Download unit 1-medication administration

1. NURSING 1202 STUDY GUIDE
UNIT 1-MEDICATION ADMINISTRATION
LECTURE CONTENT
1. Describe the ways drugs are
identified//classified.
2. Identify and compare resource
materials available for gaining
knowledge of medications.
3. Describe the nurse's legal
responsibilities in drug administration.
4. Describe the physiological
mechanisms of drug action, including
absorption, distribution, metabolism,
and excretion.
5. Describe the effects & the interactions
of drugs which nurses need to assess.
6. List and explain the variables
influencing drug actions.
7. Discuss the involvement of the
nursing process in the administration
of medication.
LAB CONTENT
1. Discuss the methods of drug delivery.
2. State the factors to consider in choosing
the various routes of drug administration.
3. Interpret a drug order and the nursing
responsibilities involved.
4. List the steps of setting up patients'
medications.
CLINICAL ACTIVITIES
1. Demonstrate ability to accurately
calculate dosages for all routes of
medication administration.
2. Prepare to correctly identify any drug
administered to your assigned patients
in clinical.
3. Assess each patient's need for and
response to drug therapy across the life
span.
5. State and practice the "RIGHTS" of drug
administration.
4. Properly record all drugs administered.
6. State the steps required to administer oral
meds safely to any age group.
5. Safely dispose of contaminated
medication equipment used in the
administration procedure.
7. Discuss important nursing considerations
for safe drug administration via oral,
topical, ophthalmic, otic, nasal, inhalation,
vaginal, and rectal.
6. Be prepared to relate the drug
information that was discussed in class
to clinical patient care.
8. Identify the correct equipment required
for injections.
7. In the clinical setting, give complete
nursing care to one patient, including all
medications except intravenous.
9. State the essential steps in mixing selected
drugs from vials & ampules.
10. Precisely locate the sites for ID, subQ,
& IM injections.
11. Demonstrate how to correctly assess
for, draw up, & administer insulins.
12. State the rationales of the steps
necessary to safely administer injections
to any age group.
INDEPENDENT ACTIVITIES
KEY:
 Required
 Suggested
NOTE: For computer assisted
instruction marked with a # , students
must complete the program with a score
of 80% and turn in the printout from the
quiz to their clinical instructor prior to
the first hospital clinical (10/28 or 11/4).
 Read Kozier, Erb, Berman & Snyder
Fundamentals of Nursing (FON): Ch.
33: p. 785 - 832 (excluding p. 811
nasogastric & gastrostomy meds) and
p. 841-851.
 Read Key & Hayes Pharmacology:
Ch. 1-5: p. 2 – 111.
 Video: Avoiding Medication Errors
(KIT. RM 146.A961989)
 Video: Medicating Children (KIT.
RJ560.M4P3)
 #CAI - Delmar’s: Administering Oral
Sublingual, and Buccal Medications
 #CAI - Delmar’s: Administering Eye
and Ear Medications
 #CAI - Delmar’s: Administering
Skin/Topical Medication
 #CAI - Delmar’s: Administering
Nasal Medication
 #CAI - Delmar’s: Administering
Rectal Medication
 #CAI - Delmar’s: Administering
Vaginal Medication
 #CAI - Delmar’s: Administering
Nebulized Medication
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13. Discuss case studies, according to
instructor's preference.
TEST # 1
 #CAI - Delmar’s: Administering an
Intradermal Medication
 #CAI - Delmar’s: Administering a
Subcutaneous Medication
 #CAI - Delmar’s: Administering an
Intramuscular Medication
 #CAI - Delmar’s: Administering
Medications via Z-Track Injection
 #CAI - Delmar’s: Withdrawing
Medication from a Vial
 #CAI - Delmar’s: Withdrawing
Medication from an Ampule
 #CAI - Delmar’s: Mixing Medications
from Two Vials into One Syringe
 Complete FON Study Guide: Ch. 33.
 Complete Pharmacology Study Guide:
p. 1-49.
