5 Written questions
5 Matching questions
- Procedure for signing out a controlled drug
- narcotic control systems
- standing order
- computerized prescriber order entry (CPOE)
- a computer system that integrates the ordering system with the pharmacy, stocked by pharmacy, central system keeps track of inventory, only those meds ordered for the pt can be removed, there is a method to bypass system to obtain drugs in an emergency. ADVANTAGES: Reduces time for nurses, med is automatically recorded at time of delivery, tight control over med, narcotics are counted and verified each time one is removed. DISADVANTAGES: Costly, requires a pharmacist, requires password, only one nurse at a time,
- b check the order, check med record to see when med was last given; obtain keys/open cabinet; fill out inventory before removing med (compare # in record to # in cabinet pt name, date, drug, dosage, sig of nurse), document that med was given immediately after administration; document effectiveness
- c after verification of an order, a nurse or another designated person does this to the order from the physician's order sheet onto the Kardex or onto a MAR.
- d indicates that a med is to be given for a specified number of doses. Ex. cefazolin 1 g q6h x 4 doses. or until said time
- e 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.
5 Multiple choice questions
- pt refuses med (thoroughly record incident and reason for refusal in nurses notes; notify dr; med error occurs
- a large index-type card usually kept in a flip-file or separate holder that contains pertinent info such as the patients name, diagnosis, allegies, schedules of current medications with stop dates, treatments and the nursing care plan.
- look at results (response to drug, therapeutic effects, adverse effects)
- 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
- is an example of manual recording of temp, pulse, resp and bp. Pain assessment nka the 5th vital sign can also be recorded on this.
5 True/False questions
stat order → administer if needed
flow sheets → This is a condensed form for recording info for quick comparison of the data. Ex would be diabetic, pain and neurological.
nurse's notes and nurse history → depends on severity of effects on the pt; if due to carelessness or negligence of the nurse, the nurse may be held legally liable; repeated errors cannot be ignored
floor or ward stock system → 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.
verification → 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