A nurse is reviewing the medication administration record of a

A medication administration record is a track record of a drug owned by a patient given by a doctor. Medical administration record or MAR is made in chart form and kept by the hospital. But the patient also has the right to request a copy of the drug record if at any time need it as part of treatment even though no longer in the hospital. This medical administration record is made in the form of a document file that is on the computer. MAR is usually held by nurses because they are the person who accompanies the patient's treatment process.

To be able to fill in the MAR document several procedures are required. You can't fill it carelessly. First, you have to make sure the patient has taken the medicine in accordance with the dose and time prescribed by the doctor.

After that, you can fill out the patient's medication administration document. That way is so that the data in the MAR in accordance with the treatment received by the patient. Because if something happens to the patient, it can be seen from the MAR it has. A MAR record consists of a chart of the details of the patient during treatment.

The first is the patient's identity that is a full name, date of birth, weight, and things that need to be known about the patient when reacting to the drug for example allergies to certain compositions.

After having the data from the patient, there will be a record between the patient and the drug consumed. Make sure your MAR is always up-to-date on the patient's condition. Because if not, the hospital will get into trouble if it does not know the progress of the treatment experienced by the patient.

In order to have a medication administration record template, you can search for it on the internet. There are various attractive designs that are owned so you don't get bored when you have to keep using it.

After completing the design, you only need to click on the download button on the screen. Make sure that when using MAR you are trained as a professional in treating patients. So the MAR template provided on the internet is not used for evil purposes.Page 1.

a nurse is reviewing the medication administration record of a

You must be logged in to post a comment. When administering heparin subcutaneously, the nurse should A Aspirate after injection B Aspirate before the injection C Vigorously massage the site D Never aspirate Ans: D Feedback: When administering heparin subcutaneously, never aspirate before administration.

When the nurse administers the morning dose of a medication during the evening, which of the rights of medication administration has she failed to follow? Childrens medication dosages are most often calculated using the childs body surface area and A Age B Diagnosis C Height D Weight Ans: D Feedback: Childrens dosages are most often calculated using the childs weight or body surface area. A severe allergic reaction from a medication requires A Asprin B Atarax C Dopamine D Epinephrine Ans: D Feedback: A severe allergic reaction, called an anaphylactic reaction, requires immediate medical intervention because it can be fatal.

Treatment includes discontinuing the medication and administering epinephrine, IV fluids, and antihistamines.

Following an allergic reaction to a medication, the nurse should A Instruct the patient to wear an identification addressing the allergy B Instruct the patient to be sure the allergy is on his medical record C Inform the patient that an allergic reaction can be transient D Inform the patient that the medication may cause an allergy only one time Ans: A Feedback: Allergic reactions result from an immunologic response to a substance to which the patient is sensitized.

The patient should wear identification noting the medication to which the patient is allergic. When the patient demonstrates a rash 30 minutes after she has taken a dose of penicillin, the nurse recognizes that the patient is likely demonstrating which type of drug reaction?

Which of the following patients is likely to have altered metabolism of medications? Metabolism takes place in the liver. Alterations in liver function, including decreased functions that occurs with aging or disease, affect the rate at which drugs are metabolized. What is involved in the absorption, distribution, metabolism, and excretion of medication?

The physiologic and biochemical effects of a drug on the body defines A Pharmacology B Pharmacotherapeutics C Pharmacokinetics D Pharmacodynamics Ans: D Feedback: Pharmacodynamics refers to the physiologic and biochemical effects of a drug on the body.

The process by which a drug moves through the body and is eventually eliminated is A Pharmacology B Pharmacotherapeutics C Pharmacokinetics D Pharmacodynamics Ans: C Feedback: Pharmacokinetics is the process by which a drug moves through the body and is eventually eliminated. In administering medications, the five rights include patient, drug, route, and time. What is the fifth right? If the dosage is inappropriate for a patient, who is responsible?