 CAI – PDS - Clinical Nursing
Concepts- Parenteral Routes
 CAI – PDS - Clinical Nursing
Concepts- Non-parenteral Routes
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UNIT 2-SPECIFIC DRUG CATEGORIES
LECTURE CONTENT
1. Insulin:
a. State the method by which insulin
is given and why.
b. Identify the classifications of
insulin & some of the common
types used.
c. Discuss the dosages, storage, and
administration of insulins.
d. Discuss what you would do when
an insulin reaction occurs.
2. Pain relievers / Anti-Inflammatories
a. Identify the 3 classifications of
analgesics.
b. Identify how narcotics are
controlled.
c. Identify the classifications,
actions, side effects, and nursing
implications of the most common
narcotic analgesics.
d. Identify the classifications,
actions, side effects, and nursing
implications of the most common
agonist-antagonists.
LAB CONTENT
CLINICAL ACTIVITIES
1. Be prepared to relate the drug
information to patient care that was
discussed in class.
INDEPENDENT ACTIVITIES
 Read Pharmacology:
Ch. 48: p. 733-748.
Ch. 18: p. 258-275.
Ch. 26: p. 372-381.
Ch. 27: p. 391-406.
Ch. 28: p. 407-422.
Ch. 29: p. 423-429.
Ch. 30: p. 433-434, 436-440.
 Also read Davis’s handbook for the
drugs discussed in this unit.
 #CAI - Delmar’s: Administering
Patient-Controlled Analgesia
 CAI - Delmar’s: Administering
Epidural Analgesia
 CAI - Delmar’s: Managing
Controlled Substances
 CAI - Delmar’s: Assisting with the
Insertion and Maintenance of an
Epidural Catheter
 Complete Pharmacology Study Guide:
 Video: Pain Management:
Pharmacologic Treatment Strategies
(KIT.RB 127.P37 2002v2)
 CAI – Mastering Clinical Skills:
Epidural Analgesia
 CAI – Mastering Clinical Skills:
Patient Controlled Analgesia
e. Describe patient-controlled
analgesia and the nursing
implications.
f. Describe epidural pain control and
the nursing implications.
g. Discuss the types adjuvants & the
purposes of using them
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h. Describe the use of NSAIDs, side
effects, & the nursing
implications..
i. Apply the nursing process to the
use of pain relievers.
3. Anti-Infectives
a. Define terms related to antiinfectives
b. Discuss how an anti-infective is
chosen.
c. Nursing implications with antiinfectives.
d. Know the 5 ways antibiotics are
grouped based on their
mechanism of action.
e. Identify the actions, side effects,
and nursing implications of the
following classifications of antiinfectives:
i. Beta-lactam antibiotics
ii. Cephalosporins
iii. Vancomycin
iv. Fluoroquinolones
v. Aminoglycosides
vi. Sulfonamides
vii. Tetracyclines
viii. Macrolides
ix. Common miscellaneous
anti-infectives
f. Identify the actions, side effects,
and nursing implications of
common antifungals.
g. Discuss Complementary antiinfectives.
TEST #2
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UNIT 3-ELIMINATION
LECTURE CONTENT
1. Urinary elimination
a. Describe the functions of:
nephron, glomerular filtrate,
bladder, urethra, urinary meatus.
b. Understand the physiological
process of urine production.
c. State several factors that affect
normal elimination.
d. Compare and contrast common
alterations in urinary elimination
patterns.
e. List and explain the data needed
to assess a person's urinary
function: nursing history,
physical assessment and urine
assessment.
f. Describe some common
diagnostic measures and nursing
implications to assess the urinary
system.
g. Describe some common
interventions to maintain normal
urinary elimination and to assist
patients with urinary problems of
urinary incontinence and
retention.
h. Discuss nursing measures to
reduce UTI in the catheterized
patient.
LAB CONTENT
CLINICAL ACTIVITIES
1. Describe how to collect a urine specimen
that is a clean-catch and from a foley.
1. Routinely assess assigned patients for
normal urinary elimination.
2. Describe how to apply an external
catheter.
2. Identify nursing diagnoses appropriate
for alterations in urinary elimination.
