Nursing

HLT54115 Diploma of Nursing

HLTENN007 – Administer and monitor medicines and intravenous therapy

Workplace Assessment Student Copy

Assessment Tool 3 and Assessment Tool 4

Workplace Skills Assessment

Assessors make professional judgements about the competence of the students to meet the requirements of the unit of study. This requires assessors to gather evidence that is:

·         Valid- covers all the requirements of the unit of competency

·         Sufficient- enables a decision about competency over time and in different contexts

·         Current- competent performance is contemporary

·         Authentic- is the students own work.

 

Assessment considers Professional Standards including the Australian Nursing and Midwifery Council Enrolled nurse competency standards and the Standards for Practice Enrolled Nurses, Code of Conduct and Code of Ethics. More information can be found at http://www.nursingmidwiferyboard.gov.au/

Workplace skills assessment is an integral component of learning and training. Embedded in the assessments are employability skills that are required by industry for this qualification. The Employability Skills described here are broad industry requirements that may vary depending on qualification packaging options.

Communication

  • Listening to and understanding work instructions, directions and feedback
  • Speaking clearly/directly to relay information
  • Reading and interpreting workplace related documentation, such as safety requirements and work instructions
  • Writing to address audience needs, such as work notes and reports
  • Interpreting the needs of internal/ external clients from clear information
  • Applying numeracy skills to workplace requirements involving measuring and counting
  • Establishing and using networks
  • Sharing information (eg. with other staff and clients)
  • Negotiating responsively (eg. re own work role and/or conditions, possibly with clients)
  • Persuading effectively (ie. within scope of own work role)
  • Being appropriately assertive (eg. in relation to safe or ethical work practices and own work role)
  • Empathising (eg. in relation to others)

Teamwork

  • Working as an individual and a team member
  • Working with diverse individuals and groups
  • Applying knowledge of own role as part of a team
  • Applying teamwork skills to a range of situations
  • Identifying and utilising the strengths of other team members (and providing encouragements and support to colleagues)
  • Giving feedback, coaching and mentoring

Problem Solving

  • Developing practical and creative solutions to workplace problems (ie. within scope of own role)
  • Showing independence and initiative in identifying problems (ie. within scope of own role)
  • Solving problems individually or in teams (ie. within scope of own role)
  • Applying a range of strategies in problem solving
  • Using numeracy skills to solve problems (eg. time management, simple calculations, shift handover)
  • Testing assumptions and taking context into account (ie. with an awareness of assumptions made and work context)
  • Listening to and resolving concerns in relation to workplace issues
  • Resolving client concerns relative to workplace responsibilities (ie. if role has direct client contact)

Initiative and Enterprise

  • Adapting to new situations (ie. within scope of own role)
  • Being creative in response to workplace challenges (ie. within relevant guidelines and protocols)
  • Identifying opportunities that might not be obvious to others (ie. within a team or supervised work context, including identification of skill gaps)
  • Generating a range of options in response to workplace matters
  • Translating ideas into action (ie. within own work role)
  • Developing innovative solutions (ie. within a team or supervised work context and within established guidelines)

Planning and Organising

  • Collecting, analysing and organising information (ie. within scope of own role)
  • Using organisational systems for planning and organising (ie. if applicable to own role)
  • Being appropriately resourceful (ie. within scope of own role)
  • Taking initiative and making decisions within workplace role (ie. within authorised limits)
  • Participating in continuous improvement and planning processes (ie. within scope of own role)
  • Working within clear work goals and deliverables
  • Determining or applying required resources (ie. within scope of own role)
  • Allocating people and other resources to tasks and workplace requirements (ie. within scope of own role)
  • Managing time and priorities (ie. in relation to tasks required for own role)
  • Adapting resource allocations to cope with contingencies (ie. if relevant to own role)

Self-management

  • Being self-motivated (ie. in relation to requirements of own work role)
  • Articulating own ideas and vision (ie. within a team or supervised work context)
  • Balancing own ideas. values and vision with workplace values and requirements
  • Monitoring and evaluating own performance (ie. within a team or supervised work context)
  • Taking responsibility at the appropriate level

Learning

  • Being open to learning new ideas and techniques
  • Learning in a range of settings including informal learning
  • Participating in ongoing learning
  • Learning in order to accommodate change
  • Learning new skills and techniques
  • Taking responsibility for own learning (ie. within scope of own work role)
  • Contributing to the learning of others (eg. by sharing information)
  • Applying a range of learning approaches (ie. as provided)
  • Participating in developing own learning plans (eg. as part of professional development)

Technology

  • Using technology and related workplace equipment (ie. if within scope of own role)
  • Using basic technology skills to organise data
  • Adapting to new technology skill requirements (ie. within scope of own role)
  • Applying WHS knowledge when using technology
  • Applying technology as a management tool

 

The Workplace Assessment Task(s) include two sections

  • Assessment Tool 3
  • Third Party Report Assessment Tool 4

 

The Workplace Assessment Tasks are required to be completed by the workplace supervisor and/or assessor using the forms provided. It is the role of the assessor to clearly articulate the assessment process, contact the student and coordinate with the student and the workplace supervisor to plan this assessment.

 

An integrated or holistic approach to competency-based assessment has been adopted to include workplace skills assessment. The workplace supervisor and/or assessor is integral to the success of workplace training and assessment. The RTO is responsible for ensuring that the necessary training and assessment meets the required standard of the qualification. Workplace training supports students through a range of training that is formal and informal.  The RTO is responsible for the final assessment of the required competencies of a qualification, which must be completed by a qualified assessor.

 

ASSESSMENT TOOL 3

Workplace Assessment Task

Student Name:
Organisation: 

 

Assessor Name:
Workplace Supervisor Name:
Unit of Competency:
Name of Workplace:
Date of assessment:
Procedure:
STARThe STAR method is a structured approach of assessment in which the student describes a previous experience that demonstrates a specific competency.  The acronym STAR

·         Situation- describe the situation

·         Task- describe the strategy that was taken with the situation

·         Action – demonstrate and highlight the skills and knowledge

·         Result- student outcomes

This is a universally recognised communication technique designed to enable students to provide meaningful and complete answers.

Situation or Task:This assessment requires observation in the workplace. This unit of competency describes the skills and knowledge required of Enrolled/Division 2 nurses to administer and monitor medications and evaluate their effectiveness for clients within a health environment

 

Action:The following Workplace Assessment is used to document student’s competence in the workplace. The Workplace Supervisor and/or Assessor observes the student performing the task and provides feedback in the appropriate boxes.

Please sign, date and provide feedback on the Workplace Assessment Task Checklist.

Student

Outcome:

Performance Evidence

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

  • undertaken nursing work in accordance with Nursing and Midwifery Board of Australia professional practice standards, codes and guidelines
  • calculated medications with 100% accuracy and used the ‘Rights of Medication’ to administer medication to at least 2 people in simulation and at least 3 people in the workplace, and which must include the following routes:
  • oral
  • sub-cutaneous injection
  • calculated medications with 100% accuracy and used the ‘Rights of Medication’ to administer medication in the workplace or in a simulation environment to at least 2 people, and which must include the following routes:
  • intramuscular injections
  • peripheral IV injection
  • safely prepared equipment for IV therapy and blood and blood products administration, and monitored IV therapy and blood and blood products administration in the workplace or in simulated environment to at least 2 people including assessing cannula site.

Knowledge Evidence

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:

  • legal requirements for practice parameters of enrolled nurse in relation to the administration and documentation of medications, including legal requirements for each route of administration
  • legal and regulatory framework including
  • health (drugs and poisons) regulations
  • State/Territory drugs and poisons Acts
  • State/Territory nurse regulatory authority codes and guidelines
  • National Safety and Quality Health Standard (NSQHS) ‘Preventing and Controlling Health Care Associated Infections’
  • Visual Infusion Phlebitis Score (VIPS)
  • scheduled medications and interpretation of scheduling of medications – Schedule 2, Schedule 3, Schedule 4, Schedule 8
  • forms of medication and how they are handled, calculated, administered and stored, including:
  • capsules
  • drops
  • inhalants
  • liquid
  • lotions and creams
  • ointments
  • patches
  • powders
  • tablets
  • wafers
  • suppositories
  • pharmacology of medications, including:
  • pharmacodynamics
  • pharmacokinetics
  • pharmacotherapeutics
  • toxicology
  • anaphylactic reactions
  • adverse reactions
  • contraindications
  • precautions
  • side effects
  • potential complications of blood transfusion including:
  • pain at IV site and arm
  • loin pain
  • urticaria (hives)
  • nausea and vomiting
  • headache
  • flushing, chills or fever
  • anxiety
  • tachycardia
  • wheezing, progressing to cyanosis
  • haematuria
  • anaphylactic reaction or shock
  • cardiac arrest
  • death
  • how to transport, store, handle, check and dispose blood and blood products safely
  • ‘Rights of medication’ – the right medication (drug, medication, medicines), right dose, right prescription (documentation), right route, right time, right person, right expiration date, right to refuse
  • how medication is administered via the following routes or methods:
  • oral
  • sublingual, buccal
  • dry powder inhalers
  • metered dose, spacer inhalers
  • nebulisers
  • oxygen therapy
  • subcutaneous injection
  • intramuscular injections
  • IV injections
  • Z-track injections
  • peripheral IV infusion, cannulation fluid
  • enteral administration – Percutaneous Gastrostomy (PEG) as well as nasogastric tubes
  • intranasal, including nebulised medications
  • ocular
  • rectal
  • subcutaneous, intramuscular routes
  • sub-cutaneous injection using pre-loaded syringes or pens
  • topical, including transdermal
  • vaginal
  • ventrogluteal injection technique
  • IV medication administration methods including:
  • bolus
  • gravity
  • electronic pump infusion
  • via burette
  • IV piggyback, tandem
  • syringe driver
  • sub-cut lines
  • pathophysiology related to medicine groups including but not limited to:
Anaesthetics

Analgesia

Antacids

Antianginals

antianxiety

Antiarrhythmics

Antibiotics

Anticholinergics

Anticoagulants

Anticonvulsants

Antidepressants

Antidiarrhoeals

Antiemetics

Antifungals

Antihistamines

Antihypertentives

Anti-inflammatory

Antineoplastics

Antiparkinsonion

Antipruritic

Antipsychotics

Antiseptics

Antiulcer

Antivirals

Anxiolytics

Hormones

Hypnotics, sedatives

Hypoglycaemics

Insulin

Beta-blockers

Bronchodilators

Electrolyte solutions
Laxatives/aperientsOphthalmic, otic

nasal medications

Contraceptives

Corticosteroids

Diuretics
Narcotic analgesia

Neuroleptics

Vitamins
  • factors to consider when calculating medication dosages including:
  • calculation formulae
  • calculation of dosages of injectable drugs including liquid, solid unit dosages
  • flow rate drops per minute
  • flow rate millilitres per hour
  • paediatric dosage calculations – considering body weight, surface area and age-related dose reduction
  • geriatric dosage calculations – considering body weight, surface area and age
  • dose administration aids (DAAs) where dose is already calculated
  • organisation policy and procedure for addressing medication errors
  • drugs commonly used for fluid and electrolyte imbalance:
  • acidifiers, alkalisers
  • diuretics
  • electrolytes
  • replacement solutions.

