SAFETY AND INFECTION CONTROL
a. ACCIDENT/ERROR/INJURY PREVENTION
i. SAFE MEDICATION ADMINISTRATION AND ERROR REDUCTION:
ADMINISTERING PHENYTOIN
1.
... [Show More] Undesirable interaction is giving omeprazole, a proton pump
inhibitor, concurrently with phenytoin, an anticonvulsant. This can
increase the serum level of phenytoin. Obtain a complete
medication history, and be knowledgeable of clinically significant
interactions. Be aware that medications can also interact
beneficially or harmfully with food and with herbal and dietary
supplements
ii. ANTIBIOTICS AFFECTING THE BACTERIAL CELL WALL:
PRIORITY FINDING AFTER A PENICILLIN INJECTION
1. Instruct clients to take penicillin V, amoxicillin, and
amoxicillin-clavulanate with meals. Tell them to take all others
with 8 oz of water 1 hr before or 2 hr after meals. Instruct clients to
report any signs of an allergic response such as dyspnea, a skin
rash, itching, and hives. Give IM injections cautiously to avoid
injecting into a nerve or an artery. Advise clients to complete the
entire course of therapy, even if symptoms resolve. Advise client to
use an additional contraceptive method when taking penicillin’s.
iii. REPORTING OF INCIDENT/EVENT/IRREGULAR
OCCURRENCE/VARIANCE
1. SAFE MEDICATION ADMINISTRATION AND ERROR
REDUCTION: PRIORITY ACTION FOR INCORRECT
MEDICATION DOSAGE
a. Use a unit-dose system to decrease errors. If not available,
calculate the correct medication dose. Check a drug
reference to ensure the dose is within the usual range.
When performing medication calculations or conversions,
have another qualified nurse check the calculated dose.
Prepare medication dosages using standard measurement
devices, such as graduated cups or syringes. Some
medication dosages require a second verifier or witness,
such as some cytotoxic medications. Automated medication
dispensing systems use a machine to control the dispensing
of medications.
2. SAFE MEDICATION ADMINISTRATION AND ERROR
REDUCTION: INDENTIFY A SITUATION REQUIRING AN
INCIDENT REPORT
a. Report all errors, and implement corrective measures
immediately. Complete an incident report within the time
frame the facility specifies, usually 24 hr. This report
should include
■Client’s identification
■Name and dose of the medication
■Time and place of the incident
■Accurate and objective account of the event
■Who you notified
■What actions you took
■Your signature (or that of the person who completed the
report)
Do not reference or include this report in the client’s
medical record. Medication errors relate to systems,
procedures, product design, or practice patterns. Report all
errors to help the facility’s risk managers determine how
errors occur and what changes to make to avoid similar
errors in the future.
3. MISCELLANEOUS CENTRAL NERVOUS SYSTEM
MEDICATIONS: TREATMENT FOR MUSCARINIC
POISONING
a. Extreme muscarinic stimulation can result in increased
gastric acid secretion, abdominal cramps, diarrhea,
sweating, tearing, urinary urgency, bradycardia and
hypotension; bronchoconstriction
b. NURSING CONSIDERATIONS ●Instruct clients to report
adverse effects if they occur. Monitor for bradycardia and
hypotension. ●Administer on an empty stomach to reduce
effects.
2. PSYCHOSOCIAL INTEGRITY
a. CHEMICAL AND OTHER DEPENDENCIES/SUBSTANCE USE DISORDER
i. SUBSTANCE USE DISORDERS: TREATMENT FOR COCAINE
TOXICITY
1.
3. PHARMACOLOGICAL AND PARENTERAL THERAPIES
i. ADVERSE EFFECTS/CONTRAINDICATIONS/SIDE
EFFECTS/INTERACTIONS
1. MYCOBACTERIAL, FUNGAL, AND PARASITIC
INFECTIONS: INTERPRETING SIDE EFFECTS OF RIFAMPIN
a. Rifampin accelerates metabolism of warfarin, oral
contraceptives, protease inhibitors, and non-nucleoside
reverse transcriptase inhibito
rs (NNRTIs) for HIV, resulting
in diminished effectiveness. [Show Less]