3. Discuss types of urinary catheters and
their purposes:
a. straight
b. foley catheter
c. 3-way catheter
3. Appropriately apply nursing measures
to attain normal urinary elimination.
4.
When given the opportunity, properly
obtain urine specimens for the lab.
4. Discuss the following procedures:
a. Inserting a urinary catheter.
b. Care of the catheters
c. Removing a urinary catheter.
d. Self-catheterization
5.
When given the opportunity, properly
obtain urine specimens for the lab.
5. Discuss urinary irrigations.
7. Understand the physiological aspects of
normal defecation.
6. Using 100% aseptic technique,
demonstrate the insertion of a urinary
catheter.
6. Provide good catheter care to all
patients with retention catheters.
STUDENT ACTIVITIES
 Read FON: Ch. 47: p. 1256-1288.
 CAI - Delmar’s: Applying a Condom
Catheter
 #CAI - Delmar’s: Inserting an
Indwelling Catheter :Male
 #CAI - Delmar’s: Inserting an
Indwelling Catheter: Female
 CAI - Delmar’s: Routine Catheter
Care
 CAI - Delmar’s: Obtaining a
Residual Urine Specimen from an
Indwelling Catheter
 CAI - Delmar’s: Irrigating a Urinary
Catheter
 CAI - Delmar’s: Irrigating the
Bladder Using a Closed-System
Catheter
 CAI - Delmar’s: Removing an
Indwelling Catheter
 CAI - Delmar’s: Testing Urine for
Specific Gravity, Ketones, Glucose,
and Occult Blood
 CAI - Delmar’s: Collecting a CleanCatch, Midstream Urine Specimen
 Complete FON Study Guide: Ch. 47.
 Video:
Urethral Catheterization (KIT.
RC901.7.C2 B2)
 CAI – Mastering Clinical Skills:
Urinary Catheters
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2. Fecal elimination
a. Discuss factors which influence
fecal elimination.
b. Describe some common fecal
elimination problems.
c. List and explain the data needed
to assess fecal elimination
function: history, physical
assessment, fecal characteristics,
and diagnostic tests.
d. Describe some nursing measures
that promote regular defecation
and relieve problems.
7. Explain the steps to perform the
following:
a. Guaiac test for occult blood.
b. Administer an S.S. or saline enema.
c. Adminster a Fleets enema.
d. Remove a fecal impaction
8. Describe what a rectal tube is and its
purposes.
8. Routinely assess assigned patient’s fecal
elimination patterns for malfunctions.
9. Identify nursing diagnoses related to
alterations in elimination.
10. When given the opportunity, properly
obtain fecal specimens for the lab.
11. Appropriately apply nursing measures
that will maintain or attain normal fecal
elimination.
 Read FON: Ch. 46: p. 1225-1253.
 CAI - Delmar’s: Testing for Occult
Blood with a Hemoccult Slide
 #CAI - Delmar’s: Administering an
Enema
 CAI - Delmar’s: Digital Removal of
a Fecal Impaction
 CAI - Delmar’s: Inserting a Rectal
Tube
 CAI - Delmar’s: Irrigating and
Cleaning a Stoma
 CAI - Delmar’s: Changing a Bowel
Diversion Ostomy Appliance:
Pouching a Stoma
 CAI - Delmar’s: Managing Irritated
Peristomal Skin
e. Differentiate between an
ileostomy and a colostomy.
f. Discuss how to change a bag on
an ileostomy or colostomy.
 Complete FON Study Guide: Ch. 46
 Video: Cleansing Enemas (KIT.
RT87.E5 B3)
TEST #3
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UNIT 4-FLUIDS AND ELECTROLYTES/ACID BASE BALANCE
CLASSROOM
1. Describe body fluid distribution and
composition.
2. Define the terms: isotonic, hypotonic,
and hypertonic fluids.
3.
Explain the various types of fluid
movement: diffusion, osmosis,
filtration, and active transport.
4. Discuss the factors which affect the
body's fluid balance.
5. List the clinical features of evaluating
a patient's fluid status: history,
physical assessment, & diagnostic
tests.
6. Discuss the assessment of a patient in
hypovolemic shock.