Assessment Conditions

Skills must have been demonstrated in the workplace or in a simulated environment as specified in the performance evidence. The requirement of the performance evidence to calculate medication with 100% accuracy and used the ‘Rights of Medication’ to administer medication must be demonstrated using simulation before being demonstrated in the workplace and with members of the public. The following conditions must be met for this unit:

  • use of suitable facilities, equipment and resources in line with the Australian Nursing and Midwifery Accreditation Council’s Standards including:
  • simulation manikins appropriate for the administration of medications via various routes including IV
  • equipment for medication administration via various routes, including:
  • pill cutter and pill crusher
  • nebuliser
  • Monthly Index of Medical Specialties (MIMS)
  • samples of medications, including:
  • tablets
  • capsules
  • drops
  • enema
  • inhalants
  • liquid (ampoules, bottles, capsules)
  • lotion and cream
  • ointments
  • patches
  • powders
  • wafers
  • suppositories
  • pre-loaded sub-cutaneous injections
  • pharmacology resources for medication interactions
  • equipment for IV therapy, including:
  • variety of IV line sets for gravity infusion, blood and blood products, IV injections and electronic pump infusions
  • syringe pump
  • information and documentation such as medication charts on which the candidate bases the planning
  • organisation policy and procedures on which the candidate bases the planning
  • modelling of industry operating conditions including access to real people for simulations and scenarios in enrolled nursing work.

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.

In addition, assessors must hold current registration as a registered nurse with Nursing and Midwifery Board of Australia.

 

 

ASSESSMENT TOOL 3

Workplace Assessment Task

 

Medication administration requires the nurse to focus on assessment of the client, understanding the legal and ethical requirements related to medication management and drug calculations. Students will demonstrate professionalism in the workplace setting following the Australian Nursing and Midwifery Council Competencies.

 

Question 1

 

The following websites may assist with this question

http://www.safetyandquality.gov.au/wp-content/uploads/2012/01/NSQHS-Standards-Fact-Sheet-Standard-4.pdf

http://www.safetyandquality.gov.au/wp-content/uploads/2012/10/Standard3_Oct_2012_WEB.pdf

The NSQHS Standards (Medication Safety Standard 4) requires health service organisations to have mechanisms for the safe prescribing, dispensing, supplying, storing, manufacturing, compounding and monitoring of the effects of medicines.  Access the organisations policies and procedures and discuss how the health service meets this Standard.

The health service are meeting this standards requirement for safe and effectual use of different medicines in each step of patient care by engaging different health professionals (health service owners, physician/ doctors, registered nurses, enrolled nurses, pharmacists and health managers) in managing the medication safety from prescribing to its effect monitoring.  This is done by standardising the practices and reviewing the treatment decision, prescription and medicine order decision. Once review is done and is found satisfactory and correct, the medicine is issued from the storage area. The administration of drug and the effect and responses is monitored by the nurses and documented and reported to the prescribing doctor/ physician. The clinical governance helps in meeting this standard as it has proper review strategies, procedure and systems like audit are used to lower the risk of occurrences of medications error and incidents in prescribing, dispensing, issue and storing, manufacturing, compounding and monitoring. Thus, the health service organisation has modified the current practices and introduces system of evaluation and feedback and involvement of internal health care teams to meet the standard.  The communication is well maintained among the carer, nursing staff and doctors about the known allergy to the patient to avoid medication error. Also, experienced and skilled clinicians such as medical practitioners and nurses who have required education are involved in medication administration and ensuring safety.

Question 2

The NSQHS Standards (Medication Safety Standard 4) requires that the clinical workforce accurately records a client’s medication history and this history is available throughout the episode of care. Access the organisations policies and procedures and discuss how the health service meets this Standard.

To meet this standard it can be discussed that completing and maintaining the patient medical history with all inclusive information is essential. Thus, health service organisation has developed a systematic and standardise procedure to collect and record an accurate medication history of the incoming patients for managing the safe medication.  This includes collection and recording information from the patient or from the carer in a face to face interview about the patient current medications, complementary medicines, over the counter medicines, recently stopped medication, allergies, drug reactions, previous illness, treatment plan and durations. The medical history are stored in an electronic medical record of the patient as well as in medication management form, and clinical patient record which is accessible to all clinicians for the continuity of safe medication management on admission,  in handing over care duties to other clinicians and in handing over discharge. Also, the health service follows a system of transfer of verified information from one care episode to another in order to reduce any error arising from inaccurate or incomplete medical information.  Thus, a systematic process needs to be in place for medication history collecting, recording and understanding in different care episodes at admission, during internal care transfer and at discharge to meet this standard.

Question 3

The NSQHS Standards (Medication Safety Standard 4) requires that the clinical workforce is supported for the prescribing, dispensing, administering, storing, manufacturing, compounding and monitoring of medicines.  Access the organisations policies and procedures and discuss how the health service meets this Standard.

The healthcare service meets this standard through gaining collaboration from multiple disciplines and partnership among the health service owners, physician/doctors, patients, carers and clinician as the management of medication safety is a complex process. The health service organisation provides support to the clinical workforce by the deployment of the information systems like mobile applications and desktops and decision support tools (for treatment decisions) and tools for developing the medication management plan for each patient to prevent medication errors. The resources for decision support and other tools like therapeutic guidelines, prescribes organisation practices and procedures, medicines information reference texts, medication charts and dosing calculators are made available for the clinical workforce for guidance and knowledge enhancement for decision making, to deliver care and to handle their medication safety responsibilities in an effective and efficient manner. The health service also provide standardisation of the routine work practices like approval, safe administration of specific medicines, monitoring practices and risk assessment plan and policies for lowering the possibility of risk of medication error and incidents. The health service organisation has formulated medication safety strategies to encourage a care environment to meet this standard. In addition, a feedback strategy is also implemented to evaluate the effectiveness of the resources available to the clinical workforce to make improvement and necessary changes.

Question 4

The clinician provides a complete list of the client’s medicines to the receiving clinician and client when handing over care or changing medications. Access the organisations policies and procedures and discuss how the health service meets this Standard.

To meet this standard the health service ensure that there is no communication breakdown in the providing complete and accurate information about the medicines for a patient during admission into hospital, shift from general care ward to emergency department and back to general care, during change of shift, form inpatient ward to medical imaging and other clinical service department and on discharge. Thus, a systematic clinical handover process is developed for medicine information communication in transferring patient care to other point of care. This includes medicines prescribed, ongoing medicine lists, specific instructions on specific medicine administration, specific reactions and risks, medications allergies, recent clinical diagnosis, recent vital signs and symptoms and responses after taking recent medicines and new medicines to be taken by the patient. Thus, the heath service has implemented policy under which it is the responsibility of the clinician and other carers to meet the requirement of complete and accurate list of medication of prescribed, current use and future use (post discharge) medicines is provided at different point of care transfers and during the patient discharge process for meeting this standard.

Question 5

The clinical workforce informs clients about their options, risks and responsibilities for an agreed medication management plan. Access the organisations policies and procedures and discuss how the health service meets this Standard.

To meet this standard the health service organisation the responsibility is taken by the clinical staff to provide relevant information to the patient, family member and their carer in both written and verbal form. The information is provided for the prescribed list of medicines, reason and also the reason for change in medicines and the choice available to the patient about the medicines and treatments plan. The patient is informed about what choices can be made in relation to medicines and treatment plan, risks and benefits of the proposed treatment course, side-effects and detailed procedure about the alternative treatment option available. In meeting this standard in the health service, the clinical staff also inform the patient and the carer about taking medicine safely, their storage and disposal, possible medication errors in home setting, medication/ treatment duration and follow up and monitoring requirements and on access medication-related resources and assistance to ensure continuity of safe and efficient medication management. The health service organisation also has patient education program to fulfil the information requirement needs in consultation, written material, fact sheets, treatment brochures and verbal instructions.

Question 6

NSQHS Standard 3 (Preventing and Controlling Health Care Associated Infections) requires that In brief, this Standard requires that:

  • Effective governance and management systems for healthcare associated infections are implemented and maintained.
  • Strategies for the prevention and control of healthcare associated infections are developed and implemented.
  • Patients presenting with, or acquiring an infection or colonisation

during their care are identified promptly and receive the necessary

management and treatment.

  • Safe and appropriate antimicrobial prescribing is a strategic goal

of the clinical governance system.

Access the organisations policies and procedures and discuss how the health service meets this Standard.

In order to meet the different criteria of standard 3, the health service has developed and implemented policies to control and prevent infection related to healthcare. Concerning the governance, the health service has implementation of bi-annual review policy for reviewing the effectiveness of existing control and prevention system against the performance indicators, quarterly risk assessments, risk management plan implementation for control/ preventive activities and monthly audits to determine the compliance with organisational policies and procedures. The health service focuses on standardised work system and procedure, evidence based practices for improvements of control and prevention system, and education program for staff members. In the context of strategies for infection control and prevention, the practices of proper hand hygiene before and after contact with patient, and use of personal protective equipment is followed. For this, the health service has hand hygiene education and training programs for staff members. The transmission-based precautions are also followed considering different mode of transmission of infectious agents to maintain a safe environment for patients, workers and visitors. For managing the patients with colonisation or acquired with inflection, the transmission based work practices and precautions are applied to avoid the infection spread.  The cleaning procedure and quality improvement plan is also implemented and environmental controls are maintained considering the issue identified and gap from pathology report and surveillance report. For antimicrobial stewardship, the health service has considered organised antimicrobial management program in the organisation to lower the risk of improper use of antimicrobial and its consequences so that patient results can be enhanced. To support this program the governance is effective in the health service and there is proper system in place for taking specialist advice in clinical conditions.

Question 7

Complete the following table by accessing the organisations policies and procedures.

