Here are some few rules or tips on medication administration. Calculation of children drug dosage can be challenging if you are not a Pediatric nurse. There is a simple method that I used when floated to Pediatric unit. If you are not sure ask experienced Pediatric nurses. Better safe than sorry. Here are the steps that I used when I floated Pediatric unit over ten years ago.
Body Surface Area ÷1.7average BSA adult × adult dose =child’s dosage.
That is if the child’s dose is unknown and adult dose is known.
For example an adult dose of a drug is 4g/day.What would be a safe dose for a child that has a BSA of 0.6m?.
you will multiply 0.6 by 4g =2.4÷1.7 =1.4g/day.
There are also other rules for dosage calculations of oral administration.
The rule of milligram per kilogram.
Step 1. Conversion of pounds to kilograms.
Step 11.Identify the safe dose.
Step 111.Multiply the child’s weight in kilograms by the safe dosage. The child’s weight must be converted from pounds to kilograms.
Step 1V.Make sure the order is safe.Compare the order with literature and what the doctor orders.
For example 20lb to kilograms .You divide by 2.2.
But if you are converting Kilograms to pounds For example 15kg to lbs. You will multiply by 2.2.
QUESTIONS AND ANSWERS .
1.The doctor orders were not clear.
What will the nurse do?
A. The nurse should call the doctor that wrote the orders for clarification should not administer the drugs if the orders are not clear.
B.Give the medication and clarify later.
C.It is okay ,it doesn’t matter.
D.B & C .
Correct answer A.
Rationale: You cannot give what you are not sure of. Because your mistake might harm the patient. So call the doctor that wrote the order for clarification. It is not okay. It does matter.
2.What standard is tort judge?.
A.No such language as tort.
B.It is not nursing.
C. None standard.
D.Did you the nurse exercise the degree of skill and care that any reasonable nurse will do?. That is a prudent nurse with same experience will do under the same circumstance.
correct answer D.
3.Can a nurse refuse to give medication?. If yes under what circumstances?.
A.If the doctor orders the medication.
B .If the drug is ordered by a licensed physician.
C.If it is manufactured by two different companies.
D.If pharmacy orders it.
Correct answer D.
Rationale: Pharmacy is not supposed to order medication, the doctors do.
4.As a Registered nurse what is your legal responsibility in relation to controlled substance.
A.Check patient room.
B.Assess patient status.
C.Know the stop time.
D.Narcotics ( controlled substances) must be stored in a locked room. That is the rule and unlicensed healthcare workers should not go into the narcotic room.
correct answer D.
5.How do you avoid liability as a nurse?.
A.Understand the policy and procedures of the institution where you work. Be careful with your charting, keep upto date with your license, read label and date open vials, listen to patient complain.Do not leave medication at bedside.
B.Do not worry you are okay.
C.Do your job.
D.Be aware.
Correct answer A.
6.Patient complain of insomnia. The doctor orders secobarbital 0.1g and to repeat ×1 in one hour if the patient did not go to sleep. In stock is Secobarbital 500mg,each secobarbital capsule is labeled 100mg.The nurse will give ——- capsule(s) per dose.
Correct answer 100mg.1capsule)
0.1gm= ———- mg.
0.100 =100.
0.1g = 100mg.
1000mg= 1gm.0.1gm converted to mg,is equal to 100mg. Secobarbital is used to treat difficulty falling asleep on a short term basis.
7.Patient complaining of anxiety and the doctor placed patient on alprazolam 1mg po q8hours .Available are 0.5mg alprazolam tablets. The nurse should administer how many tablets per dose.
Correct answer 2tablets.
8.Patient with a history of Hypertension. The doctor orders atenolol 100mg po daily. In Stock are 50mg atenolol tablets. The nurse should give how many tablets daily?.
Correct answer 2tablets.
9.Nurse Jennifer is administering medications in the hospital. What should nurse Jennifer chart.
A.She does not need to chart.The charge nurse should chart for her.
B. Use the patient as her witness.
C.Chart that she gave medication before the administration of the medication.
D. She should chart only the medications that she personally gave to the patient. And must not chart for another nurse.
Correct answer D.
Rationale:Must chart what she gave.If she didn’t chart,it is assumed that it was not given. She should chart only what she gave.
10.Most liquid medication will have to be shaken before pouring. Which medication do not need to be shaken before pouring?.
A Cough medication.
B. Aqueous solution.
C.Oral suspension.
D.liquid phenobarbital and seroquel.
Correct answer B.
HOW ABOUT OTHER RULES.
No matter what facility that you find yourself. There are step by step guidelines on how to administer medications. Follow the steps. Be in compliant with the policy and procedures of your facility. Here are some steps to follow?
A.You greet the patient. (Use of AIDET)
B.Check patient ID.
C.Sit patient in upright position.
D.Patient must be alert and able to swallow.
E.Give solid pills follow with a glass of water. Then give liquid medication .
F.DON’T LEAVE THE ROOM UNTIL PATIENT SWALLOW ALL MEDICATIONS.
G.Make your patient comfortable.
H.Watch your hands with soap and water for 20seconds before leaving the room.
Before giving medication check patient for allergy to medication. This is very important and should be a routine. In case the doctor will order medication that the patient is allergic to. So it is important to ask the patient and correct it if is not written. If patient is allergic to the medication that is ordered call and notify the doctor so that it will be ratified. Don’t keep quiet and do the wrong thing. Advocate for your patients.
Check the labels of all medications.
If a patient is NPO which stands for nothing by mouth. Find out from the doctor if it is okay to give medication with sips of water .The doctor might not want to hold certain medications for example blood pressure medication, anticonvulsant medication.
Know the food and drug interactions and act to protect patient interest.
If a patient refuses medication, find out why the refusal, document his/ her refusal and make changes to fix the situation.
Crushing of Medication.
If a medication needs to be crushed. The best thing is to use a pill crusher.Please wipe the pill crusher before use and after use.If you use mortar and pestle wipe it clean.If you have no pill crusher, trouble shooting by putting the medication in two paper cups and use a strong object(bottle)to crush the medication. After crushing the medication, you can mix it in applesauce or in water.Some patient love applesauce. The patient will easily and willingly swallow the medication.
If your patient has difficulty to swallow pills, call pharmacy for alternative form.Remember that enteric- coated and film- coated medications cannot be crushed.
If you are giving liquid medication remember that some medications settles to the bottom. And only the weak diluent is on top.So failure to shake the bottle well before pouring out the medication, will result in giving the wrong medication because it is not properly mixed.Always read the label.
For example if you buy orange juice and you pour it into a cup without shaking the whole bottle before pouring, the taste will be different. Know the medication that are diluted and the ones that are not.For example you don’t dilute cough medications unless contraindicated.
Nurses You Move Me 