1. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 32 Oral Medications

2. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? An advanced practice nurse can write a medication order.

3. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True. An advanced practice nurse can write a medication order if legally designated to do so by state statutes.

4. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Orders Lists the drug name and directions for its administration Written on client’s medical records Written by medical personnel, physician’s assistant, or advanced practice nurse

5. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Orders (cont’d) Components of medication orders –Drug name: trade name –Drug dose: the amount of drug to administer, prescribed using the relevant system of measurement

6. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Orders (cont’d) Route of administration: how the drug is given –Oral, topical, inhalant, or parenteral route Frequency of administration: how often and how regularly the medication is to be given

7. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question The standard abbreviation for writing twice a day is? a. q.d. b. q.o.d. c. b.i.d. d. t.i.d.

8. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer c. b.i.d. The standard abbreviation for writing twice a day is b.i.d.; q.d. stands for everyday, q.o.d. for every other day, and t.i.d. for three times a day.

9. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following is the most common route to administer medication? a. Oral b. Topical c. Inhalant d. Parenteral

10. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer a. Oral The oral route is the most common route to administer medication. The topical route is used for skin application, inhalant for aerosol, and parenteral for injection.

11. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Orders (cont’d) Verbal orders: instructions for client care that are given during face-to-face conversations Telephone orders: obtained from a physician during a telephone conversation Documented in the medication administration record

12. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Methods of Supplying Medications Storing medications: medications remain locked until the drugs are administered Accounting for narcotics: federal laws regulate their possession and administration; nurses are responsible for an accurate account of their use and must keep a record of each narcotic used from the stock supply

13. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Methods of Supplying Medications (cont’d) Ways to supply drugs: –Individual supply –Unit dose supply –Stock supply

14. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration Applying the 5 rights safeguards against medication errors Calculating dosages is one of the 5 rights Oral medications are prepared and taken to the client’s bedside in a paper or plastic cup for administration

15. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Drug Calculation Formula

16. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Preparing Medications Safely

17. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Taking Medications

18. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Medication Administration (cont’d) Oral medications are administered by enteral tube if client cannot swallow them Documentation is required on medication administration record Nurses are ethically and legally responsible for reporting medication errors

19. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Implications Nursing diagnoses –Deficient knowledge –Risk for aspiration –Ineffective therapeutic regimen management –Ineffective health maintenance –Noncompliance

20. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins General Gerontologic Considerations The body constitution affects the way medications work The chemical properties of the medication determine the degree to which these age- related changes influence medication actions

21. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins General Gerontologic Considerations (cont’d) Polypharmacy in older adults increases the risk for drug interactions and adverse medication reactions Taking more than one medication can cause mental changes Enteric-coated medications should never be crushed