Form of medicationHandling requirementsCalculation requirementsAdministration Stored
Capsules

 

 

 

Washing hands and drying them before giving capsuleThe capsule  dosage to be calculated on hour basis ( desired dosage) , stock strength, units of weights for capsule (in mg) and no. of capsuleIt is administered orally by swallowingCool  and dry place

Away from humidity and heat

Drops

 

 

 

 

Non-touch handling technique so that the drops are received directly the required area by the dropperDesired dosage, solution concentration, dosage intervalIt is administered ophthalmic as well as oralCool  and dry place

Away from direct sunlight and moisture

Inhalants

 

 

 

Hand hygiene (Washing hands for 30 seconds with soap and pat dry)No. of puffs, no. of hours (minimum dosage interval), dose strength (in ml)It is administered orallyStore  in the designated container
Liquids

 

 

 

Wash hands and dry them, shake bottle and use the medication measuring spoon or device to give this form of medicationDesired dosage, strength of stock, stock volume, stock strength, amount of liquid solution to be given (in ml)It is administered orallyStore in the supplied bottle and close the tap tightly

Away from heat and direct sunlight

Lotions and creams

 

 

 

Hand hygiene (Washing hands for 30 seconds with soap and warm water) and wear  medical gloves for this form of medicationstrength of stock, stock volume, amount of medication need to be appliedIt is directly applied to the skin thus, administered topicalStore in the supplied bottle, away from heat  and sunlight
Ointments

 

 

 

 

Hand hygiene (Washing hands for 30 seconds with soap and warm water) and use of medical gloves for the application of this medication formstock strength, amount of medication need to be appliedIt is administered topicallyStore in cool place

away from heat  and direct sunlight

Patches

 

 

Hand hygiene (Washing hands for 30 seconds with soap and warm water) and wear glovesStock strength,  no. of patches required., no. of daysThis form of medication re administered trans-dermallyStore in clean and dry storage box
Powders

 

 

Hand hygiene (Washing hands for 30 seconds with soap) and dry hands and wear gloves for application as per the manufacturer’s guideline for using power to mixRequired dosage  in mg, dosage interval, stock strength,  dosage intervalIt is administered orally by mixing with certain foods (yogurt), lukewarm water, milk or juices.Store in dry place in the supplied bottle/box
Tablets

 

 

Hand hygiene (Washing hands for 30 seconds with soap) and dry hands. Use of medical gloves and protective equipments for crushing or breaking pillsTablet desired dosage to be calculated on per hour basis, stock strength, units of weights for tablet (in mg/g), number of tabletsIt is administered orally.In a clean and dry place that away form heat or direct sunlight
Wafers

 

 

Wash hands and dry them, wear gloves to peel the wafer tablet foil strip and use of forceps to handle and give to the patient.Dose (in mg), number of days, minimum dosage interval

 

It is administered orally by placing on the patient tongue or under the tongue if it is a sublingual wafersStore this medication in a dry place away from moisture in their designated pack till the time of implantation

Store medication at temperature (20°C or below )

Suppositories

 

 

 

Proper hand hygiene (wash hand thoroughly with warn water and soap before and after giving this medication), and use of medical disposable gloves for application of water based lubricant on the area and insertion.Body weight of the patient for dosage ( in mg) of  1 mg to 500 mg and no. of hours (dosage interval )

 

To moisten the suppository with lukewarm water or apply water based lubricant on the insertion area; insert the tapered end of the drug gently till 1 and half inch into the rectum and close buttocks for 10-15 mins while keeping the patient in lying position.Store in the supplied pack and in a cool and dry place

Store the pack away from the moisture

Storage temperature is required below 25°C

 Question 8

Complete the following table by accessing the organisations policies and procedures.

 

Medication administrationPolicy and procedure
Oral

 

 

To be done as per the prescription, administered by the delegated staff member

Follow hand hygiene

Check the prescription for AM/ PM , dosage amount, dosage interval

Remain with the patient to ensure  medication is swallowed

Sublingual, buccal

 

 

 

Administered by the delegated staff member

Check for correct dose

Use of non-touch technique

Use of gloves and forceps and dropper

Placement of medicine on correct site so that it does not enter in between the teeth

Staff to be remained present to ensure the given medicine is absorbed and not swallowed with water/ other liquid.

Dry powder inhalers

 

 

 

In compliance to the ordered prescription

Accurately measure the dose of powder for intake metered amount of Medication delivered expressed in mg of formulation (as equivalent to metered amount) and documented

Guide patient for procedure and technique

Stay with patient during the treatment course

Metered dose, spacer inhalers

 

 

 

Check prescription for medication solution, dosage amount in mg or puffs, frequency of dose, and dosage interval

Educate patient of therapy and procedure

Hand hygiene

Appropriate method of administration either by mouthpiece or by spacer with mask in case with face injuries

One minute waiting time before giving second or subsequent puff  from previous puff

Monitor patient’s respiratory rate and pulse before and after administration

Subcutaneous injection

 

 

 

 

Administered by trained nurse

Indentify, verify and assess patient

Care for infection control

Pinch technique to inject

Ensure SC route and site is suitable

In frequent case, rotate the injection site (2.5 cm from the preceding site)

Follow injection process stated under the nursing procedure

IV injections

 

 

 

 

Administered by the trained nurse

Check for medication volume and concentration required as undiluted or diluted

Proper hand hygiene

Use of PPE

Refer Visual Inspection Phlebitis score

Inspect and monitor site

document findings

Z-track injections

 

 

 

Administered by trained nurse to create a Z track

Educate patient about the procedure

Perform hand hygiene and use gloves

Check injecting volume as per prescription

Clean of injection area with antiseptic solution

Relax muscle before injecting

Peripheral IV infusion, cannulation fluid

 

 

 

Administered by the trained  nurse

Patient verification

Careful assessment of site for catheter position, limb symmetry, infiltration, etc.

Patient assessments for any signs erythema, swelling, pain

Refer Visual Inspection Phlebitis score

Hourly monitoring of patient for pressure injury/ sore and infection signs.

Enteral administration – Percutaneous Gastrostomy (PEG) as well as nasogastric tubes

 

 

 

Administered by the registered nurse

Verify patient

Assess the position of  PEG/ tubes

Monitor the insertion site for swelling and patient sign and symptoms for adverse reaction

Tubes to be flushed with purified water prior to and after the drug administration

Minimal handling (touch) or non-touch procedure need

Single use of tube administration set

Change the administration set after 24 hours

Document findings

Ocular

 

 

 

 

Chose appropriate route depending on eye area among topical, systemic and local ocular (intravitreal, intracameral, subconjunctival, retrobulbar)

Hand hygiene

Cleanse area with clean wipes

Use of non-touch technique

Shake solution/ suspensions before use

Rectal

 

 

To be performed by competent healthcare practitioners

Decontaminate hand

Ensure patient comfort and privacy

Ensure empty bowels before administration

Choose appropriate position for administration

Use of disposal gloves, tissues and wipes

Subcutaneous, intramuscular routes

 

 

 

Assess patient

Use clinical judgement for locating site

Ensure needle size is suitable for site

Check and correct the injectable volume

Use of aseptic and non-touch technique

Pinch to inject

Disposal of use equipment and needle as per the organization guideline and procedure

Monitor patient

Sub-cutaneous injection using pre-loaded syringes or pens

 

 

 

Perform hand hygiene and use PPE as required

Confirm appropriateness of right-size needle for the patient

Check the syringe line of the dose as per prescription and discard the excessive medicine

Pinch the area and needle injected at 45-degree angle for little fat and 90-dergee angle for more fat on body site.

Monitor site and document findings

Topical, including transdermal

 

 

 

Use of gloves

Follow the standard precaution of not touching the medication directly

Clean the affected skin area before the  next dose of this form of  medication application

Locate site on chest, upper arm , flank or back(For children choose only back site for transdermal application)

Clean the site and let it dry

Remove old patch and dispose it as per the organisation procedure/ guidelines

Vaginal

 

 

 

 

Hand hygiene

Identify patient

Use of clean and non-sterile gloves

Use of applicator ( if required)

Provide sufficient privacy

Educate patient about the administration route and procedure

Follow right of medication administration

Keep the patient on lying position for 30 minutes after administering medicine

Ventrogluteal injection technique

 

 

 

Carefully locate and confirm the ventrogluteal IM site

Use of longer needle with a big gauge

Use aseptic technique

Needle to be inserted at an angle of 90-degree which is perpendicular to the patient body/ insertion area

IV medication administration methods
Bolus

 

 

 

Perform hand hygiene

Verify the identity of patient for this medication method

Check prescription for volume of dosage

Assess patient for allergies

Check for medicine compatibility with IV solution

Use of disposable gloves

Prepare medication carefully in clean area with clearly labelled and new equipments/ material

Monitor the patient after the medication

Gravity

 

 

 

 

Verify patient

Assess patient

Check volume of medication

Remove the medication from refrigerator at the time of IV administering

Wash hands using anti-bacterial serum

Use of gloves

Gather fresh equipment, inspect the equipment and check label

and prepare medication in clean area

No touching of uncapped syringe

Calculate – infusion rate for drops per minute

Electronic pump infusion

 

 

 

 

Performed by specialised nurses

Hand hygiene

Use  of sterile technique

Prepare the intravenous medication as per organisation guideline and procedure

Calculate IV rate and assess the correct rate and volume in ml per hour

Via burette

 

 

 

Verify and assess patient

Ensure burette capacity is sufficient to hold the medication amount/ volume of to be injected as per prescription per hour  basis

Check burette airway (needs to be open)

Use of aseptic technique

Label the burette

Ensure correct calculation of IV rate

Monitor patient

IV piggyback, tandem

 

 

 

Performed by specialised and trained nurses/ medical practitioners

Hand hygiene

Administer through an IV infusion pump or gravity

Use of aseptic technique

Prepare medication as per organisation guideline and procedure

Calculate correct IV rate and dilution in IV solution

Syringe driver

 

 

 

Familiarise with manufacture instruction

Refer syringe-driver medication charts

Check indications for use of this subcutaneous medication

Performed by trained nurses

Performed by nurses under the supervision of trained nurses/ medical practitioners/clinicians

Regular monitoring

Sub-cut lines

 

 

 

Assess the patient for dehydration clinical symptoms

Refer indications for use of this medication

No additive to be added to infusion.

By gravity infusion

Locate healthy and clean skin site for insertion

Performed at an controlled rate (not more than 80ml per hr)

Not to be given fluid more than 2 L in 24 hours

Monitor the patient for infection

 ASSESSMENT TOOL 3

Practical Client Assessment

 

When administering medication you are required to adhere to the Nursing and Midwifery Board of Australia professional practice standards, codes and guidelines.  You are required to be fully supervised by a Registered Nurse at all times in the workplace when administering medication.

 

Client One- Oral medication

 

Comments
Identifies indication
Verifies the validity of the medication order
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Performs hand hygiene
Abides by the general concepts of working with therapeutic substances when administering medications
Gathers equipment, depending on type of medication

–       Medication trolley

–       Medication sheet

–       Fresh water and glass

–       Pill cutter or crusher

 

Displays problem-solving abilities eg positions clients, obtains appropriate form of medication, assesses client, provides privacy
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Prepares the medication following organisations policies and procedures
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates ability to link theory to practice

 

Client Two- Oral medication

 

Comments
Identifies indication
Verifies the validity of the medication order
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.

