Medication Administration & Documentation Flashcards

What is the best way to verify a patient's identity before medication administration?

Answer: Ask for name and date of birth

The safest and most reliable way to verify a patient's identity before medication administration is to ask for their full name and date of birth. This two-factor identification method helps prevent medication errors by ensuring the right medication is given to the right patient. Cross-referencing this information with the patient's wristband and medication administration record (MAR) further enhances safety.

Which action is part of the 'Five Rights' of medication administration?

Answer: Verify the correct medication

The 'Five Rights' of medication administration are crucial safety checks designed to prevent errors. Verifying the correct medication ensures the patient receives the drug prescribed specifically for them, directly fulfilling the 'Right Medication' principle. This fundamental step is essential for patient safety and prevents potentially harmful medication mistakes.

Why is it important to document medication administration immediately?

Answer: To prevent missed or repeated doses

Immediate documentation of medication administration is a critical safety measure in healthcare. It creates an accurate, real-time record, which prevents other staff members from accidentally giving a dose again or mistakenly thinking a dose was missed. This practice ensures patient safety by maintaining clear communication and accountability regarding medication delivery.

Which of the following is an acceptable abbreviation in documentation?

Answer: mg

In medical documentation, clarity and patient safety are paramount, leading to a list of approved and unapproved abbreviations. 'mg' (milligram) is a universally recognized and safe abbreviation for a unit of mass. Abbreviations like QD, U, and cc are considered 'do not use' abbreviations by organizations like The Joint Commission due to their high potential for misinterpretation and medication errors.

What should a medication attendant do if a patient refuses medication?

Answer: Document the refusal and inform a nurse

Patients have the right to refuse medication, and a medication attendant must respect this decision. The correct procedure is to accurately document the refusal, including the reason if stated, and immediately inform a licensed nurse. This ensures the healthcare team is aware of the situation and can assess the patient's condition, address concerns, or explore alternative treatments.

Which form of documentation is best for recording medication administration?

Answer: MAR

The Medication Administration Record (MAR) is the official and most reliable document for recording medication administration. It provides a comprehensive, chronological record of all medications given, including dosage, route, time, and the administering person's initials. Using a MAR ensures accuracy, prevents errors, and serves as a legal document of care provided.

What should you do before administering a new medication?

Answer: Check for medication allergies

Before administering any new medication, it is absolutely essential to check for known patient allergies. Giving a medication to someone with an allergy can trigger a severe, life-threatening allergic reaction. This critical safety step helps prevent adverse events and ensures the patient's well-being.

Which route involves placing medication under the tongue?

Answer: Sublingual

The sublingual route specifically refers to placing medication under the tongue, where it dissolves and is absorbed directly into the bloodstream through the mucous membranes. This route allows for rapid drug absorption, bypassing the digestive system. Oral medications are swallowed, buccal medications are placed between the cheek and gum, and topical medications are applied to the skin.

What is a safe practice when giving multiple medications?

Answer: Give one at a time and observe

When administering multiple medications, it is safest to give them one at a time and observe the patient for any immediate reactions or difficulties. This practice allows the attendant to identify which specific medication might be causing an issue if an adverse reaction occurs. It also ensures the patient properly swallows each medication, reducing the risk of aspiration or choking.