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Davis Company. All rights reserved. This book is protected by copy- right. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. As new scientific information becomes available through basic and clinical research, recom- mended treatments and drug therapies undergo changes.
The author s and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author s , editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no war- ranty, expressed or implied, in regard to the contents of the book.
Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information package inserts for changes and new informa- tion regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Names: Martinez de Castillo, Sandra Luz, author.
Werner-McCullough, Maryanne, author. Other titles: Calculating drug dosages Description: Philadelphia : F. Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F.
For those organiza- tions that have been granted a photocopy license by CCC, a separate system of payment has been arranged.
To my parents, Miguel and Blanca, who said that I could. To Ron, who understands. Patient safety in medication administration has provided the foundation and motivation for the development of each chapter. Therefore, in addition to demonstrating how to solve a drug dosage problem, we have included medication administration situa- tions encountered in clinical practice. Each chapter is unique and designed to build your confidence in drug dosage calculation.
Developing competency in drug dosage calculations takes practice. We encourage you to practice solving drug dosage problems every day and to always follow recommended guidelines when administering medications. Taking the time to practice demonstrates pro- fessional growth and commitment to patient safety. This book, combined with your consistent practice of drug dosage calculations, is designed to be a valuable resource to prepare you for error-free medication administration.
We hope that this book becomes a valuable resource for you and that your students develop the competency needed in the administration of medications. Barbara W. Terry L. Connie J. Debra L. Teresa V. Vicki L. Maxine G. Kathleen N.
Reviewers xi. Kathleen A. Louis Missouri Batesville, Arkansas. LuAnn J. Kathleen S. Louis, Missouri Waco, Texas. The authors wish to acknowledge and thank the companies who allowed the reproduction of their drug labels and medication equipment images: Abbott Laboratories PDC Healthcare B.
Braun Medical, Inc. Retractable Technologies, Inc. Covis Pharmaceuticals, Inc. Barr Laboratories Inc. Pfizer, Inc. Pfizer Labs Division of Pfizer Inc. Division of Pfizer Inc. Parke-Davis Division of Pfizer Inc. We owe so much to all the staff at F. Your support and collaboration made this text- book happen. Special thanks to the students for teaching us what we needed to teach. The D r ug Label 16 Unit Review The H o use hold System 52 Unit Review F o r mul a M ethod Unit Review Administ r ation of Insulin Unit Review Tit r ation of Intrav enous Medic ations Unit Review In tak e and O utput Pa r enteral Intak e Unit Review Do sages for Pedi atr i c and E lder ly P o p u lati ons Safety in Medication Administration S afe medication administration requires the collaborative effort of all healthcare providers to initiate, evaluate, and contribute to practices that promote patient safety.
This unit provides you with information that emphasizes safe medication administration practice, from the initial reading of a medication order and drug label to the application of the Six Rights of Medication Administration. Identify safe medication practices that assist patients and families in taking greater responsibility for the management of their medication therapy. Discuss how the Six Rights of Medication Administration promote safe practice.
Safety in medication administration involves the collaborative effort of healthcare pro- fessionals, drug manufacturers, healthcare organizations, ongoing scholarly research, and informed patients and families. The prominent report To Err Is Human: Building a Safer Health System , published by the Institute of Medicine, brought attention to the number of annual deaths in hospitals that were attributed to preventable medical errors.
Medical errors that cause harm to the patient, including medication errors, are costly and have devastating effects for patients, families, and society. This careful analysis of the error recognizes that situations or processes within the healthcare system may lead the indi- vidual to make an unintentional error. This nonpunitive approach allows healthcare professionals to discuss the error or situations that may cause possible errors without. The culture of safety also recognizes that healthcare professionals need to be held accountable for errors that occur due to at-risk behaviors i.
The primary focus of this analysis is to learn how best to prevent similar errors in the future. There are many government and nongovernment agencies that address healthcare and patient safety issues, for example: the U.