A Physician B Pharmacist C Nurse D Medical technician Ans: C Feedback: Whereas physicians and other healthcare providers prescribe and pharmacists dispense therapeutic agents, it is the nurses legal domain to administer medications in a safe and timely manner. According to the nurse practice act, the nurse is liable for A Writing a physician order B Clarifying a physician order C Administering what is written D Determining the dosage Ans: B Feedback: The nurse is responsible to determine if the medication order is ambiguous or inappropriate.

The nurse must clarify the medication order with the prescribing healthcare provider. Regarding medication administration, what must occur at the change of shifts?In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of medication administration in order to:.

Clients and significant others should be taught about all aspects of the medications that they are taking. The content of this teaching and education should minimally include:. The client should be educated about the safe and correct method of self administration of medications. In addition to the education discussed immediately above, some clients may also have to be instructed about special procedures like the proper use of an inhaler, taking insulin, mixing insulins, giving oneself an intramuscular injection or self-administering tube feedings.

In addition to the Ten Rights of Medication Administration and identifying the patient using at least two unique identifiers, nurses must also insure medication safety in respect to the storage of medications, the checking for expiration dates, checking for any patient allergies, and checking for any incompatibilities.

Nurses must use at least two 2 unique identifiers, other than room number, prior to all procedures including the administration of medications. Some examples of unique identifiers include the client's first, middle and last name, a unique password or code number assigned to that person upon admission, the client's complete birthday in terms of the month, the day and the year, a photograph, and an encoded bar code containing two 2 or more unique identifiers.

Additionally, medications that need refrigeration must be refrigerated. The risk factors associated with medication errors and other medical errors such as wrong patient or wrong site surgery are discussed below:. Developmental disorders : The same concerns and interventions described above for infants and children apply to those with developmental disorders, as specific to the degree of their developmental delay.

Some psychotropic medications have sedating effects and the client may be delusional and out of touch with reality. Infants and children : These young children are at risk for medication errors because they are not able to ask questions about medications and procedures; they may not even be able to state their name. The support and presence of the family is one way to prevent medication errors among this high risk population. Language barriers : People with language barriers may not understand what you are saying or asking and, you may not know what they are saying or asking you in another language, therefore, the use of interpreters, family or friends, pictures and drawings should be used to overcome a language barrier.

Cognitive impairments : Clients who are confused, disoriented, demented or with delirium are at risk for all types of errors because of the challenges associated with accurate patient identification and the hazards of impaired cognition. Again, patient identification is highly important, and it is also beneficial to communicate with the client in a way that is understandable to them using pictures and drawings and to encourage the participation of the significant other s in all aspects of care.

Decreased levels of consciousness : Patients who are not alert, awake and oriented to time, place and person are also at high risk. Sensory disorders : Assistive devices, such as eyeglasses and hearing aids, must be consistently provided to the sensory impaired person in order to protect their safety. Additionally, the use of large print or Braille reading materials and magnifying glasses may be helpful for the visually impaired; and speaking loudly while facing the patient with an auditory impairment may offer some protection against medication errors.

Medications are manufactured for various routes of administration and in different forms. These forms are:. The oral route of administration is the preferred route of administration for all clients but the oral route is contraindicated for clients adversely affected with a swallowing disorder or a decreased level of consciousness.

Oral medications can, at times, be crushed and put into something like apple sauce, for example, for some clients who have difficulty swallowing pills and tablets, but, time release capsules, enteric coated tablets, effervescent tablets, medications irritating to the stomach, foul tasting medications and sublingual medications should not be crushed.

An alternative route for some clients is a liquid form of the medication. Nurses must, therefore, begin a new medication with the lowest possible dosage and then increase the dosage slowly over time until the therapeutic effect is achieved. Prior to the administration of medications, the nurse must check and validate the medication order, and also apply their critical thinking skills to the ordered medication and the status and condition of the client in respect to the contraindications, pertinent lab results, pertinent data like vital signs, client allergies, and potential interactions of the medication that is to be given.

