1. 26 Medications in Home Care 1. List four guidelines for safe and proper use of medications REMEMBER: Although home health aides do not usually handle or give medications, you need to understand the kinds of medicine your clients may be taking, and what to do if a client experiences side effects or refuses to take a medication.

2. 26 Medications in Home Care Transparency 26-1: Guidelines for Use of Medications Never handle or administer medications unless specifically trained and assigned to do so. Never touch the inside of the medicine bottle or pills. Never put any medication in the client’s mouth. Observe clients taking their medication. Remind them to take meds. Bring med container to client. Provide food or water. Observe, report, and document. Know the difference between prescription drugs and over- the-counter, or nonprescription, drugs. Be aware of all medications a client is taking, both prescription and nonprescription. Report side effects or interaction symptoms including itching, trembling or shaking, anxiety, stomachache, diarrhea, confusion, vomiting, rash, hives or headache. Report and document observations.

3. 26 Medications in Home Care 2. Identify the five “rights” of medications REMEMBER: Knowing the five “rights” of medications will help prevent dangerous and possibly fatal mistakes.

4. 26 Medications in Home Care Transparency 26-2: Five Rights of Medications The right client (check the client’s name on the label) The right medication (check the name of medication and expiration date) The right time (check label on what time or how often and compare with instructions in care plan) The right route (check label for instructions on how it is to be taken) The right amount (check label for dosage)

5. 26 Medications in Home Care Transparency 26-3: HHA’s Role in Medication Assistance Remind client to take medication. Check for right person, medication, time, expiration date, route, and amount. Read the medication label. Bring container to client. Bring needed equipment. Provide food or water. Shake liquid medications if ordered. Open and close containers. Position client for taking medication. Observe client taking medication. Document that client took medication, the time and any other medications or food taken at same time. Report reactions. Clean and store or dispose of equipment. Return medication to storage.

6. 26 Medications in Home Care 3. Explain how to assist a client with self-administered medications HHAs are generally NOT allowed to do the following: Break apart or crush capsules or tablets Mix medication with food or drink Pour or mix medication from one bottle into another, even if both contain the same medicine Touch medication directly with their hands Assist with medication if the client’s name is different from that on the label Assist with medication whose label has been removed or changed

7. 26 Medications in Home Care 3. Explain how to assist a client with self-administered medications HHAs are generally NOT allowed to do the following (cont’d.): Assist with medication if medication name does not match the name on the care plan Use appearance as the only way of identifying a medication Assist client in taking more or less of a medication than is ordered Remove or change a medication label Assist client with medicine at a time when it is not ordered Provide the wrong liquid for swallowing medications

8. 26 Medications in Home Care 3. Explain how to assist a client with self-administered medications HHAs are generally NOT allowed to do the following (cont’d.): Put medication into the client’s mouth Draw up solution for injections Give the client an injection Dispose of used injection needles/syringes Insert suppositories or other medication into the rectum Insert or apply vaginal medication Do special cleaning of the client’s eyelids or eyelashes to prepare for eye medications Put drops into the eye, ear, or nose Apply prescription medications to the skin

9. 26 Medications in Home Care 3. Explain how to assist a client with self-administered medications Remember the following when assisting clients with self- administration: Document all medication taken. Report and document any possible reactions. Watch for side effects such as dizziness, drowsiness, headache, nausea and vomiting, or confusion. More serious effects are allergic reaction or hypersensitivity to drug (hives, fever, rash, or difficulty breathing).

10. 26 Medications in Home Care 3. Explain how to assist a client with self-administered medications NOTE: Depending on agency and state rules HHAs may be allowed to assist clients with medication nebulizers. The box on pp. 432-433 discusses nebulizer use.

11. 26 Medications in Home Care 4. Identify observations about medications that should be reported right away The following are signs of possible side effects from medications: Dizziness, fainting Nausea, vomiting Rash, hives, itching Difficulty breathing, swelling of throat or eyes Drowsiness Headache, blurred vision Abdominal pain Diarrhea Any other unusual sign

12. 26 Medications in Home Care 4. Identify observations about medications that should be reported right away Report the following problems immediately: Client refuses to take medication Client takes wrong dose Client takes medication at wrong time Client takes wrong medication Medication container is missing or empty

13. 26 Medications in Home Care 5. Describe what to do in an emergency involving medications Possible medication emergencies include Allergic reaction (if severe, call 911 or for emergency help) Wrong dose taken Medication interactions/complications (if severe, call 911 or for emergency help) Overdose of medications (call poison control)

14. 26 Medications in Home Care 5. Describe what to do in an emergency involving medications REMEMBER: In the case of an emergency involving medications, do not give liquids, food, or other medications unless instructed. The supervisor should be notified as soon as possible.

