1. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 36 Calculation of Medication Dosage and Medication Administration

2. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Legal and Ethical Implications of Medication Administration Laws vary from state to state Thorough knowledge of medications administered to patient Ethical considerations –Using drugs for personal benefit –Proper authorization

3. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Legal and Ethical Implications of Medication Administration The medication order –Given by provider The prescription –Written legal document that gives directions for compounding, dispensing, and administering medication to patient –Eight parts

4. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Legal and Ethical Implications of Medication Administration The prescription –Two types of medicines Prescription Over-the-counter (OTC) –Prescriptions for controlled substances –Approved prescription abbreviations and symbols

5. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculation of Drug Dosages Understanding ratio –Ratio expressed as a quotient –Ratio expressed as a fraction –Ratio expressed as a decimal Understanding proportion –Means and extremes –Solving for X

6. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculation of Drug Dosages Weights and measures –Metric system guidelines –The seven common metric prefixes Micro Milli Centi Deci Deka Hecto Kilo

7. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculation of Drug Dosages Weights and measures –Fundamental units –Household measurements –Metric system conversion Proportional method for converting metric equivalents Moving the decimal in the correct direction

8. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Medications Measured in Units How to calculate unit dosages –Proportional method –Formula method Insulin –Individualized needs and treatment

9. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Medications Measured in Units Types of diabetes –Type I insulin-dependent diabetes mellitus –Type II noninsulin-dependent diabetes mellitus –Type III gestational diabetes –Type IV other types of diabetes

10. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Medications Measured in Units Importance of exact dosage Precautions to observe when administering insulin Expressing the weight of medication Expressing the volume of medication

11. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculating Adult Dosages The proportional method The formula method

12. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculating Children’s Dosages Young’s, Clark’s, and Fried’s rules replaced by more exact methods By body surface area (BSA) –Nomogram –Used for infants and children up to 12 years of age

13. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Calculating Children’s Dosages By kilogram of body weight –Mathematical process –Proportional method

14. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Medications The “Six Rights” of proper drug administration

15. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Medications Click to play the video

16. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Medications Medication errors –When a medication error occurs –Standard procedure for reporting errors

17. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Medications Patient assessment –Age –Physical condition –Body size –Gender Muscular build Skin texture Injection sites to avoid

18. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Oral Medications Equipment and supplies for oral medications

19. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Parenteral Medications Parenteral routes –Subcutaneous –Intramuscular –Intradermal Multiple dose form Unit dose forms

20. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Parenteral Medications Hazards associated with parenteral medications Reasons for parenteral route selection –Rapid response time to medication –Accuracy of dosage –Need to concentrate medication in specific body part or area

21. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Parenteral Medications Reasons for parenteral route selection –Inability to administer orally because medication is destroyed by gastric juices or patient is incapable of taking medication orally –Liquid or powder form –Expressed in terms of volume –Ordered in terms of weight and volume

22. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parenteral Equipment and Supplies Syringes –Disposable syringes –Non-disposable syringes –Combination disposable and non-disposable cartridge- injection syringes

23. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parenteral Equipment and Supplies Click to play the video

24. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parts of a Syringe

25. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parts of a Needle

26. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parenteral Equipment and Supplies Safe disposal of needles and syringes –Sharps containers –Needlesticks

27. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parenteral Equipment and Supplies Click to play the video

28. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Principles of Intravenous Therapy Patient needs and conditions Patient safety Types of solutions Legal aspects Basic IV Administration Set >>

29. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Site Selection for Injections

30. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Injection Angles

31. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Site Selection and Injection Angle Marking the correct site for intramuscular injection –Dorsogluteal site –Ventrogluteal site –Deltoid muscle –Vastus lateralis site

32. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Basic Guidelines for Administration of Injections Withdrawing medication –Withdrawing medication from a vial –Withdrawing medication from an ampule Reconstituting a powder medication

33. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Basic Guidelines for Administration of Injections Administering subcutaneous, intramuscular, and intradermal injections

34. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Basic Guidelines for Administration of Injections Click to play the video

35. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Z-track Method of Intramuscular Injection Given to avoid irritation to subcutaneous tissues –Imferon is an example of a medication given by this route Pull skin to side before inserting needle

36. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Z-track Method of Intramuscular Injection Click to play the video

37. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Allergenic Extracts MAs may administer allergenic extracts –Always follow guidelines –Have emergency supplies on hand Allergic reactions –Observe the patient for 20-30 minutes after administration

38. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Inhaled Medications Inhalation therapy –Inhaler may be used to administer medication to the lungs Implications for patient care

39. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administration of Inhaled Medications Administration of oxygen –Hypoxemia –Oxygen tanks –Dosage –Methods of oxygen delivery Oxygen safety precautions