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RA 9173 Philippine Nursing Law of 2002 have stated that parenteral injection is in the scope of nursing practice.
Board of Nursing Resolution No.8 Sec.30 (c) Art.VII or administratively under Sec.21 Art.III states that any registered nurse without training and who administers IV injections to patients shall be held liable, either criminally whether causing or not an injury or death to the patient.
Pharmacokinetics
- The process by which a drug is absorbed, distributed, metabolized, and eliminated by the body. PHARMACOKINETICS - what the BODY does to the DRUG (PROCESSES)
Pharmacokinetic PROCESSES
Absorption Distribution Metabolism Excretion
Pharmacodynamics
The study of the action or effects of drugs on living organisms. PHARMACODYNAMICS - what the DRUG does to the BODY (EFFECTS)
Pharmacodynamics
Symptomatic Curative Restorative Preventive Diagnostic
Benefits
Rapid Response Effective Absorption Accurate Titration Less Discomfort
Risks
Solution and drug incompatibilities. Poor vascular access in some clients. Immediate adverse reactions.
Incompatibility
Drug + Diluent = must be compatible -The more complex the solution, the greater the risk of incompatibility
An incompatibility results when two or more substances react or interact so as to change the normal activity of one or more components.
Incompatibility may result in the loss of therapeutic effects and may occur when:
Several drugs are added to large volume of fluid to produce an admixture. Drugs in separate solutions are administered concurrently or in close succession via the same IV line
Incompatibility may result in the loss of therapeutic effects and may occur when:
A single drug is reconstituted or diluted with the wrong solution One drug reacts with another drugs preservative
If peripheral venous access isnt possible, the doctor may use a central vein, commonly by the subclavian route.
The following are some adverse drug reactions that you might notice:
Skin rash Easy bruising Bleeding
10 GOLDEN RULES FOR ADMINISTERING DRUGS SAFELY Administer the right drug. Administer the right drug to the right patient. Administer the right dose.
Administer the drug by the right route. Administer the drug at the right time. Document each drug you administer. Teach your patient about the drug he is receiving.
Take a complete patient drug history. Find out if the patient has any drug allergies. Be aware of patient drug drug or drug-food interactions.
If any of the above are unclear or open for interpretations, it is the Responsibility of the nurse to clarify the order with the physician.
Definition of Terms: Transcription of medical orders- is the act of writing out medical orders. Kardex- is the summarize written presentation of all the care and treatment of the patient.
Medication/Treatment sheet- is the legal documents in the patients chart were medicines and treatments administered to the patient are written, acknowledged and administered by nurses.
Physicians Order Sheetis a legal document wherein medical orders are written and use as reference of nurses in the transcription and executing nursing care.
All medication and treatment orders must be written legibly and must contain the following: a. generic name and brand name of medicines b. Dosage of the medicines c. Frequency of administration d. Route of administration e. Signature over printed name of attending physician or authorized representative f. Date and time order was written
The registered nurse indicates that he/she has checked and completely transcribe the medical order by signing his/her name with the date and time directly right after the doctors order.
As a general rule, telephone orders are received and carried out only in emergency cases by nurses. Nurses receive telephone orders only from consultants. RNs will review all orders immediately after the physician writes.
Documentation
Type and amount of drug given Date and time given Confirmation that the I.V. line was patent Patients response to the medication Condition of the insertion site Ongoing monitoring that you provided
Where to Document
Nurses Progress Notes Medication Sheet Infusion Sheet Vital Signs Monitoring Sheet Input and Output Monitoring Sheet
Weighing In
Remember!!! 2.2 lb. = 1 kg
Remember!!!
Nomogram
Find your weight in the right column and your height in the left column. Place a straightedge on the nomogram so the weight and height are connected. The point where the straightedge crosses the center column denotes your body's surface area in square meters.
(works for any computation of Dosage if you have a given and a need to determine the unknown). Rule :
1. Units for each ratio must be the same. 2. Units for each ratio must be placed in the same order.
Rate Calculations
Macrodrip Set 10 drops = 1 ml 15 drops = 1 ml 20 drops = 1 ml Microdrip Set 60 drops = 1 ml Blood Set 10 drops = 1 ml
FORMULA
FORMULA
ml per hour =
Total no. of ml Total no of hours