Summary
Summary Nur 155Krcte Notes
- Course
- NUR 155
- Institution
- Galen College Of Nursing
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Ng tubes when you crush and dissolve you use sterile water. You can flush with tap water.Important to give schedule meds when scheduled.
Rules of med admin chapter 35
NEVER give a med that you did not draw up
Med reaction-check airway (lungs, don’t want anaptyctic shock)
Give wrong med, check patient first, alert charge nurse, PCO, safety report
Reconcile meds at admission, transfer and discharge (what are you taking, when was the last time you took it.)
if someone says they take a med everyday, then asked when was the last time they took it and they said a
week ago, they aren’t compliant—want find out why…)
Give schedule meds on time unless refused and charted—(wanna find out why they are refusing and chart why
they refused it)
Only chart meds given when meds have been gives
NEVER leave meds unattended.
Cnnot use a med for any purpose then what it is ordered for. Must separate order
Always check check HR for BP meds, check RR when giving narcotics, check pain scale
Questioning medication orders
Giving med from vial (Pg789)
Clean hub
Fill syringe with air
Push air from syringe into airspace of vial
Invert vial, pull up ordered about
Tap syringe to remove air
Anything given by needle is an infection risk.. clean.. right needle, right place
Syringes (pg780)
Syringes are 0.5-60mL
Use approate syringe for the amt of med that needs to be given
Large syringes are used for irrigating and bolus feeds
(10mL’s are normally used for flushing)
ALWAYS have different syringe for insulin… always give insulin in the insulin specific syringe
NGtubes (pg780)
Make sure meds are crushable, tales can be open
Check to see if they come in liquid form
Dilute meds with warm sterile water
Turn off suction and clamp tubing for 20-30 mins after med administration
Can flush with tap water
IV med admin (803)
Clean IV (alcohol whipes)
Flush with normal saline
Give meds as directed (slow push—slow push especially with morphine)
Clean IV
Flush with normal saline
, Transdermal medications (pg793)
Intradermally – bevel up, 15 degree angle (forearm)
subQ -45degrees, pinch tissues( tummy back of arms)
IM – 90degrees, aspirate 5-10 seconds, remove is blood return (ventrogluteal- most preferred, deltoid, dorsal
gluteal.)
Suppositories (pg 819)
Rectal- left lateral or left sims with upper leg fixed, lube suppository with gloved finger. Insert supposoritory
just pass the anal spincter. Ask patient to remain in position for 5 mins to retain
Vaginal- supine position—insert 8-10cm (3-4in). client stays in supine position for 5-10 mins
Topical meds (8-11)
Ointments, creams, pates, lotion, powders, and patches
Clan area with warm soap and water, pat dry
Patches - remove previous patch and place new patch in another area.
NEVER PUT A PATCH ON IF THEY HAVE AN OLD PATCH ON!! Alternate sides with patches
Ophthalmic drops (813)
Never put them directly on the eye
Lower conjunctiva sac
Press nasolacrimal sac
Keep them from squinting
Otic drops (816)
Warm medication by rolling in-between hands
Pull pina upwards and backward
Cotton loosely in meatus of auditory canal for 15-20 mins to hold medication. Do not press into canal.
Blooms (pg 440,452 (chart for verbs)**KNOW)
Cognitive domain “thinking or knowing domain”- compares, explains, evaluates, identifies, label, lists, names,
plans, select (think Behavior)
Affective domain “feeling domain” accepts, attends, chooses discusses displays, joins, participates
Psychomotor “skill domain” assembles, calculates, changes, demonstrates, measures (think CPE)
Assessing Client learning needs (p444)
Literacy
Health literacy
Understanding of current illness
Sources of education available
Self-initiating education
Client’s readiness (how do we help motivate??)—what do we do--- get them involved, eliminate barriers
Acute Pain- 1088
Mild to severe increase pulse
Elevated BP
Diaphoresis
Dilated pupils
Reports pain
Behavior- crying, rubbing area, holding area
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