A complete medication order must include the client's full name, the date and the time of the order, the name of the medication, the ordered dosage, and the form of the medication, the route of administration, the time or frequency of administration, and the signature of the ordering physician or licensed independent practitioner's signature.

The four general types of medication orders are stat orders, single orders, standing orders and prn orders. Stat medication orders are administered immediately and only once; single orders are also given only once but not necessarily immediately; a standing order is an order for a medication that will be given at specific times until it is discontinued by a doctor's order or by default when a facility's policy states that all standing orders are automatically discontinued after 7 days unless the physician has reordered the medication.

A prn order indicates that the ordered medication is only given when a specified condition, like pain or nausea, is present.

This questioning and validation requires that the registered nurse use, integrate and apply their critical thinking and professional judgment skills. Automated order entry using a computer eliminates some medication order errors including those that result from illegibility of handwriting and ordering a medication with which the client is allergic to, however, nurses should never assume that this is the case. For example, medications that have sound alike names and medications that are similar in terms of their correct spelling can remain at risk even when computerized, automatic order entry is used.

Medication orders are often transcribed by hand onto a medication administration record MAR or Medex, when the facility is not using computerized order entry.

The client's allergies are determined, all contraindications for the medication as based on the client's health problems and disease conditions are determined, pertinent diagnostic laboratory results such as checking the client's prothrombin time and partial thromboplastin time prior to the administration of heparin, client data like a blood pressure and a pulse rate prior to the administration of an antihypertensive medication and digoxin, for example, are assessed and any possible interactions with other medications, foods and alternative and over the counter preparations are assessed in order to determine whether or not the medication should be administered.

The doctor must be notified whenever the nurse has any concerns or problems with these things. Medications can only be mixed together when they are compatible with each other.Colleague's E-mail is Invalid. Your message has been successfully sent to your colleague. Save my selection. The author has disclosed that she has no financial relationships related to this article.

The process of medication delivery includes several components: prescribing, transcribing, dispensing, administering, and monitoring. One-third of all medication errors occur during the administration phase of medication delivery. Nurses need to recognize the challenges they face when administering medications to their patients. Because nurses consistently administer medications, they're well positioned to prevent medication errors. This article defines medication errors and near-miss events, explores human and environmental factors contributing to medication administration errors, and discusses the nurse's role in minimizing errors.

Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use.

Intercepting a medication error before it reaches the patient is an example of a near-miss event. Often nurses aren't aware that a medication error or near-miss event has occurred.

This contributes to the inability to change key aspects of a complex medication delivery system. Medication administration errors are the subject of much research.

Medication administration errors are underestimated and underreported. Explanations for underreporting include a lack of awareness that a medication error has occurred, unfamiliarity with medication administration error reporting processes, fear of legal ramifications, and fear of being perceived as incompetent.

About half of nurses are reticent about reporting medication errors because they fear disciplinary action. A stigma is associated with making an error, and nurses perceive they'll be a target for repercussions if they admit to making a mistake. For instance, the error could have a negative impact on the nurse's performance evaluation.

a nurse is reviewing the medication administration record of a

Decades ago, Leape recognized this paradox in healthcare: The standard of practice in medicine and nursing is perfection—even though medical professionals acknowledge that mistakes are inevitable and most want to learn from these mistakes, ideally in an understanding and supportive environment.

Reason used a Swiss cheese model to represent accident causation and illustrate how an error can slip through despite overlapping system defenses and safeguards.

a nurse is reviewing the medication administration record of a

However, safety gaps exist, and when gaps line up, errors occur. Unless a pattern of errors or evidence of reckless behavior occurs, a single event shouldn't warrant disciplinary action or termination.

In order for nurses to learn from their mistakes, they must be willing to disclose them; this in turn improves practice and ensures a safer patient care environment.

