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PNUR 124 WEEK 2 STUDY GUIDE
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Lecture notes of 26 pages for the course PNUR 124 at (WEEKLY CONTENT)
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PNUR 124Week 2: DRUG INFORMATION AND MEDICATION ADMINISTRATION
1. Start your studying by going to the CNO website
at http://www.cno.org/en/learn-about-
standards-guidelines/standards-and-guidelines/
and check out the Medication Practice Standard
and available Resources. Outline the principles
of Medication Administration (Authority, Safety
and Competence)?
Authority
o Nurses must have the necessary
authority to perform medication
practices
Describes when an order is
required
Mentions the type of order
needed for controlled
substances
Outlines that orders must be clear, complete, and appropriate
Nurses (RNs & RPN’s) must have necessary authority to perform
medication practices. Medication order required to when a
controlled act is involved, when administering a prescription
medication or when the law applies to their practice setting.
Competence
o Nurses ensure that they have the knowledge, skill, and judgement
needed to perform medication practices safely
Medication practice must be evidence-informed
o The nurse ensures they have knowledge, skill, and judgment to perform
med admin skill (e.g. when to hold a medication if BP is low, how to
administer a subcutaneous injection). Do not perform skill if you do not
have the knowledge to do so. Ensure that practice is evidence based
Safety
o Nurses promote safe care and contribute to a culture of safety within
their practice environments, when involved in medication practices
Provide client education
Collaborate with healthcare team and experts
Advocate for system approaches
o Provide client education on medication, consult with HCP if order is
incorrect or not appropriate for client, clarify alternate route of meds
with pharmacist, and perform evidence-informed practice
Medication Administration Principles
o Who prescribes medications?
,PNUR 124
Doctor, Dentist, Nurse Practitioner, Pharmacist and Advanced
Practice Nurse (APN’s)
o What is a prescription?
Written direction for preparation and administration of
medication.
Generic VS. Brand Name
o Generic name is the chemical name given by the manufacturer and the
name approved by health Canada under the food and drugs
administration act. The drug is developed and officially listed in
publications (less expensive).
For example:
acetaminophen
furosemide
o Trade name is the name that the manufacturer markets the drug under
(usually short and easy to remember), and means that the drug has a
patent and registered trademark. (the property of that company).
For example:
Tylenol
Lasix
2. Identify sources of drug information in Canada.
The Compendium of Pharmaceuticals and Specialties is published annually by the
Canadian Pharmacists Association
Is a comprehensive (but not entirely complete) list of the pharmaceutical
products distributed in Canada
Also contains other helpful information for health care professionals
Information voluntarily submitted by pharmaceutical manufacturers
Medication Regulation
Federal and Provincial regulations affect drug administration by developing
regulations to guide nursing practice.
Specifications as to who can prescribe medications.
Regulating bodies includes CNO
Regulations promote safe medication administration practice
3. Discuss Canadian drug legislative acts controlling drug use and restricted drugs of
abuse.
Two Acts form the underlying foundation for the drug laws in Canada:
Food and Drugs Act and the Food and Drug Regulations are the primary pieces of
legislation concerning drugs (prescription and over the counter (OTC) drugs) in
Canada and has two main purposes:
1. To protect the consumer from drugs that are contaminated, adulterated or
unsafe for use
, PNUR 124
2. To address drugs that are labeled falsely and those with misleading or
deceptive labeling (focus is on appropriate advertising and selling)
Federal legislation: Health Canada
Drugs are categorized under this Act according to “Schedules”
“Controlled Drugs” are regulated by the 1997 Controlled Drugs and Substances Act
(CSDA) and Narcotic Control Regulations
Controlled Drugs and Substances Act (1997) and Narcotic Control Regulations
addresses the possession, sale, manufacture, disposal, production, import, export
and distribution of certain drugs, their precursors and other substances classified
as controlled.
o Controlled substances may only be dispensed by healthcare providers to
clients suffering from specific diseases or illness.
o The RCMP (per Health Canada) are responsible for enforcing the CDSA.
o Describes 8 Schedules and the factors that determine which schedule a
controlled substance should be under are based on potential for abuse
and the ease with which illicit substances can be manufactured in illegal
labs in Canada (and the usefulness of the substance as a therapeutic
agent)
o (but are separate from the Food and Drugs Act schedules)
o CDSA also allows sale of some low dose codeine preparations without a
prescription but only available from pharmacist
E.g. Acetaminophen with Codeine 8 mg (Tylenol #1)
Calmylin (cough suppressant with codeine)
o (Examples: Schedule I contains heroin and cocaine (considered the most
dangerous drugs); Schedule II contains marijuana; Schedule III contains
amphetamines and LSD; Schedule IV contains barbiturates that can also
have therapeutic uses)
o CDSA also provides for the non-prescription sale of certain codeine
preparations (example: Tylenol #1 for sale only by pharmacists)
Legal Aspect of Drug Administration
o Nurses are responsible for their own actions regardless of whether there
is a written order
o If the doctor or prescribing health care provider writes an incorrect order.
The nurse who administers the incorrect dosage as well as the prescribing
health care professional is responsible for the error
o Controlled substances are kept under lock and key, lock drawer,
cupboard or dispensing system (in some settings, nurses count narcotics
at end of each shift)
o Verification required for high alert medications (insulins, some control
substances chemotherapy agents)
Category System for Drugs in Canada
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