7. Discuss fluid deficits and excesses in
various age groups.
8. Differentiate the major electrolytes of
the body and the importance of each.
9. Discuss some major factors which
affect the body's electrolyte balance.
10. List and explain the data needed to
assess a patient for an electrolyte
imbalance: history, physical
assessment, and lab tests.
11. Discuss some clinical cases of
electrolyte imbalances.
LAB CONTENT
1. .
1. Identify and describe the essential parts
of IV infusion equipment.
2. Discuss the physiological and
psychological considerations that are
important in parenteral administration.
3. Demonstrate the following parenteral
procedures:
a. Change primary IV solutions.
b. Change primary IV tubing.
c. Maintain the IV infusion.
d. Regulate the infusion flow rates.
e. Change IV dressings.
f. Discontinuing IV infusions.
4. Discuss the procedures:
a. Administrating an IVPB.
b. Administrating an IVP.
5. Identify the types of mechanical
problems that are commonly encountered
with IV infusion systems and the
appropriate nursing measures to cope
with them.
6. Accurately document initiation of IV
procedures, nursing interventions related
to IV therapy, and assessment of the
patient receiving an IV infusion.
CLINICAL ACTIVITIES
STUDENT ACTIVITIES
1. Accurately assess your assigned patients
for fluid and electrolyte imbalances.
 Read FON: Ch. 50: p. 1351-1368 and
1404 -1406. .
 Read Pharmacology: Ch. 14: p. 203220.
 CAI - Mosby’s: Fluids and
Electrolytes
 CAI - Delmar’s: Preparing an IV
Solution
 CAI - Delmar’s: Adding
Medications to an IV Solution
 CAI - Delmar’s: Administering
Medications via Secondary
Administration Sets
 CAI - Delmar’s: Administering
Medications via IV Bolus or IV Push
 CAI - Delmar’s: Administering
Medications via Volume-Control Sets
 CAI - Delmar’s: Preparing the IV
Bag and Tubing
 CAI - Delmar’s: Setting the IV Flow
Rate
 CAI - Delmar’s: Assessing and
Maintaining an IV Insertion Site
 CAI - Delmar’s: Changing the IV
Solution
 CAI - Delmar’s: Discontinuing the
IV and Changing to a Saline or
Heparin Lock
 CAI - Delmar’s: Changing the IV
Gown
 #CAI – PDS - Clinical Nursing
Concepts & Skills - Fluid &
Electrolyte Balance, 2 scenarios
 #CAI – PDS - Clinical Nursing
Concepts & Skills – Acid-Base
Balance, 4 scenarios
2. Determine if your patients are in an
acid-base imbalance.
3. When the opportunity arises, be
prepared to:
a. Assemble the proper equipment &
solutions for IV administration.
b. Change IV tubing as indicated
using aseptic technique.
c. Change IV dressings as indicated
using aseptic technique.
d. Discontinue IV infusions.
4. Routinely calculate assigned patients' IV
flow rates & regulate as indicated.
5. Routinely observe for any patient
complications or mechanical
malfunctions during parenteral therapy
and apply the correct nursing measures.
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12. Describe pH as related to the body's
acid-base balance.
13. Discuss the 3 major body regulators
for acid-base balance.
14. Discuss the 4 major acid-base
imbalances and how to assess a
patient's status.
15. Discuss some clinical cases of acidbase imbalances.
16. Identify the purpose, uses, and legal
implications of IV therapy.
 Complete FON Study Guide: Ch. 50
 Complete Pharmacology Study Guide:
Ch. 14.
 Video: Assessing fluids and
electrolytes. KIT.RC630.M31989X
 Video: Signs & symptoms of fluid &
electrolyte imbalances. RD52.F59
S54 2002
 Video: Maintaining the IV System
(KIT. RM 170.M35 1994)
 Video: Detecting & Managing IV
Therapy Problems (KIT. RM170.D4)
17. Differentiate the types of isotonic,
hypotonic, & hypertonic solutions
commonly used in IV therapy.
18. Discuss some common IV
medications and how to administer
them.
