administer and monitor s8 meds
TRANSCRIPT
Administer and MonitorSchedule 8 Medications
WorkshopPresented by Colleen
Reeve
Medications
Drugs are substances that bring about a chemical change in the body
When used for therapeutic purposes
Diagnosis Treatment Cure Relief or prevention of health
condition
Nurse’s Role
As the person administering medications you have a number of responsibilities
Key ones includes Being aware of
The action of the medicationThe therapeutic effectsNon-therapeutic effectsThe reason it has been prescribed
Medication Preparations
Variety of forms for administration.Choice may depend on a number of
reasons Absorption rate required Difficulties that may be
experienced with swallowingDrug side-effectsPatient preferences
Routes of Medication
Most convenient and acceptable method for patients to receive medication is orally
May be administered a number of other ways.
Drug Schedules The assigning of Drugs and Poisons into one of
eight schedules is in accordance with the Standard for the uniform scheduling of drugs and poisons published by the Australian Health Ministers’ council. The decision on which drugs go into which group is done by the National Drug and Poisons Schedule Committee for inclusion in the relevant state or territory legislation. The Queensland Act being the Therapeutic Goods Act 1989 (Section 52B).
The classifications are made according to potency, addictive qualities and suitability for ingestion by humans or animals.
Pharmacology
The two main areas of pharmacology that specifically relate to your practice are;
Pharmacokinetics
and Pharmacodynamics
Pharmacokenetics
How the body handles a drug over a period of time. It deals with the absorption, distribution, biotransformation and excretion of drugs.
These processes influence the effectiveness of the drug – to be effective it must be available at the site of action in the correct concentration.
WHAT THE BODY DOES TO THE DRUG
Pharmacodynamics
Pharmacodynamics is the process by which specific drug doses produce biochemical or physiological changes in the body.
Adverse Drug Reactions
The definition described by the World Health Organisation for an adverse drug reaction is
‘ any response to a drug which is noxious, unintended and occurs at doses used for prophylaxis, diagnosis and therapy’.
Adverse Drug Reactions
While drugs may be prescribed to cure or alleviate a particular problem, because of the intricate workings of the body systems, the response to these drugs can spill over to areas where the effect is not advantageous.
A term that is commonly used to refer to these is Side–effects
Adverse Drug Reactions
To reduce the incidence of severe
reactions and to minimise the effect on your patients, it is essential that, as the nurse responsible for administering medication, you have a knowledge of the adverse effects of drugs, how to recognise them and how to prevent them.
Principles of Safe Medication Administration
Unfortunately errors in administering medication happen all too often.
To minimise the risk of these occurring a number of principles need to be followed when preparing to administer medication to a patient
The 5 Rights
THE RIGHT TIME THE RIGHT ROUTE
THE RIGHT AMOUNT/ DOSETHE RIGHT MEDICATION/DRUGTHE RIGHT PATIENT
ALLERGIES, EXPIRY DATE
Medication Storage
Chemical components Schedule classification Organisation Requirements
NURSES RESPONSIBILITY TO KEEP LOCKED WHEN UNATTENDED
Calculation Formula
Strength required x Volume
Stock Strength
Drugs and Poisons Regulation 1996
Sections relevant to Enrolled Nurses
Section 52Section 58ASection 155Section 162Section 252
Opioid analgesics
Non-clinical use criminalized since 1914
Widely used in medicine as strong analgesics
Analgesia derives from Greek an- “without” and algia “pain”
Narcotic effects can be reversed by the drug naloxone (Narcan)
Advantages
Despite extensive research , no other analgesics have been found that are more effective for severe pain.
No upper limit to dosage and achievable pain relief as long as dose increased gradually to allow tolerance to develop to adverse reactions
Types of Routes and Preparations
Injection – can be given IV, IMI, SC and epidural
Oral – Mixtures and Controlled release tablets
Patches for transdermal absorption Dose required intravenously and by
epidural is significantly less than when given IV, IMI or orally.
Key Opioid Side Effects
Cough suppression Decreased gastrointestinal
motility
Common Side effects Nausea and vomiting Drowsiness, dizziness, headache Orthostatic hypotension Respiratory Depression Itchiness Dry mouth Miosis – pupil constriction Urinary retention Constipation
Serious Side Effects CNS disturbances;
Confusion Hallucinations Delirium Urticaria Hypothermia Bradycardia/Tachycardia Ureteric or Biliary spasm Muscle rigidity Myoclonus- convulsive body movements Flushing- due to histamine release
Opioid Side Effects
Psychologic Dependence – Addiction
A pattern of compulsive drug use
A continuous craving for an opioid
Tolerance Necessity for increasing the dose
over time to achieve the desired clinical effect.
Develops to analgesic effects sedation emetic effects euphoria respiratory depression
Dependence
Withdrawal syndrome – caused when drug discontinued
dosage rapidly reduced when antagonist
administered.
Withdrawal Syndrome Severe dysphoria Anxiety Eye tearing Rhinitis Goose bumps Sweating Nausea and vomiting Cramps and deep pains
S8 Storage Regulations
Kept in a separate locked cabinet with keys kept in possession of an RN.
Cabinet must be minimum of 10mm thick steel with continuous welding to all joints.
Door of cabinet the same with pick proof lock and steel back plate.
S8 Regulations
A Register must be kept with all drugs signed in and out and checked by two nurses: RN/EN (Med)
All medications selected, administered and recorded by the SAME NURSE
S8 Register
Information recorded includesPatient’s namePrescribed drug and doseDate and time of
administrationBalance of medication
Both Nurse administering and the witness must sign the register.
Administration Procedure
Ensure legal medication order Witness RN/EN(Med) unlocking S8
cabinet. Check drug together against order Observe removal of drug and
return balance.
S8 Administration Accompany RN/EN (Med) to the
patient Witness the administration of drug Counter sign medication sheet Assessment, monitoring and
evaluation of patient for analgesic effects as well as adverse reactions.
Documentation of these effects
REMEMBER
THE ADMINISTERING NURSE IS TOTALLY RESPONSIBLE FOR THEIR ACTIONS AND IS ACCOUNTABLE IN A COURT OF LAW