 

Performs hand hygiene
Abides by the general concepts of working with therapeutic substances when administering medications
Gathers equipment, depending on type of medication

–       Medication trolley

–       Medication sheet

–       Fresh water and glass

–       Pill cutter or crusher

 

Displays problem-solving abilities eg positions clients, obtains appropriate form of medication, assesses client, provides privacy
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Prepares the medication following organisations policies and procedures
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates ability to link theory to practice

 

Client Three- Oral medication

 

Comments
Identifies indication
Verifies the validity of the medication order
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Performs hand hygiene
Abides by the general concepts of working with therapeutic substances when administering medications
Gathers equipment, depending on type of medication

–       Medication trolley

–       Medication sheet

–       Fresh water and glass

–       Pill cutter or crusher

 

Displays problem-solving abilities eg positions clients, obtains appropriate form of medication, assesses client, provides privacy
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Prepares the medication following organisations policies and procedures
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates ability to link theory to practice

 

Client Four- Sub-cutaneous injection

 

Identifies indication
Verifies the validity of the medication order
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Performs hand hygiene
Gathers equipment

–       Syringe, needles

–       Alcowipes, gauze swab

–       Kidney dish or similar

–       Ordered medication in viral or ampoule

–       Sharps container

–       Medication sheet

Adheres to the general concepts of working with therapeutic substances following organisations policies and procedures
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Draws up medication using an Aseptic Non-Touch Technique to prepare medication
Displays problem-solving abilities eg positions client, obtains appropriate form of medication, assesses client
Locates and assesses appropriate site
Safely administers medication to maximise effects and minimise discomfort
Tends to puncture site appropriately
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

Client Five- Sub-cutaneous injection

 

Identifies indication
Verifies the validity of the medication order
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Performs hand hygiene
Gathers equipment

–       Syringe, needles

–       Alcowipes, gauze swab

–       Kidney dish or similar

–       Ordered medication in viral or ampoule

–       Sharps container

–       Medication sheet

Adheres to the general concepts of working with therapeutic substances following organisations policies and procedures
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Draws up medication using an Aseptic Non-Touch Technique to prepare medication
Displays problem-solving abilities eg positions client, obtains appropriate form of medication, assesses client
Locates and assesses appropriate site
Safely administers medication to maximise effects and minimise discomfort
Tends to puncture site appropriately
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

Client Six- Sub-cutaneous injection 

Identifies indication
Verifies the validity of the medication order
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Performs hand hygiene
Gathers equipment

–       Syringe, needles

–       Alcowipes, gauze swab

–       Kidney dish or similar

–       Ordered medication in viral or ampoule

–       Sharps container

–       Medication sheet

Adheres to the general concepts of working with therapeutic substances following organisations policies and procedures
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Draws up medication using an Aseptic Non-Touch Technique to prepare medication
Displays problem-solving abilities eg positions client, obtains appropriate form of medication, assesses client
Locates and assesses appropriate site
Safely administers medication to maximise effects and minimise discomfort
Tends to puncture site appropriately
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

 

Simulation Seven- Intramuscular injection

 

Identifies indication
Verifies the validity of the medication order
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Performs hand hygiene
Gathers equipment

–       Syringe, needles

–       Alcowipes, gauze swab

–       Kidney dish or similar

–       Ordered medication in viral or ampoule

–       Sharps container

–       Medication sheet

Adheres to the general concepts of working with therapeutic substances following organisations policies and procedures
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Draws up medication using an Aseptic Non-Touch Technique to prepare medication
Displays problem-solving abilities eg positions client, obtains appropriate form of medication, assesses client
Locates and assesses appropriate site
Safely administers medication to maximise effects and minimise discomfort
Tends to puncture site appropriately
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

 

Simulation Eight- Intramuscular injection

 

Identifies indication
Verifies the validity of the medication order
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Performs hand hygiene
Gathers equipment

–       Syringe, needles

–       Alcowipes, gauze swab

–       Kidney dish or similar

–       Ordered medication in viral or ampoule

–       Sharps container

–       Medication sheet

Adheres to the general concepts of working with therapeutic substances following organisations policies and procedures
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Draws up medication using an Aseptic Non-Touch Technique to prepare medication
Displays problem-solving abilities eg positions client, obtains appropriate form of medication, assesses client
Locates and assesses appropriate site
Safely administers medication to maximise effects and minimise discomfort
Tends to puncture site appropriately
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

 

Simulation Nine- Intramuscular injection

 

Identifies indication
Verifies the validity of the medication order
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Performs hand hygiene
Gathers equipment

–       Syringe, needles

–       Alcowipes, gauze swab

–       Kidney dish or similar

–       Ordered medication in viral or ampoule

–       Sharps container

–       Medication sheet

Adheres to the general concepts of working with therapeutic substances following organisations policies and procedures
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Draws up medication using an Aseptic Non-Touch Technique to prepare medication
Displays problem-solving abilities eg positions client, obtains appropriate form of medication, assesses client
Locates and assesses appropriate site
Safely administers medication to maximise effects and minimise discomfort
Tends to puncture site appropriately
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

 

Simulation Ten- Peripheral IV injection

 

Identifies indication
Verifies the validity of the medication order
Assesses patient IV site and drug. Assesses patient IV site and drug. Accurately uses the Visual Infusion Phlebitis Score (VIPS).
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Gathers equipment

–       Medication sheet

–       Required medication

–       Syringes and needles

–       Alcowipes

–       Injection tray

–       Sharps container

–       Gloves

–       Watch with a second hand

Performs hand hygiene
Adheres to the general concepts of working with therapeutic substances following organisations policies and procedures
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Prepares the syringe with medication, saline and/or heparin
Wears gloves
Injects medication into an existing line
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

 

Simulation Eleven – Peripheral IV injection

 

Identifies indication
Verifies the validity of the medication order
Assesses patient IV site and drug. Accurately uses the Visual Infusion Phlebitis Score (VIPS).
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Gathers equipment

–       Medication sheet

–       Required medication

–       Syringes and needles

–       Alcowipes

–       Injection tray

–       Sharps container

–       Gloves

–       Watch with a second hand

Performs hand hygiene
Adheres to the general concepts of working with therapeutic substances following organisations policies and procedures
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Prepares the syringe with medication, saline and/or heparin
Wears gloves
Injects medication into an existing line
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

 

 

Simulation Twelve – Peripheral IV injection

 

Identifies indication
Verifies the validity of the medication order
Assesses patient IV site and drug. Accurately uses the Visual Infusion Phlebitis Score (VIPS).
Evidence of effective communication with the client Explains medication (the name, purpose, action and potential side effects of drugs) and procedure to client.
Gathers equipment

–       Medication sheet

–       Required medication

–       Syringes and needles

–       Alcowipes

–       Injection tray

–       Sharps container

–       Gloves

–       Watch with a second hand

Performs hand hygiene
Adheres to the general concepts of working with therapeutic substances following organisations policies and procedures
Uses the “rights of medication administration” and performs drug calculation with 100% accuracy
Prepares the syringe with medication, saline and/or heparin
Wears gloves
Injects medication into an existing line
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

 

Simulation Thirteen- Removal of Peripheral IV Cannula

 

Comments
Identifies indication
Evidence of effective communication with the client.
Gathers equipment

–       Gloves

–       Cotton wool

–       Tape

–       Receptacle

Watch with a second hand

Perform hand hygiene, wearing non-sterile gloves, carefully remove the dressing, holding the cannula in place at all times.
Slowly withdraw the cannula, maintaining a neutral angel with the skin.
Cover site with cotton wool and tape or Band-Aid.
Advise the client hat the cotton wool and tape or Band-Aid should remain in situ for 24 hrs.
Document date and reason of removal
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

 

Simulation Fourteen- Removal of Peripheral IV Cannula

 

Comments
Identifies indication
Evidence of effective communication with the client.
Gathers equipment

–       Gloves

–       Cotton wool

–       Tape

–       Receptacle

Watch with a second hand

Perform hand hygiene, wearing non-sterile gloves, carefully remove the dressing, holding the cannula in place at all times.
Slowly withdraw the cannula, maintaining a neutral angel with the skin.
Cover site with cotton wool and tape or Band-Aid.
Advise the client hat the cotton wool and tape or Band-Aid should remain in situ for 24 hrs.
Document date and reason of removal
Documents and reports relevant information
Cleans, replaces and disposes of equipment appropriately
Demonstrates and ability to link theory to practice

 

Workplace SupervisorWorkplace Assessor

The student’s knowledge is:

Feedback to student:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Competent

1

Not Competent

1

Feedback to student:

 

 

 

 

 

Student signature: Student signature:

 

Workplace Supervisor signature: Assessor signature:

 

Date:Date:

 

 

Assessment Tool 3

VERBAL Assessment

Question 1

What are peripheral IV devices?

Peripheral IV devices are referred to as cannula or catheter devices. These are used for therapeutic reason for blood products administration, and fluids and medication administration. These devices are inserted into the peripheral vein.
Feedback to student

 

 

Question 2

Discuss what is meant by the term aseptic technique.

The aseptic technique is the procedure, rules and safe practices used to avoid pathogen contamination and to minimise the infection risk. The technique are required to be followed by nurses, clinicians and other medical practitioners healthcare setting involving surgery room, outpatient care centre area and other clinical areas.  For example, maintaining personal hygiene, performing proper hand hygiene, and the use of disposable gloves.
Feedback to student
Question 3

What is meant by the term phlebitis

 

Phlebitis is vein inflammation. This can be due to blood clots and injury to the vein. It is most commonly witnessed in leg vein.  It can occur in three form chemical phlebitis (due to fluid/ drug infusion), mechanical phlebitis (movement of foreign entity) and infective phlebitis.

Feedback to student
Question 4

What is meant by decontaminate hands?

The decontaminated hands are free from any contamination of the visible solid substances, dust or dirt and from the potential infectivity from body fluids.
Feedback to student

 

 

Question 5

When does Infiltration occur? How would you use the Visual Infusion Phlebitis Score (VIPS)

 

 

 

 

 

Feedback to student

 

 

 

 

Question 6

When does Extravasation occur?

 

 

 

 

Feedback to student
Question 7

What is a Haematoma?

It is bleeding from broken capillaries resulting in the swelling outside of the blood vessels area. This sweeping of blood can be due to surgery, disease, and injury to capillaries/ into the tissues.
Feedback to students
Question 8

Discuss the pump’s used in the facility.

