Medication Management (NZ Regulations) Flashcards

Under the Medicines Act 1981, which schedule classification applies to prescription medicines in New Zealand?

Answer: Prescription Medicine (formerly Rx)

The Medicines Act 1981 classifies medicines as: Prescription Medicines (require a prescription from an authorised prescriber), Restricted Medicines (pharmacist sale), Pharmacy-only, and General Sale. Schedule 8 under the Misuse of Drugs Act covers controlled drugs.

What are the 'Five Rights' of medication administration?

Answer: Right patient, right drug, right dose, right route, right time

The Five Rights (Rights of Medication Administration) are: right patient (identify using two identifiers), right drug, right dose, right route, and right time. Some frameworks add: right reason, right documentation, right response.

A nurse is about to administer an IV medication when they notice the patient's wristband name does not match the medication chart. What should they do?

Answer: Stop and clarify the identity discrepancy before administering — do not proceed until verified

Patient identification must be verified using two independent identifiers (name, date of birth, NHI number) before any medication is given. A wristband discrepancy must be resolved before proceeding — wrong-patient administration is a serious adverse event.

Under the Misuse of Drugs Act 1975, which of the following is a legal requirement when administering a Class B controlled drug (e.g., morphine) in a hospital?

Answer: Two nurses must verify the drug, dose, and patient; the controlled drug register must be signed by both

Controlled drugs require two-nurse checking (two registered health practitioners in NZ hospitals) and documentation in the controlled drugs register for each administration, including counting the remaining stock. This applies to Schedule 2 (Class B) drugs like morphine and fentanyl.

A patient is prescribed gentamicin IV. Which monitoring parameter is most critical for detecting early toxicity?

Answer: Renal function (serum creatinine, eGFR) and drug levels (trough/peak)

Gentamicin is nephrotoxic and ototoxic. Renal function (creatinine, eGFR) must be monitored closely, and drug levels (trough concentration in NZ practice) are measured to ensure levels are within the therapeutic window and avoid toxicity.

Which of the following is the correct action if a nurse suspects a patient is having an allergic reaction to a recently administered antibiotic?

Answer: Stop the antibiotic immediately, assess the patient using ABCDE, call for help, and prepare for anaphylaxis management

If an allergic or anaphylactic reaction is suspected during drug administration, the drug must be stopped immediately. The patient is assessed using ABCDE, help is called, and anaphylaxis management (adrenaline if indicated) is initiated.