGES: Frequent need to return or discard unused meds; complex ordering, preparing, administering, controlling, and recording systems required-time consuming
- d althought the physician may order the correct dosage of the med, changes in the pt's status may require that the dosage be altered; the nurse must use the proper equipment, the proper drug form and the proper concentration; calculations must be right; check usual drug dosage
- e guidelines developed for the practice of nursing. These guidelines are defined by the nurse practice act of each state, by state and federal laws regulating health care facilities by JCAHO and by professional organizations such as the ANA and other agencies.
5 Multiple Choice Questions
- Drug Distribution Systems, interpreting Dr's orders, documentation; three checks, six rights, handling controlled substances; helpful resources
- is an adaptation of the system used in the acute care setting. This is designed with ind drawers to hold one resident's med containers for 1 week. Drawer is labeled with the resident's name, room #, pharmacy name and telephone number and name of the health care facility.
- if a portion of med must be discarded due to smaller prescribed dose, two nurses must check the dose, preparation, and portion; both must cosign the inventory control record to verify transaction
- nurse makes a professional judgment on its acceptability and safety of drug order, including type of drug dose and dose preparation, therapeutic intent, route potential allergic reactions or contraindications
- ask the pt's name as you are checking the bracelet, errors may occur on a busy unit; at risk for errors: pediatric pt, geriatric pt, non english speaking pt, confused or critically ill pt; nursing home patients ay not be wearing a bracelet
5 True/False Questions
physicians order form → generally used for emergency basis
nurse consequence for med error → grants permission to the health care facility and physician to provide treatment.
The right documentation → althought the physician may order the correct dosage of the med, changes in the pt's status may require that the dosage be altered; the nurse must use the proper equipment, the proper drug form and the proper concentration; calculations must be right; check usual drug dosage
narcotic control systems → Paper system; narcotic/controlled substances is delivered to the unit and signed for by RN and she verifies that meds are all there and in good condition before signing; kept locked in specified cabinet; narcotic keys are carried by nurses and turned over to the next shift when narcotics are counted; at end of each shift, narcotics are counted, inventoried by 2 nurses one from oncoming shift and one from ending shift; narcotics are signed out as they are used.
Drug administration resources → floor or ward stock system, ind presc. order system, unit dose system, automated dispensing system