BASIC MEDICINE MANAGEMENT

BASIC MEDICATIONMANAGEMENTFOR NURSESD. D. Millett, RN, BS

There are over 500,000 legal and illegal drugs on the market and on the streets today. They ALL have multiple names, either brand names, street names or generic names. They have been placed in numerous different categories and often, a drug can and will be used for multiple types of reasons and benefits. Knowing the names all of the hundreds of thousands of drugs is fruitless, not even the different generations or variations of the same drugs/medication.Basic Medication Management

Basic Medication Management

In nursing school, your best bet is to focus and learn the main categories of medications that are used in the hospitals and by the majority of the patients. Within each of the categories, and with repetition and studying, you will begin to become more and more familiar with their names (both generic and brand), their intended uses, the method of delivery, their cautions, and their way to metabolize within the human body.

Basic Medication Management

More than anything else, one of the most important REQUIRMENTS is for you to know, verbatim, what the 5 Rs are when passing out medications. Furthermore, you must not only KNOW what the 5 Rs are, but forevermore, hold yourself up to nursings highest standards and never deviate from what you are learning and practicing RIGHT NOW.

Never take a short cut, or take someone elses word, when you are giving a patient their medication IF YOU ARE NOT CERTAIN OF ANY OF ONE OF THE 5 Rs, STOP, and go to reread the orders.

THE 5 Rs in Nursing Right medication: Was this Rx ordered? Right dose: how many ml, tablets, or liters? Right Time: Some medications MUST be given and taken at certain times of the day. Right Route: IV, feeding tube, PO, SQ, or IM? Right patient: always check, and recheck this! Birthdate and name and hospital number.

THE 5 Rs in Nursing THE MOST IMPORTANT THING YOU MUST NEVER FORGET ARE THE 5 Rs when giving a patient ANY and ALL medications. The other important thing is to know is why the 5 Rs are so vitally important that even if one R is skipped, it could mean the death of your patient.

~ one more time ~

IMPORTANT THINGS TO KNOW When you are going to give a medication, know why the patient is prescribed it.

Know what the medication does.

Where the medication is metabolized or broken down in the body (i.e. if the patient has stage 4 cancer of the liver, make certain the drug does not metabolize there)?

What are the potential side effects?

Does the medication have any blood work that must be drawn first before you give it to the patient?

Are there any lab values you MUST check before you give the medication?

Inform the patient of the medications name(s) before you give them the medication(s).

Must it be taken with food or without?

IMPORTANT THINGS TO KNOW

IMPORTANT THINGS TO KNOW What other medications is the patient on and if there are several, are any of them contraindicated when taken together.

What homeopathic medicines or herbs does the patient take, i.e. St. Johns Wart or baking soda with water for acid reflux.

Would you be concerned if an elderly patient was taking baking soda?

Did the doctor sign the orders? Or is it a STANDING ORDER?

IMPORTANT THINGS TO KNOW

When giving activated Charcoal to children per poison control protocols, children will drink it right down (usually!) if mixed with Coca-Cola (with parents & doctors permission).

WEAR GOWNS!

Does the patient eat or drink things that could cause a dangerous reaction.

Grapefruit and its juice have a reaction to over 60 medications, including Viagra and Tylenol.

IMPORTANT THINGS TO KNOW

If the patient has been prescribed a different medication in the hospital, make certain the two medications are compatible. For example, patient may be on Calcium Channel Blockers and was just prescribed a Beta Blocker. Why could this be a potentially deadly error?

Are they allergic to anything? What happens when they take the yellow pill with the big, blue one?

Ask the patient about their medications! You will be surprised what you might learn.

FYIThe 5 Rs are vital to a nurse. However, there is additional information or warnings about every drug on the market. As nurses, as well as students, you will be expected to learn and know these things. It takes time, and it depends on what unit you will be working on, to know what medications you will get to know intimately.

FYI Know the antidotes for certain medications, like Narcan reverses opioids and Mucomyst is for Tylenol overdose.

Know there that you might need a Tylenol level if someone is taking certain Opioids.

Know the INR, PT and PTT levels of patients on Anticoagulants.

Know that you must take an Apical pulse before giving Digoxin and that it is toxic.

CATAGORIES OF MEDICINE One great way to learn about all of the medication and drugs out there, is to first learn the medications drug category. There are over 40 different categories, but knowing and understanding the main ones, and how they effect the human body, will make learning about pharmacology that much easier.

CATAGORIES OF MEDICINE Some of the main categories to know: Beta Blockers and Calcium Channel Blockers

Insulin and the differences between the types

Antibiotics

Diuretics

Opioids

Anticoagulants

GREAT WEBSITES (hope they help!) Here are some websites that list the Top 100 and 200 prescribed medicines, as well as a great Pill Identifier Tool: http://www.drugs.com/ http://www.rxlist.com/ RxList Pill Identifier Tool

And watch for the patients with polypharmaceuticals!!