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Chapter 20 provides knowledge of drug administration. After studying this chapter you will be able to: Identify your responsibilities regarding drug administration, execute dosage calculations accurately, check the patient before administering any drug, identify the rights of drug administration, describe the various techniques of drug administration,...
CHAPTER 20 Drug Administration © 2011 The McGraw-Hill Companies, Inc All rights reserved 202 Learning Outcomes 20.1 Identify your responsibilities regarding drug administration 20.2 Execute dosage calculations accurately 20.3 Check the patient before administering any drug 20.4 Identify the rights of drug administration © 2011 The McGraw-Hill Companies, Inc All rights reserved 203 Learning Outcomes (cont.) 20.5 Describe the various techniques of drug administration 20.6 Differentiate different types of needles and syringes 20.7 Demonstrate how to administer an intradermal, subcutaneous, or intramuscular injection © 2011 The McGraw-Hill Companies, Inc All rights reserved 204 Learning Outcomes (cont.) 20.8 Outline information needed to teach a patient about drug use, interactions, and adverse effects 20.9 Describe special considerations related to drug administration 20.10 Describe nonpharmacologic ways to manage pain © 2011 The McGraw-Hill Companies, Inc All rights reserved 205 Introduction • Drug administration is very important and can be a dangerous duty – Given correctly – restore patient to health – Given incorrectly – patient’s condition can worsen • Medical assistant must – Understand principles of pharmacology – Understand fundamentals of drug administration • Routes • Dosage calculations • Techniques for injection • Rights of medication administration • Patient education You should be familiar with the medications frequently prescribed in your practice © 2011 The McGraw-Hill Companies, Inc All rights reserved 206 Drug Administration and Scope of Practice • States’ medical practice acts define medical assistants’ exact duties • Know your scope of practice in the state where you will work © 2011 The McGraw-Hill Companies, Inc All rights reserved 207 Dosage Calculations • Measurement systems – Metric – Apothecaries – Household • TJC recommends using metric units © 2011 The McGraw-Hill Companies, Inc All rights reserved 208 Dosage Calculations (cont.) • Basic units of volume and weight for: • Household system • Metric system – Liter (L) – volume – Grams (g) – weight – Drops, teaspoons, tablespoons, ounces, cups, pints, gallons, quarts – volume • Apothecaries’ system – Fluid ounces, fluid drams, pints, quarts – volume – Pounds – weight © 2011 The McGraw-Hill Companies, Inc All rights reserved 209 Dosage Calculations (cont.) • Conversions between systems – Approximate equivalents – Charts – Calculations Ratio method Fraction method â 2011 The McGraw-Hill Companies, Inc All rights reserved 2010 Formula Method Desired dose × Quantity of dose on hand Dose on hand The physician orders aspirin, 10 grains On hand are 5-grain aspirins 10 grains × tablet = 10/5 or tablets grains © 2011 The McGraw-Hill Companies, Inc All rights reserved 2035 Special Considerations (cont.) • Patients who are breastfeeding – Some drugs are excreted in breast milk – Ingestion can be dangerous because baby can’t metabolize or excrete drugs – Check drug information sources for contraindication during lactation © 2011 The McGraw-Hill Companies, Inc All rights reserved 2036 Special Considerations (cont.) • Elderly patients – Age-related changes affect • Absorption • Metabolism • Distribution • Excretion – May have increased risk of • Drug toxicity • Adverse effects • Lack of therapeutic effects © 2011 The McGraw-Hill Companies, Inc All rights reserved 2037 Special Considerations (cont.) • Patients from different cultures – Can affect a patient’s understanding of drug therapy and compliance with it – Obtain drug information sheets in the languages that are commonly spoken by patients in your office © 2011 The McGraw-Hill Companies, Inc All rights reserved 2038 Apply Your Knowledge What children and the elderly have in common in relation to drug administration? ANSWER: Both have alterations in metabolism and absorption of drugs requiring adjustments in dosages Fantastic! © 2011 The McGraw-Hill Companies, Inc All rights reserved 2039 Charting Medications • Progress notes – Administration – Special problems • New symptoms • Patient’s statements • Patient tolerance • Be sure to have the right chart • Be specific and accurate © 2011 The McGraw-Hill Companies, Inc All rights reserved 2040 Nonpharmacologic Pain Management • Biofeedback – evokes relaxation; helps block pain perception • Guided imagery – patient envisions being in a calm, nurturing place; promotes relaxation • Relaxation exercises – breathing techniques © 2011 The McGraw-Hill Companies, Inc All rights reserved 2041 Apply Your Knowledge You administer a medication to Mr Max What and where should you chart? ANSWER: You should chart in the progress notes the date, time, dosage, route, and name of the medication, as well as how well the patient tolerated it I M P R E True or false: ANSWER: helps block pain perception S F Biofeedback involves special breathing techniques _ S T Audiotapes can be used with guided imagery _ I T Relaxation exercises are used to relax different muscle _ groups V E ! © 2011 The McGraw-Hill Companies, Inc All rights reserved 2042 In Summary 20.1 As a medical assistant, you must be able administer or assist with administering medications by various routes, perform drug dosage calculations accurately, and provide patient education as necessary 20.2 Dosage calculations must be done accurately using the formula, ratio, or fraction method If you are unsure of your calculation results, you should double-check yourself, check with a coworker, or ask the physician © 2011 The McGraw-Hill Companies, Inc All rights reserved 2043 In Summary (cont.) 20.3 Before administering a medication, assess the patient for allergies; evaluate any drug-drug interactions; and check all injection sites for abnormalities Additionally, you should be aware of the patient’s condition and have the patient sign a consent form if necessary 20.4 The rights of drug administration include the right patient, right drug, right dose, right time, right route, right technique, right documentation, right to know, and right to refuse © 2011 The McGraw-Hill Companies, Inc All rights reserved 2044 In Summary (cont.) 20.5 You may be asked to assist or administer medications by any of the following routes: oral, buccal, sublingual, intradermal, intramuscular, intravenous, inhalation, eye, ear, rectal, subcutaneous, sublingual, topical, transdermal, urethral, and vaginal Your responsibilities will vary based upon the facility where you practice You should be familiar with the routes and medications used at your facility 20.6 Needles vary in length from ½ to inches They vary in gauge (diameter) from 18 to 26; the smaller the number, the larger the diameter of the needle © 2011 The McGraw-Hill Companies, Inc All rights reserved 2045 In Summary (cont.) 20.7 The three most common injection routes are intradermal, subcutaneous, and intramuscular All injections are given using aseptic technique Intradermal (ID) injections are administered between the upper layers of skin and create a wheal Subcutaneous (sub-Q) injections are administered just under the skin Intramuscular (IM) injections are administered into a muscle © 2011 The McGraw-Hill Companies, Inc All rights reserved 2046 In Summary (cont.) 20.8 Patients should be aware of possible interactions and taught to report all medications including OTC, supplements, and herbal remedies They should know how to read the prescription label and in some cases the package insert Patients should be aware of the possible adverse effects of medications and what and when to report them to the health-care facility © 2011 The McGraw-Hill Companies, Inc All rights reserved 2047 In Summary (cont.) 20.9 Pediatric and geriatric patients require extreme care when calculating doses due to the differences in how their bodies absorb, metabolize, eliminate, and distribute the medications Treat pediatric patients with special care and communication to make the experience as positive as possible Restraining may be necessary Checking medications given to pregnant and breastfeeding patients for possible adverse effects is essential Being considerate to patient’s cultural differences is also part of a medical assistant’s role © 2011 The McGraw-Hill Companies, Inc All rights reserved 2048 In Summary (cont.) 20.10 To avoid the overuse or abuse of pain medications, other types of pain therapy have gained popularity Some examples include biofeedback, guided imagery, and relaxation exercises © 2011 The McGraw-Hill Companies, Inc All rights reserved 2049 End of Chapter 20 Words are the most powerful drug used by mankind ~Rudyard Kipling © 2011 The McGraw-Hill Companies, Inc All rights reserved ... bloodstream • Pay close attention – Dose – Route – Form of medication • Medical assistant – Close attention to detail – Strong patient assessment skills – Expert technique © 201 1 The McGraw-Hill Companies,... quarts – volume – Pounds – weight © 201 1 The McGraw-Hill Companies, Inc All rights reserved 20 9 Dosage Calculations (cont.) • Conversions between systems – Approximate equivalents – Charts – Calculations... weight for: • Household system • Metric system – Liter (L) – volume – Grams (g) – weight – Drops, teaspoons, tablespoons, ounces, cups, pints, gallons, quarts – volume • Apothecaries’ system – Fluid