 

 

 

 

Feedback to students
Question 9

What is meant by double checking

 

 

 

 

Feedback to students

 

 

Assessment Tool 3

Medication Log

 

Health professionals such as Nurses, Paramedics, Podiatrists and Optometrists require a detailed understanding of the pharmacological properties of the medicines that are used daily in the treatment of patients under their care. Complete the following log book of the medications that you have administered.  If you have not had an opportunity to administer a medication from a medication group, complete the log book using a MIMMS.

 Medication Groups

 

GroupPathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
AnaestheticsThe pathophysiology related to general/ local anaesthetics includes

loss of consciousness, memory affect ( partial loss or complete loss), loss of pain feeling (incapable to feel)  analgesia, loss of sensation, relaxation of muscles, respiratory suppression and  nerve propagation disrupted

Methohexital Brevital Sodium Single dose 50-120 mg (no scheduling of daily dosage)Weight of patients, concentration of anaesthetic in mg, dilution in ml, required dosage volume in mlConfusion  and feeling of numbness when coming out  ( after feeling awake)

Rapid heartbeat

Shallow breathing

Swelling around injection site

 PropofolDiprivan Single dose (can be 2mg/ kg)Weight of patient, concentration of anaesthetic in mg, required dosage volume in ccFeeling of passing out after feeling awake

Weak breathing

Discomfort and pain in the injection site

mild itching around injection site

slight burning in the region of the IV needle

Halothane FluothaneAdults- dose concentration is 2–4% Child- the concentration is 1.5–2%

(in oxygen or with nitrous oxide– oxygen)

Concentration of required dosage

 

Respiratory depression

Arrhythmias

Bradycardia

Hepatic damage

Tetracaine AmetopArea in sq. cmOne to five tubes ( 40-45 minutes) Oedema

Skin itching

Skin flushing and blistering in the treated area

Thiopental sodium PentothalFor average weight adult – 50 to 75 mg which is 2-3ml of a 2.5% solution and for heavy weight ( more than 70 kg) an initial dose of 75-125 mg and up to 4mg/kg after 60 seconds if requiredPatient weight,  concentration/ strength and volume of dosage

Consider age

Feeling of continuous drowsiness,

Weak and/ or trouble breathing

slow heartbeats;

Body shivering/ chills

Respiratory distress

Coughing

Bronchospasm

Laryngeal spasm

AntacidsCondition of  excessive amounts of acids production in stomach

Mucus secretion

Lower the stomach acid

Secretion of  bicarbonates

Secretion of prostaglandins

Magnesium Hydroxide Milk of Magnesia 30-60 mL/ dayCalculation of dosage in mLs for per day

Concentration of the drug in mg per mL

Drowsiness

Feeling of passing out

Slow heartbeats

Nausea and severe vomiting

Rectal bleeding

No bowel movement

Pantoprazole

 

 PeptacChild: 5-10 mg/kg

Adult: 150-300mg

Weight of Emily

Required dose in mLs per day  or in mg

Concentration in mg per mL

body weight and stock strength

 

Abdominal discomfort and slight to severe pain

Diarrhea

Constipation

nausea and vomiting

Aluminum hydroxide/ magnesium carbonate

 

 Gaviscon Adults: Tablets – 2–4 tabs

Liquid – 10 mL to 30 mL

Body weight, stock strength, concentration in mg/kg or in ml

Require dosage, dosage interval

Diarrhea

Constipation

Nausea

Severe headache

Dehydration

 

 

 

Hydrotalcite

 

 Altacite Plus Adults:  2–4 tabs ( up to 500 mg)

Child 1-2 tablets

Weight of patient

dosage in mLs/ day, dosage interval, stock strength

Concentration of the drug in mg per mL

Diarrhoea

Nausea and vomiting

Chest tightness

Constipation

Difficulty in breathing

Hives

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
AntianginalsCondition of imbalance among the myocardial supply and demand of oxygen

Descending artery –coronary atheroma

Rise in ventricular pressure (end diastolic left)

During diastole – Sub-endocardinal crunch in ischemia area

Reduce the heart rate

Increase the coronary blood flow

Re-distribution of the coronary blood flow

Ranolazine

 

 Ranexa 0.4 to 0.8 mg in 15 minutes as spray

0.3 to 0.6 mg as sublingually tablet in 15 minutes

2.5 to 6 mg  as capsule

Required dosage, dosage interval in minutes, stock strength, drug concentration,

dosage interval

Feeling of passing out

severe dizziness

chest pain

nausea

headache

constipation

little or painful urination

Swelling in feet

fast heartbeats

Shortness of breadth

Nitroglycerin

 

 Rectiv 0.2 mg/ hr to 0.6 mg/ hr and

100 mcg/ mL to  400 mcg/ mL

Weight of patient, stock strength, required dosage in mLs day for per hour and per day  and concentration

in mcg per mL

Feeling of light headedness

Moderate to severe dizziness

Headaches

Dry mouth.

Low blood pressure

Rapid  heartbeat

 

Isosorbide dinitrate

 

 Isordil / Dilatrate-SR Oral dosage- 5 to 40 milligrams (mg) two to three times in a day

Sublingual dosage – 2.5 to 5 mg in 15 minutes

Stock strength, drug concentration, required dosage, dosage interval, body weightPale skin

Bluish colour in  palms, fingernails and  lips

Dark coloured urine

Sore throat and fever

Pain in arms and back

Chest discomfort and heaviness

Confusion feeling

Headache

Unusual tiredness

Dizziness

Blurred vision

Faintness when getting up rapidly from a sitting , resting or lying position

Sweating and fainting

Irregular heartbeat

Difficulty with breathing

Nitroglycerin sublingual NitrostatSublingual dosage- one to three tablets in 15 minutes depending on severityRequired dosage, Stock strength, drug concentration, dosage intervalDizziness

Unusual sweating

Fainting

unusual weakness

Chest pressure/ heaviness

Pain in chest and spreading  to back, shoulders and jaw

Nitroglycerin (transdermal) Minitran 0.2mg/hr or 0.4mg/hr patch  for 12 hours or a dayDosage interval, required strength in mg per hour and per dayIncreasing chest pain

Mild dizziness

light-headed feeling

Moderate to severe headache

Pale skin and or bluish coloured fingers and toes

Slower heart rate

 

Antianxiety

 

Increase action of brain chemical

Stimulate receptors on nerves

Change in the receiving chemical messages

FluoxetineProzac10 to 80 mg per day in capsule formStock strength, drug concentration, required dosage in mg, dosage intervalNausea,

Anxiety

loss of appetite

unusual weight loss

unusual drowsiness and dizziness

unusual tiredness

trouble sleeping,

severe mood changes

muscle spasm

fast/irregular heartbeat

eye redness, pain and swelling

Change in vision

DiazepamValiumAdults: 2 mg to 10 mg depending on severity and Child: 1mg to 2.5 mg

Dosage – 2-3 times a day

Stock strength, drug concentration, required dosageDrowsiness and dizziness

Tiredness, restlessness and unsteadiness

Weakness in muscle (difficulty in walking)

Blurred vision

Yellow coloured skin and yellowing eyes

Mood swings

Confusion

Hallucinations

Trouble urinating

Sore throat with  fever

LorazepamAtivan1 to 10 mg per day in tablet formstock strength, required dosage in mg,  dosage intervalSevere dizziness and drowsiness, headache

Nausea,

constipation

Change in appetite

Mental changes like depression, suicidal thoughts and/ or hallucinations, vision changes

Memory problems

Unusual weakness causing  trouble in walking

Fever with  persistent sore and swelled throat, trouble sleeping and breathing yellowing of skin and eyes

Rash and itching in  the  tongue and face

AlprazolamXanax0.25 to 0.5 mg – 3 times a day in tablet formstock strength, required dosage in mg,  dosage intervalHigh drowsiness, lightheaded and dizziness

yellowing eyes or skin

Tongue and throat swelling

slurred speech

hallucinations

High saliva production

Breathing trouble

Loss of coordination and difficulty in  Trouble in walking

Antiasthma Mechanism of genomic and non genomic

Anti-inflammatory action

Albuterol  sulfateProventilDilution – 5 mL  in 500 mL of Sodium Chloride-Dextrose or in Sodium Chloride InjectionRequired dosage, stock strength, drug concentration in ml, dilution in ml, dosage intervalNervousness

Mouth/throat dryness

Cough

Dizziness

Headache

Muscle cramps

Chest pain

Trouble sleeping

Persistent nausea

ZafirlukastAccolate20 mg to 40 mg per daystock strength, required dosage in mg,  dosage interval,Cough

Headache

Sore throat

Fever

Abdominal pain

Moderate to severe Stomach pain

Difficult urination and dark coloured urine

Persistent nausea/vomiting

Yellowing of the eyes and skin

BenralizumabFasenra30 mg once every 4 weeksStock strength, required dosage in mgRapid heartbeat

Rashes and itching in skin, skin redness

Fever

Headaches

joint pain or swelling

swelling in face, hands,

Chest tightness

Trouble in breathing

Trouble in swallowing

FormoterolForadil Aerolize / PerforomistCapsule dosage: 12-mcg to 24 mcg in 24 hoursDosage strength, required dosage in mcg,  dosage interval, body weightPain in body , headaches

Chest pain

Fever

sore throat

Cold and cough

nasal congestion

Difficulty in breathing, shortness of breath

unusual tiredness/ weakness

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
AntiarrhythmicsIrregular heath activity and rhythms uneven electrical activity

Change in cardiac conduction action and pathways

Adenosine

 

 Adenocor In solution: 3mg/ml sStock strength, drug concentration, required dosage in mg per ml,  dosage interval, Bradycardia

Atrioventricular block

Breadth shortness

Nausea

Headache , pressure in head

Dizziness

Palpitations

Rise in blood flow (flush) to skin

 Amiodarone

 

 Cordarone Tablets: 400 to 1,600 mg per dayDosage/ stock strength, required dosage in mg,  dosage interval, body weight Neurologic problem ( fatigue, poor coordination, tremor, malaise)

Gastrointestinal problem (constipation, nausea, vomiting)

Ophthalmic problem (blindness, eye discomfort, lens opacities, corneal degeneration and macular degeneration)

Moricizine Ethmozine 600 mg to  900 mg per dayRequired dosage in mg per day, Stock strength,   dosage interval, body weight Dizziness

Pain and headache

Nausea and vomiting

Dyspnea

Fatigue

Hypesthesia

Flecainide

 

Tambocor 50 mg -400 mg per dayStock strength, required dosage in mg per day,  dosage interval, body weightWeak pulse and slow heart rate

Fainting

Dizziness

High potassium (muscle weakness)

Fast weight gain

Jaundice

Disopyramide phosphate

 

 Disopyramide 150 mg -800 mg per dayDosage/ stock strength, required dosage in mg,  dosage interval, body weightFeeling of dizziness and passing out

Fainting

Chest pain

Heartbeat sensations

Swelling of feet, lower legs

Fever

Sore throat

AntibioticsIncrease activity of immune system

Hinder and Block process in microorganism

 