TEST #4
8
UNIT 5-PERIOPERATIVE CARE & OXYGENATION
LECTURE CONTENT
1. Preioperative Care
a. Describe the ways surgeries are
classified.
b. Discuss factors that increase
surgical risks in patients.
c. List and explain the data to
include in the preop assessment
of a surgical patient: history,
physical assessment, and
diagnostic tests.
d. Identify the essential features of
an informed consent for a
surgical procedure.
e. List and explain the nursing
responsibilities for the patient
prior to surgery.
f. Discuss the required content of
preop teaching.
g. Identify the common types of
anesthesia that may be used in
surgery.
h. Describe the effects of general
and regional anesthesia.
i. Discuss the SN role in the OR.
LAB CONTENT
1. .
1. Discuss the reasons for GI intubation.
2.
Explain the uses of the commonly used
types of GI intubations.
3. Discuss the following procedures:
a. Inserting an N/G tube.
b. Charting, nursing Dx & nursing
orders.
c. Removing an N/G tube.
d. Irrigating an N/G or feeding tube.
e. Maintaining an N/G or feeding tube.
f. Review giving meds per tube.
g. Avoiding complications that
commonly occur with them.
4. Identify the assessment data pertinent
to wounds.
5. Discuss the types of drains most often
seen with wounds.
6.
Discuss the nursing responsibilities
involved with sutures.
7. Discuss how to properly clean and dress
a wound:
a. Sterile dressing change.
b. Irrigating a wound.
c. Packing a wound.
d. Wet-to-dry dressings.
e. Securing dressings.
8. Discuss the proper procedure for
irrigating a wound.
CLINICAL ACTIVITIES
1. When the opportunity arises, be
prepared to use the techniques of GI
intubation, irrigation, and feeding.
2. With the opportunity, be prepared to :
a. Provide appropriate preop teaching.
b. Prepare pt's skin before surgery.
c. Adequately prepare & record
patient’s care on the day of surgery.
d. Accompany patients to surgery.
e. Accompany patients to the PAR.
3. When given the opportunity, be
prepared to:
a. Assess pertinent data of the patient's
postop condition and accurately
record it.
b. Prepare a postop nursing care plan.
c. Provide nursing measures to relieve
postop discomfort and prevent
complications.
4. When given the opportunity, be
prepared to:
a. Identify & gather proper dressing
materials.
b. Appropriately assess a wound.
c. Change a dressing using aseptic
technique, securing it well.
d. Irrigate or pack a wound using
aseptic technique.
e. Remove skin sutures.
f. Accurately record observations of
wound care and nursing care.
INDEPENDENT ACTIVITIES
 Read FON: Ch. 35: p. 897-934, Ch.
34: p. 856-894, Ch. 45: p. 1205-1220,
and Ch. 33: p. 811.
 Read nutrition book on postop diets.
 CAI – Delmar’s: Applying moist
Heat
 CAI – Delmar’s: Applying Dry Heat
 CAI – Delmar’s: Applying Cold
Treatment
 CAI – Delmar’s: Applying
Antiembolic Stockings
 CAI – Delmar’s: Applying Pneumatic
Compression Device
 CAI – Delmar’s: Assisting with a
Continuous Passive Motion Device
 CAI – Delmar’s: Administering
Preoperative Care
 CAI – Delmar’s: Preparing A
Surgical Site
 #CAI – Delmar’s: Assessing
Immediate Postoperative Care
 CAI – Delmar’s: Postoperative
Exercise Instruction
 CAI – Delmar’s: Inserting and
Maintaining a Nasogastric Tube
 CAI – Delmar’s: Assessing
Placement of a Large Bore Feeding
Tube
 CAI – Delmar’s: Assessing
Placement of a Small Bore Feeding
Tube
 CAI – Delmar’s: Removing a
Nasogastric Tube
 CAI – Delmar’s: Feeding and
Medicating via a Gastrostomy Tube
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j. List the nursing responsibilities
involved in the immediate postop
period and the significance of
each.
k. Identify postoperative
complications, their causes, and
the nursing interventions to
prevent them.
l. Define types of wounds and the
phases of the healing process.
m. Identify factors that inhibit
wound healing and measures to
promote the healing process.
n. Describe the nursing process
involved with the care of wounds.
o. Describe the complications of
wound healing.
