Medication Safety
Name 3 of the rights of medication administration
Right medication, right dose, right time, right documentation, right route, right reason
A resident comes to you stating that they are constipated. Which PRN are you giving?
APAP, Mylanta, Acidophilus, or DSS/Colace
DSS/Colace
What medication reverses an opioid overdose?
Narcan (Naloxone)
2
How long should you wash your hands with soap and water?
at LEAST 20 seconds!
You go to give a resident their medicaiton and they state, "these dont look like my pills". What should you do?
Do not administer- go back to the medcart and double check the meds and verify you have the right resident. Complete safety checks (6 rights!)
Mrs. James dropped her APAP onto her Livingroom floor. She tells you housekeeping just cleaned her room and to just give it to her to take. what is your next action?
DO NOT GIVE IT- explain to the resident that you will go get her different tablets to take. Waste the medication in destroyer RX solution and re-administer the medication.
Why would you give someone an epi-pen?
for a severe allergic reaction
- difficulty breathing, facial swelling, tongue swelling, dizziness/lightheadedness, pale skin, rapid/weak pulse
A family member brings you a bottle of Aleve and states they want you to give their mother a dose now because it'll help their arthritis. What do you do?
You open a new bottle of eye drops for a resident. What is one step you must take?
Label the bottle with the date it was opened and when it needs to be thrown out.
What should you do immediately after discovering you have made a medication error?
Ensure that the resident is okay and safe. Check vital signs and notify your supervisor/nurse on call for guidance.
STOP! Call the nurse on call to confirm the right dose.
A resident fell while getting ready for bed. They report they hit their head and now feel dizzy. What do you do?
Check if there are any open areas/bleeding and ensure resident safety. Stay with the resident, Call 911 so resident can go to ER for evaluation + check vital signs if time allows.
TRUE OR FALSE: You notice a resident has a bottle of multivitamins in their room when emptying trashes. It should be fine because it's just a vitamin and an OTC product. You should just take out the trash and let it be.
FALSE- alert the nurse on call.
You notice a residents dose changed on their Lasix. They are going from 20mg to 10mg per the EMAR and secure chat. You pull the med card and notice its 20mg tablets so you cut one in half to make 10mg so match the order/EMAR. Is this the correct procedure?
NO! Only RNs/LPNs can split pills! You should call the nurse on call for guidance if you notice this discrepancy during the med pass.
You notice a residents routine medication states "pending confirmation discontinue" in the EMAR. You don't see a secure chat about this change and the medication is still in the residents drawer. What do you do?
Call the nurse on call to verify if this is a true change or a pharmacy triggered order.
You receive a call from someone's doctor and they give you orders to give Mrs. Smith a dose of lasix and check her weight daily for 3 days. It's okay to give the med since the doctor told you to?
NO! Only the RN/LPN can take verbal orders from the doctor/healthcare provider!
What should you do after you administer an epi-pen?
Call 911! The person should go to the ER for evaluation.
You notice the narcotic count is incorrect during change of shift. What do you do?
No staff member can leave. Call the nurse on call or executive director immediately
Before giving a resident their PRN dose of Haldol, what should you do?
Review their written plan for psychoactive medication administration and attempt non-pharmacological interventions first. If ineffective, call the RN before giving any PRN psychoactive medication.
A resident refuses medication. What do you do next?
Ask the resident why they are refusing the medication and call the nurse on call for guidance.
A resident requests that their medications be crushed and put in chocolate pudding. She only takes 3 pills, can you just crush them and give them to her? Aspirin EC, APAP, and omeprazole DR cap.
NO- EC meds cannot be crushed. And neither can a DR capsule :)
Must get RN approval before CRUSHING meds.
Mr. Perry hits his call button- when you arrive to his room you notice a skin tear on her left arm that's about 2 inches long. Mr. Perry states he hit it on the doorway. What steps do you take next?
Grab wound care supplies. Follow standing orders for wound care- Clean area with NS wound cleaner, pat dry. Replace skin if able and present. Apply mepitel, cover with non-adherent dressing and tape. Alert nurse on call and fill out incident report.
Mr. Bill came to you stating he feels dizzy after skipping lunch. Knowing he is a diabetic, you check a finger stick glucose and it is 67. What do you do next?
Have the resident sit down to ensure safety. Check the EMAR/plan of care for treating his low blood sugar. Give 15g of carbs (can of OJ, glucose tablets, etc.) and recheck a Finger stick blood glucose in 15 minutes. Alert the nurse on call of the incident.
What should you check first if a resident states their oxygen "isnt working"
Check that the concentrator is turned on, tubing is connected and not kinked, and oxygen is flowing (stick the ends of the nasal cannula in a small cup of water and look for bubbles).