Erythromycin

 

 Erythrocin 250 mg to 500 mgRequired dosage in mg, Stock strength, dosage interval, body weightPersistent Nausea and vomiting

loss of appetite

Liver problem ( yellowing of skins and eyes, dark coloured urine)

Persistent Diarrhea

unusual tiredness

muscle weakness

blurred vision

hearing loss

irregular heartbeats

 

 

 

Azelaic Acid

 

 Skinoren 2.5 cm  for 1 inch of cream per daySkin area in sq cmSkin Burning

Skin itching and dryness

Skin redness

Pruritis

 MetronidazoleRozex7.5 mg/kg to 4 g in 24 hoursRequired dosage in mg per kg, Stock strength, dosage interval, body weightSkin burning and redness

Skin itching and irritation

Skin dryness and rash

Allergic reactions  (swelling of face, lips, mouth, tongue)

Hives

Chest heaviness and pressure

Doxycycline

 

 Efracea 40 mg daily doseStock strength Stomach discomfort

Abdominal pain

Nasopharyngitis

Hypertension

Sinusitis

Diarrhea

Anxiety

TretinoinAknemycin Plus Topical- 0.05% on skin area

30-250 mg/ kg  per day

4%/ml solution as lotion

Required volume of dosage, drug concentration in ml and in mg/ kg, Stock strength, dosage interval, body weight Blisters

Diarrhea

Edema

Erythema

Skin Dryness, itching, rash

Epigastric pain

Fever

Ototoxicity

Nausea and vomiting

AnticholinergicsBarrier of muscarinic receptors in autonomic nervous systemUmeclidinium and vilanterol (inhalation powder)

 

 Anoro Ellipta 1 inhalation in 12 hoursDosage concentration, stock strengthDry mouth

Chest pain

Dehydration

Nausea

Vomiting

Tremors

anxiety

Blurry  vision

Tiotropium

 

 Braltus 10 mcg per doseDosage interval, stock strengthDry mouth

Dehydration

Glaucoma

Palpitations

Bronchospasm

Nausea

 

 

 

 

 

 

AnticoagulantsPathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
Mechanism of  clotting mechanism Intravascular blood flow change

 

PhenindionePhenindione, Dindevan, Fenindion50-200 mg in 24 hoursDosage required, body weight, drug concentration, stock strength, dosage intervalLiver inflammation

Bleeding

Bruising

Skin rash

Skin necrosis

Fever

Sore throat

Diarrhea

Vomiting

Orange coloration of urine

 

 

 

 

 

 

AnticonvulsantsDecrease the ongoing excitation. Changes in the electrical activity in neuronsPerampanel Fycompa 2 mg to 12 mgDosage required, drug concentration, stock strength, dosage interval Depression

Falls

Dizziness

Blurred vision

Dysarthria

Vertigo

Fatigue

Somnolence

AntidepressantsPathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
Changes in neurones

Increase in biogenic amines at nerve terminal

 

ClomipramineAnafranil25 mg to 250 mgRequired volume of dosage, drug concentration in in mg, Stock strength, dosage interval, body weightDry mouth

Dyspepsia

Anorexia

Constipation

Nausea

Somnolence, dizziness,

Anxiety

Tremor

 

 

 

 

 

 

 

AntidiarrhoealsChange in motility speed and increase  absorption time

Mucosal absorptive mechanisms

 Loperamide Imodium 8 mg to 16 mgRequired dosage, drug concentration in in mg, Stock strength, dosage interval, body weight Hives

Skin rash

Constipation

Stomach pain and discomfort

Dizziness, Drowsiness

Dry mouth

Vomiting

Unusual Fatigue

 

 

 

 

 

 

 

 

 

 

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
AntiemeticsStomach lining action

Change the motion sensing ability

Promethazine

 

 Phenergan 12.5 mg  to 25 mg in 12 hoursRequired dosage amount, drug concentration in mg/ kg, Stock strength, dosage interval, body weightDrowsiness

Dizziness

Somnolence

Confusion

Disorientation,

Blurred vision

Fatigue,

Euphoria

Tremors

Dry mouth

Nausea and vomiting

Respiratory depression

 

 

 

 

 

 

 

 

AntifungalsInteraction with fungal sterols in membrane

synthesis inhibition of fungal sterol

Ketoconazole NizoralChild: 3.3 mg/ kg to 6.6. mg / kg

Adult : 200 mg-

400 mg

Required  dosage, drug concentration in mg and  in mg/ kg, Stock strength, dosage interval, body weightGynecomastia

Insomnia

Anxiety

Headache

Abdominal pain,

Somnolence

Paresthesia

Photophobia

Epistaxis

Vomiting, nausea,

Diarrhea

 

 

 

 

 

 

 

 

  
PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
AntihistaminesBinding towards H1 cellular receptorsCetirizine Zyrtec 5 mg to 10 mgRequired dosage, drug concentration in mg/, Stock strengthTremors

nose bleed

Dizziness

Nausea

tongue discoloration

Dry mouth

headache

fatigue

diarrhea

malaise

trouble  breathing

stomach pain

hallucinations

low blood pressure

 

 

 

 

 

 

 

 

AntihypertentivesChange in body fluid

blood pressure insensitive towards sodium intake

lower systemic circulation overload  circadian blood pressure rhythm stabilise

Enalapril

 

Vasotec 2.5 mg to 80 mgRequired dosage amount, drug concentration in mg, Stock strength, dosage interval, body weight Fatigue

Diarrhea

Rash

Itching

Hypertension

Dizziness

 

 

 

 

 

 

  
 

 

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
Anti-inflammatoryInhibition of cyclooxygenase

Inflammatory stimuli induction

Aspirin

 

 Ecotrin 150 mcg–300 mcg per mLRequired volume of dosage, drug concentration in mcg/ ml, Stock strength, dosage interval, body weightRenal Dysfunction

Anaphylaxis

Salicylism

Confusion

Hallucinations

Seizure

Nausea and vomiting

 

 

 

 

 

 

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
AntineoplasticsManagement of neoplastic cells

Bone marrow function suppression

 

Methotrexate

 

 Rheumatrex 15 to 30 mgRequired dosage, drug concentration, Stock strength, dosage interval, body weightStomatitis

Abdominal distress

Chills

Fever

Nausea, vomiting

Dizziness

  
 

 

 

 

 

 

Antiparkinsoniondopamine neurons loss

Nigrostriatal system degeneration

Carbidopa-Levodopa

 

 Sinemet 25 mg to 1000 mgRequired dosage amount, drug concentration in mg, Stock strength, dosage interval, body weightChest pain

Asthenia

Hypotension/ hypertension

Phlebitis

Palpitations

Diarrhea

Vomiting

Dry mouth

 

 

 

 

 

 

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
AntipruriticWealing disorder

Histamine release

Diphenhydramine Benadryl 12.5 mg to 50 mgRequired dosage, drug concentration in mg, Stock strength, dosage intervaDrowsiness

Swelling

Redness

Severe sore throat

  
 

 

 

 

AntipsychoticsMovement disorders that are drug induced

Increase activity towards serotonin blocking

 Clozapine Clozaril 12.5 mg to 900 mg in 24 hoursRequired dosage, drug concentration in mg, Stock strength, dosage interval, body weightSeizures

Eosinophilio

Hyperglycemia

Dizziness

Constipation

Headache

Hypertension

Dry mouth

Nausea, vomiting

 

 

 

 

 

 

 

 

AntisepticsInteraction with the cell surface

Penetration to target site

Inhibition of growth

 

Povidone-Iodine

 

Betadine 3 applications/dayDosage area in sq cm and dosage intervalSkin irritation

Nausea

erythema

   
 

 

 

 

 

 

 

 

 

 

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
AntiulcerImbalance among the aggressive and defensive factors

Changes in gastroduodenal mucosa

Inhibition of gastric acid secretion

Omeprazole Prilosec 20 mg to 1000 mg in 24 hoursRequired dosage, dosage interval, drug concentration, stock strength Headache

Upper respiratory infection

Abdominal pain

Nausea, vomiting

Asthenia

Flatulence

Diarrhea

 

 

 

 

 

 

 

 

 

 

 

 

AntiviralsPathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
Inhibition of virus development

Growth obstruction

Peramivir

 

Rapivab 100 mg to 600 mg IV in single doseRequired dosage, dilution required, drug concentrationDiarrhea

Constipation

Insomnia

Hypertension

 

 

 

 

 

 

AnxiolyticsIrregular regulation of the neurobiological substratesAlprazolam

 

 Xanax 0.25 mg to 10 mg in 24 hoursDosage required, dosage interval, stock strength, drug concentration Drowsiness

Light-headedness

confusion

Depression

Insomnia

Dry mouth

Constipation

Nausea, vomiting

Diarrhea

 

 

 

 

 

 

 

 

 

 

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
Beta-blockersAltered heart beat

Change in the blood pressure

 Acebutolol Sectral 200 mg  to 800 mg in 24 hoursDosage requires, dosage interval, stock strength, drug concentration Dizziness

Headache

Light-headedness

extreme tiredness

Muscle cramps

Abnormal heart beats

Upset stomach

Constipation

Diarrhea

Lupus erythematous

 

 

 

 

 

 

 

 

BronchodilatorsAirway inflammation

Resistance in the respiratory airway

 

Albuterol sulfate syrup

 

 Ventolin Syrup 2 mg to 32 mgBody weight,  dosage required, drug concentration, dosage intervalShakiness

Tremor

Headaches

Anxiety

Changes in  appetite

 

 

 

 

 

 

 

 

  
PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
ContraceptivesLuteinizing hormone suppression

Ovulation suppression

Thick cervical mucus development

Obstruct endometrial growth

Phenytoin

 

 Dilantin 1 to 3 mg/kg per minute  up to 50 mg per minute as per clinical conditionRequired dosage, drug concentration in mg per kg per  minute, stock strengthSeizure

Cardiovascular Risk

Hepatic Injury

Hyperglycemia

Purple glove syndrome

 

 

 

 

 

 

 

 

CorticosteroidsChange activity of immune system

Change in handling tissue damage

Betamethasone

 

 Diprolene50 g per weekDosage interval, required dosage for area in sq cmSkin bruising

Rash

Irritation, dryness

Allergic contact dermatitis

Perioral dermatitis,

Bullous dermatitis

Miliaria.