15. 26 Medications in Home Care 6. Identify methods of medication storage Remember the following methods of storage: Keep client’s medication in one place, separate from others. If children or disoriented elderly are in the home, recommend that medications be locked away. All medications should be in childproof containers, outside the reach of children, if children are in the home. Refrigerate, if necessary, on a high shelf. Store away from heat and light. The client or a family member (not HHA) should discard expired or unlabeled meds, but not in trash. Ask your supervisor for disposal instructions.

16. 26 Medications in Home Care 7. Identify signs of drug misuse and abuse and know how to report these Drug abuse includes the following: Refusing to take meds Taking wrong dose or at the wrong time Mixing with alcohol Taking medications that have not been prescribed Taking illegal drugs

17. 26 Medications in Home Care 7. Identify signs of drug misuse and abuse and know how to report these REMEMBER: Clients may not take their medication for a number of reasons, such as dislike of side effects, Alzheimer’s disease, or difficulty swallowing. Report any difficulties to your supervisor.

18. 26 Medications in Home Care Transparency 26-4: Signs of Drug Misuse or Abuse Depression Anorexia Change in sleep patterns Withdrawal or moodiness Secrecy Verbal abusiveness Poor relationships with family members

19. 26 Medications in Home Care Chapter Exam 1. Which of the following is an over-the-counter drug? (A) Antibiotics (B) Cholesterol medication (C) Decongestant (D) Nitroglycerin 2. Which of the following is part of the five “rights” of medication? (A) Right Home Health Aide (B) Right Note (C) Right Report (D) Right Client

20. 26 Medications in Home Care Chapter Exam (cont’d.) 3. Which of the following is a way HHAs may help clients with self- administered medications? (A) Mix medication with food or drink (B) Take the medication out of the bottle for the client (C) Provide food or water to take with the medication (D) Place the medication in the client’s mouth 4. Which of the following statements is true of proper medication storage? (A) Medications should be stored away from heat and light. (B) The HHA is responsible for disposing of expired medications. (C) Medications can be disposed of in the trash. (D) Medications should be stored in lower shelves in the refrigerator if children are in the house.

21. 26 Medications in Home Care Chapter Exam (cont’d.) 5. How should the HHA respond if a client refuses to take certain medications? (A) Insist that the client take the medication, telling the client it will cure his illness. (B) Call the client’s family to see if they can get the client to take the medication. (C) Try to find out why the client does not want to take the medication and report to the supervisor. (D) Explain that the HHA will have to leave the house unless the medication is taken.

22. 26 Medications in Home Care Chapter Exam (cont’d.) 6. In the five “rights” of medications, what does the “right route” refer to? (A) How often the medication should be taken (B) In what way the medication should be taken (C) How the client should drive to the pharmacy to get the medication (D) When the medication expires 7. Which of the following is a home health aide not allowed to do when assisting a client with medications? (A) Shake liquid medications (B) Report possible reactions to the medication to the supervisor (C) Cut tablets in half (D) Read the medication label to the client

23. 26 Medications in Home Care Chapter Exam (cont’d.) 8. What should a home health aide do if a client seems to have a negative reaction to a medication? (A) Check online to see if the client’s symptoms match common reactions to the medication. (B) Have the client lie down for half an hour. (C) Give the client a glass of water, wait 10 minutes, then call a supervisor if the client has not improved. (D) Report the reaction immediately to a supervisor.

24. 26 Medications in Home Care Chapter Exam (cont’d.) 9. You discover a client has taken another household member’s prescription medication by mistake. What should you do? (A) Give the client syrup of ipecac to induce vomiting. (B) Call the local poison control number immediately. (C) Encourage the resident to eat plain crackers to soak up the medication in his stomach. (D) Wait to see if there is an adverse reaction, then call your supervisor.

25. 26 Medications in Home Care Chapter Exam (cont’d.) 10. Which of the following statements is true? (A) Because prescription drugs are legal, they cannot be abused. (B) There is nothing wrong with taking drugs that were prescribed for someone else, as long as the person taking them has the same condition. (C) Misuse of prescription drugs can be fatal. (D) It is never a problem to mix medications with alcohol.