NR 293 Exam 1 Review
1. Review medication administration-errors, six rights
a. Right client - always confirm that you are treating patient
b. Right route - Confirm the appropriateness of the prescribed route while also making sure
the patient can take/receive the medication by the prescribed route. If medication order
does not include the route be sure to ask the prescriber to clarify it. NEVER ASSUME
THE ROUTE
c. Right drug - make sure you administer the correct drug to the patient. If doubt exists or
an error is deemed possible, contact the prescriber and/pharmacist immediately.
d. Right dose - always confirm that the dosage amount is appropriate for the patient’s age
and size. NEVER ASSUME THE DOSAGE
e. Right time - Each health care setting or institution has a policy regarding routine
medication administration times, be sure to follow them and commit them to memory.
f. Right Documentation - Document how that whole thing went according to how it
actually went
g. Medication errors - any preventable event that may cause or lead to inappropriate
medication use or patient harm while the medication is in the control of the health care
professional, patient, or consumer.
2. Review types of Treatment, empiric, prophylactic palliative etc
a. Acute Therapy - includes more intense drug treatment and is implemented in the acutely
ill or critically ill. Needed to sustain life or treat disease.
b. Maintenance Therapy - does not eradicate pre-existing problems, but will prevent
progression of a disease or condition. Used for treatment of chronic illnesses such as
hypertension.
c. Supplemental Therapy - supplies the body with a substance needed to maintain normal
function.
d. Palliative Therapy - The goal of palliative therapy is to make the patient as comfortable
as possible. Focuses on providing patients with relief from symptoms, pain, and stress of
a serious illness.
e. Supportive Therapy - maintains the integrity of body functions while the patient is
recovering from illness or trauma. An example would be providing fluids and electrolytes
to a patient in order to prevent dehydration who is losing fluids by constant vomiting
and diarrhea.
f. Prophylactic Therapy - drug therapy provided to prevent illness or other undesirable
outcomes during planned events.
g. Empiric Therapy - treating presenting symptoms before knowing what it is
3. Review age related drug administration
a. Infants
i. perform the injection swiftly and safely while the infant is safely and securely
positioned by parent.
, ii. Allow self-comforting measures (use of pacifier, fingers in mouth, self-
movement)
b. Toddlers
i. Offer a brief explanation within the toddlers range of understanding while their
guardians are present. Make sure they are securely held
ii. Provide comfort measures immediately after the procedure (touching, holding)
iii. Help toddler understand treatment with use of puppets, stuffed animals, or
hospital equipment
iv. Provide healthy ways to release aggression
c. Preschoolers
i. Offer a brief explanation within the toddlers range of understanding while their
guardians are present.
ii. Provide comfort measures immediately after the procedure (touching, holding)
iii. Make use of magical thinking (using ointments or “special medication” to make
discomfort go away)
iv. Note that role of parent in providing comfort and understand is important
d. School-age children
i. Explain the procedure, and allow for some control over body and situation
ii. Provide comfort measure
iii. Explore feelings and concepts through the use of therapeutic play
iv. Set age appropriate behavior limits (okay to cry or scream, but no hitting or
biting) and provide age appropriate activities for releasing aggression and anger.
v. Use this opportunity to teach about the relationship between receiving
medication and body function and structure (what a seizure is and how
medication can help)
vi. Offer the complete picture (need to take medication, relax with deep breaths;
medication will help prevent pain)
e. Adolescents
i. Prepare the patient in advance for procedure, minus scare tactic
ii. Allow for expression in a way that does not cause losing face, such as giving the
adolescent time alone after the procedure and giving adolescent time to discuss
his or her feelings
iii. Explore with the adolescents any current concepts of self, hospitalization, and
illness, and correct any misconceptions
iv. Encourage self-expression, individuality, and self-care
v. Encourage participation in procedures as appropriate
4. Review your drug categories in pregnancy and classifications
a. Category A - No risk is demonstrated in the first trimester and there is no evidence of a
risk in later trimesters; fetal harm appears remote.
b. Category B - There is no risk to animal fetus when information on human fetus is not
available.
c. Category C - Adverse effects reported in the animal fetus: information for humans is not
, available.
d. Category D - Potential risk to human fetus exists; use with pregnant women only if
benefit outweighs risk.
e. Category X - Fetal abnormalities reported in humans and confirmed in animal or human
studies. Do not use the drug with pregnant women.
5. Review cultural implications
Cultural Group Common Health Verbal and Family Biologic Variations
Beliefs and Nonverbal
Alternative Communications;
Healers Touch/Time
African Practice folk Asking personal Have close Keloid formation,
medicine, employ questions of extended family sickle cell anemia,
“root doctors” as someone met for ties lactose
healers, the first time seen Women play intolerance, skin
spiritualists as intrusive and important key role color
Used herbs, oils, not proper in making health
and roots Direct eye contact care decisions
seen as rude
Present oriented
Asian Believe in High respect for Have close Many drug
traditional others, especially extended family interactions,
medicine; hot and individuals in ties; family needs lactose
cold foods; positions of more important intolerance, skin
herbs/teas/soups. authority than individual color, thalassemia
Use of Not usually needs
acupuncturist, comfortable with
acupressurist, and custom of shaking
herbalist; Tai Chi; hands with those
Qi Gong of opposite sex
Presented
oriented
Hispanic View health as a Expressing Have close Lactose
result of good luck negative feelings extended family intolerance, skin
and living right; seen as impolite ties; all family color
see illness as a Avoiding eye members involved
result of doing a contact seen as in health care
bad deed respectful and decisions
Heat, cold, and attentive Past cultural
herbs used as Touching experiences in the
remedies acceptable family with illness
Use curandero, between two and healing
spiritualist persons in practices holds
conversation significant value