Pruritus

Acneiform eruptions

Hypopigmentation

 

 

 

 

 

 

  
 

 

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
DiureticsChanges sodium handling

Lessening sodium re-absorption in nephron at variou sites

 

Furosemide

 

 Lasix 20 mg to 600 mg in 24 hoursDosage required, dose strength, stock strength, dosage intervalchills

fever

lower back pain

unusual bruising

unusual weakness

Mouth and lip ulcers

swollen or painful glands

chest tightness, shortness of breath, wheezing

difficult urination

 

 

 

 

 

 

 

 

 

Electrolyte solutionsElectrolyte imbalance

Rehydration

(in illness related to diarrhea)

 

Electrolyte Oral Solution

 

 Rehydralyte One to two caps in 24 hoursRequired dosage, dosage intervalAllergic reactions on skin and face

Fever

Dry mouth and  eyes

Upset stomach

Nausea

Wheezing and trouble breathing

Chest  tightness

Mood changes

Confusion

Unusual muscle weakness

Seizures

Little urination

  
 

 

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
HormonesObstruction in hormonal activity

Disorder in endocrine

Clomiphene

 

 Clomid Oral: 50 to 100 mg for 5 dayDosage required, stock strength Ovarian enlargement,

blurred vision,

nausea and vomiting

stomach discomfort,

breast discomfort,

 

 

 

 

 

 

 

 

 

 

 

 

Hypnotics/sedativesPathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
Altered sleep behaviour

Complex thinking/ mental changes due to CNS depression

 

Zolpidem tartrate

 

 Ambien 5 or 10 mg in 12 hoursDose require, stock strength, drug strength dosage interval Behavioural changes

CNS-depressant effects

Mood changes – depression

Hives

Swelling (tongue, throat)

Facial swelling

Nausea

Vomiting

Trouble breathing

 

 

 

 

 

 

Hypoglycaemics

 

Metabolic abnolmalities, disorder

Definceiny of insulin

insulin resistance

Rise in output activity of  hepatic glucose

GlipizideGlucotrol2.5 mg to 40 mg in 24 hoursDosage required, drug concentration, stock strength, the patient’s blood glucose levelGastrointestinal disturbances

Nausea

Diarrhea

Constipation

Cholestatic jaundice

Erythema

Skin allergic reaction ( irritation, itching)

InsulinLoss of beta cell function

Disorder in beta-cell function (pancreatic islet)

Insulin glulisineApidra/ Apidra solostar100 units/mLDosage strength required, drug concentration, stock strengthHypoglycemia

Hypokalemia

Lipodystrophy

Lipohypertrophy

 

 

 

 

 

Laxatives/aperientsPathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
GI obstruction

Water absorption in colon

swelling in the intestine

Psyllium(Metamucil)

 

 Psyllium 15mg-30mgDosage interval, drug concentration, stock strength, required dosageStomach pain

Nausea

Vomiting

skin rash

skin itching

rectal bleeding

Facial swelling (including tongue)

Trouble breathing.

Difficulty in swallowing

 

 

 

 

 

 

AnalgesiaSensitization of central nervous system

Increase activity of ionotropic glutamate receptors

Acetaminophen/  paracetamol

 

 Tylenol 15 mg/kg to 1000mgDosage require, drug concentration./ strength, stock strength, dosage interval, body weight

 

Increase sweating

unusual tiredness or weakness

unusual bruising

cloudy urine

little urination

black stools

fever or chills

lower body or back pain

ulcers on the lips or in the mouth

yellow eyes or skin

 

 

 

 

 

 

 

 

 

PathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
Narcotic analgesiaIncrease activity among transmembrane molecules

post-translational modification gene products

formation of receptors

 

MeperidineDemerol50 mg to 150 mg oral tablets (4 hours gap between dose)

Orl solution – reduced to 25% to 50% with phenothiazines and tranquilizers

Dosage strength, stock strength, drug concentration, body weight, dosage intervalAddiction and abuse

Respiratory Depression

Seizures

Severe Hypotension

Adverse Reactions in gastrointestinal tract

Adrenal Insufficiency

Neonatal Opioid Withdrawal Syndrome

 

NeurolepticsComplex central nervous system (CNS) actions

Antagonist effect of D2 receptor,  muscarinic, H1-histaminergic and 5-HT2 receptors neurotransmission,

AripiprazoleAbilify10 to 30 mg in 12-24 hoursDosage strength, stock strength, body weight, dosage intervalWeight gain

Dizziness, Drowsiness

Unusual tiredness,

Light-headedness feeling

headache, and trouble sleeping

Nausea and vomiting

excess salivation

blurred vision

constipation

OphthalmicOcular inflammation

tear film disorder

disorder of the ocular surface

Ciprofloxacin HclCiloxan2 drops each in 12 hoursDosage intervalStinging or burning eyes

Eye discomfort,

Eye pain

Eye itching and redness

blurred vision

Eye discharge

Otic Medicationsmiddle ear inflammationNeomycin and Polymyxin B Sulfates and HydrocortisoneCortisporin otic solution2-4 drops  three to four times in 24 hoursDosage intervalSkin sensitization

Burning and itching

Dryness

Acneiform eruptions

Dermatitis

Skin maceration

Hypopigmentation

 

 

 

Pathophysiology

 

Generic
Name
Brand
Name
DoseCalculation Side
Effect
Nasal medicationsEosinophilic inflammation

Ventilation restriction

Sinus ostia obstruction

Mucus retention

Infection

TriamcinoloneNasacort allergy 24hr2 actuations in each in 24 hoursDosage required strength and dosage intervalNosebleeds

Hives

Facial swelling

Throat and tongue swelling

Fever or chills

Blurred vision

Eye pain

Moderate to severe nose stinging or burning

 

Oxymetazoline nasalDristan/ 12 hour nasalOne drop for 3-4 times a daydosage intervalHives

Swelling in face, lips, mouth, tongue, throat

Cough

Trouble breathing

Severe stinging in nose

Uneven heart rate

Severe headache

Anxiety,

Shortness of breath.

Runny nose

Levocabastine hydrochlorideLivostinOne drop each four times a daydosage intervaldry mouth

unusual  fatigue

Burning in and around nose

Headache

visual disturbance

eye pain/dryness

redness in eyes

erythema

dyspnea

 

IV fluidsReduced circulation to vital organs

Blood or plasma loss of intravascular volume

Metabolic responses to stress I which are non-specific)

Loss of external fluid and electrolyte from the gastrointestinal tract

Internal fluid distribution change and

Handling change in fluid or electrolyte for vital and specific organ in situation of restricted food intake.

sodium chloride injectionNormal Saline (9%)Depends  on the patient body weight, age, and clinical condition- (0.9% or  45% or more )Stock strength, required dosage, drug concentration, dosage duration, body weight

Rate of administration in ml per minute, drops per minutes based on tubing

Infection at the injection site

Phlebitis signs (slight pain, redness)

Extravasation

Hypervolemia

DextroseDextrose 5% in water/

D50W, DGlucose

Intravenously: 20 ml to 100 ml or Oral : 4g  to 20 gadministration rate in ml per minute, drops per minutes based on tubing, dosage durationSkin rash, itching, redness

Hives

blistered skin

Chest tightness

Wheezing and difficulty in breathing,

Sore throat and difficulty in swallowing

fever

Face swelling

Tongue or throat swelling

lactated ringer’s injectionLactated Ringer’sDepends on clinical conditionBody weight, Drug concentration, required dosage in ml per 500 ml or 1000 ml , dosage duration, administration rate in ml per minute, drops per minutesAllergic reactions ( itching, facial and throat swelling, hives)

Coughing

Difficulty in  breathing

fever,

skin redness, swelling and infection at the injection site

 

Sodium chloride (flush)Normal Saline Flush , BD PosiFlush SF, Syrex, ThermojectDepends on clinical conditionDrug concentration, required dosage in ml, dosage duration and Body weight. administration rate in ml per minute, drops per minutesMild to severe irritation around the catheter

Swelling in and around site

Pain

Burning

Redness

Cold feeling

 

§  Drugs commonly used for fluid and electrolyte imbalance:

§  acidifiers, alkalisers

§  diuretics

§  electrolytes

§  replacement solutions.

 

Reduced gastrointestinal perfusion

Reduction in circulating volume of blood’

maldistribution of fluid

Mucosal in the ischaemia region

Mucosal reliability  compromised

Impaired gut function

Systemic inflammatory responses

Micro-circulatory failure

 

Calcium polystyrene SulfonateCalcium resonium15 g to 60 g in 24 hoursRequired dosage in mg or g, stock strength, drug concentration, dosage intervalChest pain, heaviness, tightness

Blood vomiting

Cough with mucus

Sore throat

Fever or chills

Stomach pain, cramps

Abdominal pain

Persistent Dizziness

constipation

dry mouth

wheezing, difficulty in breathing

sodium polystyrene sulphonateResonium A15 g to 60 g dose

20 ml – 100ml as suspension

Required dosage, stock strength, drug concentration, dosage intervalChest pain and tightness

Blood vomiting

Sore throat

cough

Fever , chills

Abdominal pain

Dizziness

Numbness around face

Severe constipation

Increased urination

Amiloride-HydrochlorothiazideAmiloride / ModureticOne two two tablets of 5/50 mg in 24 hoursDosage required, stock strengthModerate to severe headache

Dizziness

Dry mouth

Nausea, vomiting,

loss of appetite,

Muscle weakness, cramps

stomach and/ or abdominal pain, dehydration

Fainting,  seizures

 

 

 

 

 

Sodium FluoridePhos-Flur1.1% as sodium as cream/ paste/gel

0.2% as solution

 

Sock strength, required dosage, drug concentrationUpset stomach

Feeling of throwing up

Hives

Skin rash, itching and redness

Blistered

Chest tightness

trouble breathing

wheezing

difficulty in swallowing, or speaking

Face swelling including tongue and throat.