9. Review the correct application of
heat/cold to an injured part.
5. Demonstrate the proper applications of
10. List the important data to record on any
wound care.
6. In the clinical setting, use appropriate
safety measures when applying heat or
cold applications to patients.
11. Discuss assigned case studies according
to the instructor's preference.
bandages and binders.
 CAI – Delmar’s: Maintaining
Gastrointestinal Suction Devices
 CAI – Delmar’s: Irrigating a Wound
 CAI – Delmar’s: Packing a Wound
 CAI – Delmar’s: Cleaning and
Dressing a Wound with an Open
Drain
 CAI – Delmar’s: Dressing a Wound
with Retention Sutures
 CAI – Delmar’s: Maintaining a
Closed Wound Drainage System
 CAI – Delmar’s: Care of the
Jackson-Pratt Drain Site and
Emptying the Drain
 CAI – Delmar’s: Removing Skin
Sutures and Staples
 CAI – Delmar’s: Preventing and
Managing the Pressure Ulcer
 CAI – Delmar’s: Applying a Pouch
to a Draining Wound
 CAI – Delmar’s: Applying ABD, Tor Breast Binders
 Complete FON Study Guide: Ch. 33,
Ch. 34, & Ch. 35.
 Video: Pre & Postoperative
Care(KIT.RD49.B3)
 Video: Surgical Wound Care (KIT.
RD52.W6B3)
 Video: Closed Suction - Wound
Drainage (KIT.RD51.B3)
 Video: Nasogastric Intubation
(KIT.RT87.157 B3)
 CAI -Mastering Clinical Skills:
GI tubes
 CAI -Mastering Clinical Skills:
Enteral Feedings
 CAI – PDS - Clinical Nursing
Concepts: Perioperative Care,
 CAI – PDS - Clinical Nursing
Concepts: Inflammation, Infection,
and Wound Healing
10
2. Oxygenation
a. Define terms related to
oxygenation.
b. Describe factors which affect
oxygenation.
c. Describe the nursing assessment
data that determines a patient's
oxygen needs.
d. Identify common diagnostic tests
for oxygen deficits and explain
their value in developing a
nursing care plan.
12. Discuss the procedures of:
a. Oximetry.
b. Oropharyngeal / nasopharyngeal
suctioning.
c. Incentive spirometer.
d. Caring for a pt with a nasal cannula.
e. Caring for a pt with a simple face
mask.
f. Using the Venturi mask.
7. Routinely assess and properly record
your assigned patients' oxygen needs.
8. When given the opportunity,
a. Collect and send sputum specimens
to the lab.
b. Take oximetry readings.
c. Perform adequate suctioning for
assigned patients.
d. Teach correct use of spirometry.
e. Provide nursing measures for
patients with oxygen
administration.
 Read FON: Ch. 48: p. 1291-1315, p.
1318-1322, and p. 1325-1329.
 CAI - Delmar’s: Administering
Oxygen Therapy
 CAI - Delmar’s: Assisting a Client
with Controlled Coughing and Deep
Breathing
 CAI - Delmar’s: Assisting a Client
with an Incentive Spirometer
 CAI - Delmar’s: Administering Pulse
Oximetry
 Video: Respiratory Suctioning
(KIT.RC735.15 R3121993)
e. List and provide the rationales for
measures to maintain or attain
normal respiratory function.
f. Utilize the nursing process in
planning the care of the patient
with oxygenation needs.
FINAL TEST!!!!!!!!
 Complete FON Study Guide: Ch 48.
 CAI - Delmar’s: Administering
PulmonaryTherapy and Postural
Drainage
 CAI - Delmar’s: Administering
Intermittent Positive-Pressure
Breathing
 Video: Respiratory Therapy: Intro for
Nurses(KIT.RM161.R3151993)
 CAI - Mastering Clinical Skills:
Oxygen Administration
 CAI - Mastering Clinical Skills:
Pulse Oximetry

11