Question

1. A 76-year-old client is ordered three medications to be administered at 9 AM.
a. Discuss how the client’s current diagnosis and medical history will apply to the drug administration.
b. If one medication was available in 50-mg scored tablets and the nurse needed to give 175 mg, how many tablets would the nurse have to give?

2. Client safety is a major objective when administering medications.
a. What actions will the nurse take when interpreting medication orders?
b. Discuss various safety mechanisms that have been implemented to increase client safety.

3. A 70-year-old client reports an allergy to atropine.
a. What questions should the nurse ask the client?
b. What follow-up steps would the nurse take regarding this allergy?

Answer 1

A)Correct diagnosis and detailed history of the patient helps to formulate most effective treatment.

A diagnosis is made basis of medical science and reported symptoms rather than diagnostic tests, for instance a proper diagnosis of infectious disease usually request both an examination of signs and symptoms, as well as laboratory test result in characteristic of pathogen involved. The doctor decides medical treatment and prescribed drugs based on the findings from diagnostic test and history of of the patient.

Medication histories are important in preventing prescription errors and consequent to the patients. Apart from preventing prescription errors, acquired medication history is also useful in detecting drug related pathology for changes in clinical science that may be the result of drug therapy.

B) available dose is 50 mg

Prescribed dose is 175 mg

The nurse has to give ,3 and 1/2 tablets.

2.it is important that the nurse checks the medication administration report of the client for administering any medication this will help identify recently administered drug.,the time of administering drug and also helps to avoid drug that may interfere or add to the effect of another medication the client has received.

Diet and fluid oder

this is to avoid administering medication to the client who is kept nil orally in preparation for surgery for some diagnostic tests . But, if the client is receiving medication such as, anticonvulsants, antidiabetic, antihypertensive drugs. Digoxin etc., it is better to consult the concerned phycision regarding the administration of the drug.

Laboratory values: this may be used to monitor serum drug levels, medication effects and side effects. For example, anticoagulants are administered after assessing prothrombin time. Before giving chemotherapy blood count is monitored. Ash this drugs cat course severe leukopenia or thrombocytopenia. medicationThose medication which affects kidneys are administered after checking kidney functions and periodic evaluation of kidney function is also carried out.

Physical assessment

This is done to assess the client's physical ability to take the medication.

1. Ability to sollow: if there is any suspicion regarding the client's ability to swallo, give sips of water. If the client cough or chockes the water. Do not give oral medication.

2. Gastrointestinal motility should be normal

3. Advocate muscle mass, before giving subcutaneous or intramuscular injections make sure that adequate muscle mass is present.

4. Adequate venous access: before giving IV make sure, Canula is inserted into patient vein and there is no redness swelling at the site.

5. Vital signs: measure and record vital signs before administering medication that have effect on vital signs.

B) safety mechanisms

• Observe the 10 rights of medical adminisadministration- right client, right route, right dose ,right medicine, right method, right documentation, write history and right assessment, right to refuse.
• Observe for symptoms of overdose of the drug before it is administered.
• identify the client correctly by bed number room number calling the name of the client asking the client to repeat his name, asking others who know the client.
• Give the drug one by one.
• Stay with the client and he has taken the medication completely.
• Observe for any contraindications in oral administration of medicine such as nausea, vomiting, unconsciousness, etc whether the truck and safely be administered through the oral route.
• Always give the medicine you have prepared yourself.
• Remove the unpleasant taste of medicines from mouth by use of orange syrup, lemon juice or by mouthwash.
• Always provide a drink of freshwater to the client after giving oral medicine.
• Report an error in medication immediately to charge nurse and the physician.
• Do not leave the medicine with the client. Prepare fresh dose of medicine if the medication is to be given later.
• The code is dose of medicine soon after it is administered.
• New standard abbreviations in recording medication.
• Record only that medicine which you have administered.
• Before administering medication explain the procedure to the client on the discuss the need for the medication.
• When giving oral drugs, assist the client to a sitting position.a lateral position is the next safest and easiest because the patient lying on the back man as per the drugs and fluids when swallowing.unless contraindicated raise the head and with extra pillows to provide proped up position.

3. a) the most common symptom of atropine allergy for itching and burning. The nurse take history regarding the symptoms of allergic reaction.such as.

• The time of starting the simple allergic symptoms
• The duration of the reaction and
• Triggering factors
• History of allergy to any other drugs
• Any self treatment taken. etc

B) the nurse assess the general condition of the patient, vital signs and, location and extension of signs and symptoms.

Patch tests are used to find out allergic reaction in the case of dermatitis.

Stop the drug as soon as possible. Start IV fluids.

Provide time management if present.

Although several antimuscarinic drugs, other than atropine that can be used to treat op in toxification. Of those, two that have been suggested as replacement for atropine are, glycopyrrolate and scopolamine.