VitaminsPathophysiologyGeneric
Name
Brand
Name
DoseCalculation Side
Effect
Inadequate dietary intake

Inadequate utilisation

Impaired intestinal absorption

Lower absorption due to deficiency

Decrease level such as folate, calcium

Progression of organ failure

Cardiovascular diseases

PyridoxineVitamin B6, Nestrex0.1 mg to 80mg per dayBody weight, Dosage required stock, strength, drug concentration, dosage intervalDecreased sensation- sensory nerve damage

Headache

Sleepiness

Loss of appetite

Nausea and vomiting

Stomach pain

Numbness

Unstable gait

B Complex-Vitamin C-Folic AcidRenavit0.45 g per dayDosage required, stock strengthUpset stomach

allergic reaction

Skin rash

Skin itching

Facial swelling including tongue

severe dizziness

breathing difficulty

Nut.Tx / Metab.DisordeFruitivitsOral powder-

46 Kcal per 100 gram

Dosage required strength, drug concentration, dosage intervalConfusion

Mood swing, depression

Nausea

Loss Of Appetite

Feeling of unwell

Skin rash and redness

Taste Problem

Bronchospasm

Other

ASSESSMENT TOOL 3

Workplace Assessment Task

Medication Administration – Oral Medications

  • Wash hands
  • Have equipment ready:
  • Medication Chart
  • Medications
  • Delivery device: e.g. medicine cup; spoon; dropper
  • Cup of water for client
  • Do not touch the medications while dispensing
  • Educate the client and request their permission
  • Check that the prescription is valid, the route required and time of last administration
  • Dispense the medication:
  • Check the bottle; box or the blister pack for the generic name of the drug; the dose/strength of each tablet and the expiry date. If a liquid, check the bottle label for generic name; dose per number of millilitres and expiry date.
  • Perform any calculations and have an RN check them if you are unsure
  • Dispense medication into cup without touching the tablet; if a liquid keep the label upright as you pour and have the measuring cup on a flat surface
  • Check the label against the medication order a second time

 

  • Ensure client is in the correct position to be able to take the medicine

 

  • Check the client identification: Check the ID band and verbally ask the client for their full name and date of birth. Can use photo ID if this is provided and is accurate

 

  • Check the client allergy status: ask the client; check the medication chart and check the ID band

 

  • Proceed only if client has no swallowing difficulties

 

  • Allow client to put medications into their own mouth if this is appropriate

 

  • Give client cup of water

 

  • OBSERVE client taking the medication

 

  • Record administration of medication after client has swallowed same

 

  • Record fluid intake

 

  • Observe client for response to medication
Workplace Supervisor

Feedback to student

Workplace Assessor

The student’s knowledge is:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Competent  1Not Yet Competent  1
Feedback to student:

 

 

 

 

 

Student signature:Student signature:

 

Workplace Supervisor signature: Assessor signature:
Date:

 

Date:

 

 

Assessment Tool 4

Supervisor Workplace Observation Statement

 

Instructions for Workplace Supervisor/Third Party

The collection of third party evidence provides assessors with authentic and valid evidence. The completion of this report will provide complementary evidence for the assessor to make the professional judgement about the achievement of competency.

 

Name of Supervisor/Third Party:
Organisation:
Phone:
Email:
Qualifications (please attach)
Relationship to student:
TaskFeedbackDateSupervisor Initials
Check client medication chart in relation to timing and route of medication to be administered   
Raise issues related to drug and poison administration with appropriate personnel 

 

 

  
Check for and identify common contraindications and adverse reactions of prescribed medications and refer to registered nurse   
Confirm client identity and check for any known allergies 

 

  
Refer to drugs and poisons schedules and classifications as determined by law 

 

 

  
Ensure infection control methods are applied correctly   
Identify pharmacology and substance incompatibilities in relation to specific situations involving medication administration   
Check expiry dates of medication prior to administration   
Explain the process of medication administration to the client and ensure their readiness   
Position the client appropriately prior to administration of medication   
Correctly identify administration route for each medication to be administered, using appropriate terminology   
Accurately calculate dosages for administration of drugs   
Prepare medications in accordance with legislative requirements and organisation guidelines   
Apply medication administration techniques and precautions specific to each client situation and as per medication orders   
Ensure medication is stored and disposed of in accordance with medical instructions and organisation policy and procedures   
Administer medications within scope of own role in line with the jurisdictional legislative requirements and organisation policy   
Store medications in a safe manner according to legislative requirements and organisation policy 

 

  
Administer PRN medications within legislative requirements and organisation policy   
Apply quality management and risk assessment practices relating to administration of medication   
Provide client information and education relating to medication requirements   
Record administration of medications in accordance with relevant policy and procedures   
Contribute to information provided to clients and carers on medication administration (including possible side effects) in consultation/collaboration with the registered nurse   
Evaluate client understanding of information provided   
Recognise acute and delayed adverse reactions to medications and act upon within role responsibility   
Implement emergency actions to address acute and delayed adverse reactions within role responsibility   
Record and report response to emergency strategies, where appropriate   
Assess and manage a client experiencing pain using appropriate medication and non-medication therapies   
Record and report effectiveness of pain relieving medication   
Identify the purpose and function of intravenous therapy being administered to a client   
Check for common fluid and electrolyte imbalances and record and report   
Calculate intravenous therapy rates   
Recognise and report the risks and complications associated with intravenous therapy   
Document observations and monitor peripheral intravenous therapy   
Provide nursing care for client with fluid and/or electrolyte imbalance   
Monitor action of drugs commonly used in fluid and/or electrolyte imbalance through client responses and record and report   
Monitor action of drugs commonly used in fluid and/or electrolyte imbalance through client responses and record and report   
Remove intravenous cannula according to organisation policy and procedure   
Observe and question client to identify signs of pain and/or discomfort   
Clarify the location and nature of pain, taking into account factors which may influence a client’s perception of pain   
Use the pain assessment scale to ensure consistency of interpretation   
Undertake comprehensive observations as required to assess pain experienced by client   
Identify and apply a range of medication and complementary strategies which may assist in alleviation of pain and discomfort in consultation/collaboration with registered nurse   
Monitor and evaluate the effectiveness of using these strategies in consultation/collaboration with registered nurse   
Record observations and evaluation of pain management strategies in consultation/ collaboration with registered nurse   

 

Comments

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Supervisor/Third Party Declaration

I declare that I have observed the student perform the workplace assessment/s in line with the criteria stated in the assessments. I confirm that I have not received any inducements to complete this report and have advised of any personal relationship with the student.

 

Signed:Date:

 

 

Position:______________________________________________________________

 

 

ASSESSMENT TOOL 3

Workplace Assessment Task

Medication Administration – Oral Medications

  • Wash hands
  • Have equipment ready:
  • Medication Chart
  • Medications
  • Delivery device: e.g. medicine cup; spoon; dropper
  • Cup of water for client
  • Do not touch the medications while dispensing
  • Educate the client and request their permission
  • Check that the prescription is valid, the route required and time of last administration
  • Dispense the medication:
  • Check the bottle; box or the blister pack for the generic name of the drug; the dose/strength of each tablet and the expiry date. If a liquid, check the bottle label for generic name; dose per number of millilitres and expiry date.
  • Perform any calculations and have an RN check them if you are unsure
  • Dispense medication into cup without touching the tablet; if a liquid keep the label upright as you pour and have the measuring cup on a flat surface
  • Check the label against the medication order a second time

 

  • Ensure client is in the correct position to be able to take the medicine

 

  • Check the client identification: Check the ID band and verbally ask the client for their full name and date of birth. Can use photo ID if this is provided and is accurate

 

  • Check the client allergy status: ask the client; check the medication chart and check the ID band

 

  • Proceed only if client has no swallowing difficulties

 

  • Allow client to put medications into their own mouth if this is appropriate

 

  • Give client cup of water

 

  • OBSERVE client taking the medication

 

  • Record administration of medication after client has swallowed same

 

  • Record fluid intake

 

  • Observe client for response to medication

 

 

 

Workplace Supervisor

Feedback to student

Workplace Assessor

The student’s knowledge is:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Competent  1Not Yet Competent  1
Feedback to student:

 

 

 

 

 

Student signature:Student signature:

 

Workplace Supervisor signature: Assessor signature:
Date:

 

Date:

 

 

 

Assessment Tool 4

Supervisor Workplace Observation Statement

 

Instructions for Workplace Supervisor/Third Party

The collection of third party evidence provides assessors with authentic and valid evidence. The completion of this report will provide complementary evidence for the assessor to make the professional judgement about the achievement of competency.

 

Name of Supervisor/Third Party:
Organisation:
Phone:
Email:
Qualifications (please attach)
Relationship to student:
TaskFeedbackDateSupervisor Initials
Check client medication chart in relation to timing and route of medication to be administered   
Raise issues related to drug and poison administration with appropriate personnel 

 

 

  
Check for and identify common contraindications and adverse reactions of prescribed medications and refer to registered nurse   
Confirm client identity and check for any known allergies 

 

  
Refer to drugs and poisons schedules and classifications as determined by law 

 

 

  
Ensure infection control methods are applied correctly   
Identify pharmacology and substance incompatibilities in relation to specific situations involving medication administration   
Check expiry dates of medication prior to administration   
Explain the process of medication administration to the client and ensure their readiness   
Position the client appropriately prior to administration of medication   
Correctly identify administration route for each medication to be administered, using appropriate terminology   
Accurately calculate dosages for administration of drugs   
Prepare medications in accordance with legislative requirements and organisation guidelines   
Apply medication administration techniques and precautions specific to each client situation and as per medication orders   
Ensure medication is stored and disposed of in accordance with medical instructions and organisation policy and procedures   
Administer medications within scope of own role in line with the jurisdictional legislative requirements and organisation policy   
Store medications in a safe manner according to legislative requirements and organisation policy 

 

  
Administer PRN medications within legislative requirements and organisation policy   
Apply quality management and risk assessment practices relating to administration of medication   
Provide client information and education relating to medication requirements   
Record administration of medications in accordance with relevant policy and procedures   
Contribute to information provided to clients and carers on medication administration (including possible side effects) in consultation/collaboration with the registered nurse   
Evaluate client understanding of information provided   
Recognise acute and delayed adverse reactions to medications and act upon within role responsibility   
Implement emergency actions to address acute and delayed adverse reactions within role responsibility   
Record and report response to emergency strategies, where appropriate   
Assess and manage a client experiencing pain using appropriate medication and non-medication therapies   
Record and report effectiveness of pain relieving medication   
Identify the purpose and function of intravenous therapy being administered to a client   
Check for common fluid and electrolyte imbalances and record and report   
Calculate intravenous therapy rates   
Recognise and report the risks and complications associated with intravenous therapy   
Document observations and monitor peripheral intravenous therapy   
Provide nursing care for client with fluid and/or electrolyte imbalance   
Monitor action of drugs commonly used in fluid and/or electrolyte imbalance through client responses and record and report   
Monitor action of drugs commonly used in fluid and/or electrolyte imbalance through client responses and record and report   
Remove intravenous cannula according to organisation policy and procedure   
Observe and question client to identify signs of pain and/or discomfort   
Clarify the location and nature of pain, taking into account factors which may influence a client’s perception of pain   
Use the pain assessment scale to ensure consistency of interpretation   
Undertake comprehensive observations as required to assess pain experienced by client   
Identify and apply a range of medication and complementary strategies which may assist in alleviation of pain and discomfort in consultation/collaboration with registered nurse   
Monitor and evaluate the effectiveness of using these strategies in consultation/collaboration with registered nurse   
Record observations and evaluation of pain management strategies in consultation/ collaboration with registered nurse   

 

 

 

 

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Supervisor/Third Party Declaration

I declare that I have observed the student perform the workplace assessment/s in line with the criteria stated in the assessments. I confirm that I have not received any inducements to complete this report and have advised of any personal relationship with the student.

 

Signed:Date:

 

 

Position:______________________________________________________________

 

 

 

 

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