Food and Drug Administration, the U. Because of the research with medication safety and the implications of the findings and recommendations to nursing practice, the Institute of Medicine and the Institute of Safe Medication Practices will be discussed. T h e In sti tute o f Med i ci ne The Institute of Medicine IOM , an independent, nonprofit organization established in , serves to inform government policy makers and the public sector on national healthcare issues.
Through national research studies, the IOM provides reliable infor- mation and makes recommendations for best practices. In the July IOM report Preventing Medication Error: Quality Chasm Series, the IOM indicated that medication errors can occur at every phase of the medication process, from prescribing and dis- pensing to administering and monitoring for the effects of the drug.
However, based on the report, medication errors occur most frequently at the prescribing and admin- istering phases. The prevention of harm to a patient is of priority. To this end, the IOM strongly advocates that the first and foremost intervention for safety in the use of medications is the establishment of a partnership between the patient and the health- care provider.
The goal of this partnership is to facilitate the process for the patient to take more responsibility in the management and in the monitoring of his or her medications. Table lists the recommendation identified in the IOM report. The implications for nursing practice in Table serve as a reminder of the importance of teaching patients and families so that they can take a more active role in monitoring their medications.
Table Encourage the use of reliable resources for obtaining drug information. Ensure the patient knows whom to contact for questions regarding his or her drug therapy. Openness regarding errors and problems Communicate openly with the patient and family when errors occur, explain consequences and interventions to correct the problem.
The Institute of Safe Medication Practices The Institute of Safe Medication Practices ISMP is a nonprofit agency established in with the primary purpose of identifying the causes of medication errors and of recommending evidence-based strategies for the prevention of these errors. The research, resources, and services provided by the ISMP have had a strong influence in changing medication practices across all healthcare set- tings.
In , the ISMP published a list of abbreviations, symbols, and dose designa- tions the way medication doses are written that were prone to cause medication errors if misread or misinterpreted. Table highlights some of the ISMP recommended changes in the use of abbreviations, symbols, and dose designations with examples for correct use. The recommendations made by the ISMP were supported by national pa- tient safety organizations and have become standard practice.
Write 5 mg, never 5. Write 0. Never mL. Include properly spaced commas for dose numbers expressed Write heparin 5, units, never heparin in thousands e. These drug names Therapeutic: opioid analgesics have the potential to be confused with each other and Pharmacologic: opioid agonists may lead to a medication error.
Identification of a high alert Drug Names. This listing is found at the Web site drug in a drug reference guide. More infor- mation regarding look-alike and sound-alike drugs can be found in Chapter 2, The Drug Label.
Medicines management is a core nursing skill. This review gives an introduction to and taster of our newly launched online Nursing Times Learning unit on drug calculations. Medication errors are most frequently due to the wrong dose, omitted or delayed medication or the wrong medication being administered National Patient Safety Agency, a. The most frequently cited wrong-dose error stems from calculation error. These errors can be the result of nurses not having the right knowledge or skills, or of other factors, such as distractions or stress. Nurses need to understand the measurements used for drug dosages and be able to convert between these different units of measurement Fig 1.
Safety in Medication Administration 1. Safety in Medication Administration 2. The Drug Label II. Systems of Measurement 3. The Metric System 4.
In this nursing test bank , practice dosage calculation problems to measure your competence in nursing math. As a nurse , you must be able to accurately and precisely calculate medication dosages to provide safe and effective nursing care. The goal of this quiz is to help students and registered nurses alike to grasp and master the concepts of medication calculation. In this section are the practice problems and questions for drug dosage calculations. Included topics are dosage calculation, metric conversions, unit conversions, parenteral medications, and fluid input and output.
In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of dosage calculations in order to:. Safe nursing care mandates accuracy in the calculation of dosages and solution rates. In this section you will get a brief review of basic arithmetic calculations and a review of the ratio and proportion method that is used for the calculation of dosages and solutions. The three measurement systems that are used in pharmacology are the household measurement system, the metric system and the apothecary system.
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