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Furthermore, not reporting errors sets up other nurses to make errors and fails to improve the system. Policies and procedures for medication error reporting should provide clear definitions for medication errors and near-miss events, and a means for delineating contributing factors, such as staffing and environmental conditions.

A system for reporting and analyzing medication errors should be implemented in an efficient and user-friendly manner. Integrating pharmacokinetic and pharmacodynamic principles into clinical practice is essential for patient safety. Understanding the onset, peak, and duration of medication effects encourages timely medication administration and helps prevent the possible accumulation of adverse reactions.

For example, knowing the rates of infusion for I. Being familiar with nursing implications for the medications nurses administer is critical for improved patient outcomes.

For example, before administering furosemide, a nurse must check the patient's potassium level because furosemide is a potassium-wasting loop diuretic.

Lung sounds should be assessed before amiodarone administration. An apical heart rate must be obtained before administering digoxin. The patient's BP must be assessed before administration of any antihypertensive medication.

If the nurse isn't familiar with a specific medication, many resources are available, including comprehensive drug guides. Hospitals commonly have electronic databases for medications. Smart phone users can consult drug reference applications to research unfamiliar medications.A Medication Administration Record [1] MARor eMAR for electronic versionscommonly referred to as a drug chartis the report that serves as a legal record of the drugs administered to a patient at a facility by a health care professional.

The MAR is a part of a patient's permanent record on their medical chart. The health care professional signs off on the record at the time that the drug or device is administered.

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The actual chart varies from hospital to hospital and country to country. However they are typically of the format:.

A kardex plural kardexes is a genericised trademark for a medication administration record. In the Philippinesthe term is used to refer the old census charts of the charge nurse usually used during endorsement, in which index cards are used, but has been gradually been replaced by modern health data systems and pre-printed charts and forms. From Wikipedia, the free encyclopedia. This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources.

Unsourced material may be challenged and removed. Elsevier Health Sciences. Retrieved Categories : Medical records. Hidden categories: Articles needing additional references from May All articles needing additional references. Namespaces Article Talk. Views Read Edit View history. Help Learn to edit Community portal Recent changes Upload file. Download as PDF Printable version. Add links.New York City schools offer many health services to support student health. School physicians and nurses conduct physical exams and help manage the health of students with health issues like asthma, allergies and diabetes.

Students with health issues and disabilities can receive prescribed medicine, skilled nursing treatments and Accommodations in school. Office of School Health nurses and physicians are dedicated to improving the health of New York City students. Click below to read the services each can offer your child:. Ninety percent of all New York City public schools have school nurses. Our school nurses are actively involved in school health programs. School nurses:. Our school physicians are board-certified or board-eligible physicians.

They provide care in a select number of public and private schools in New York City. School physicians:. Help your child feel healthier and more comfortable during the school day.

If your child has a health condition, they may benefit from taking prescribed medicine at school or a skilled nursing treatment. Ask if taking medicine at school or a skilled nursing treatment would help your child better manage his health condition. Applying for your child to take medicine at school or getting a skilled nursing treatment is easy:.

We offer three different levels of supervision while your child is taking medicine.

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Your child will be assisted by a trained adult. For example, if your child asks, the staff member may help open bottles, pour liquid or assemble a nebulizer. Your child will give themselves medicine without any help. For rescue medicines, like those needed for asthma, diabetes, and allergies, your child will carry the medicine with them during the school day.

a nurse is reviewing the medication administration record of a

This option is best for students who can consistently take their medicine correctly on their own. Controlled substances must be kept in the school medical room.

Large school buildings have additional units installed throughout the building. High school coaches are required to take portable AEDs to all games and practices. While these are accepted on a rolling basis, we recommend submitting them by May That way your child will have no break in access to their medication.

If your child has asthma, your school will provide free Flovent and Albuterol. You must bring any other medical equipment, prescription and over-the-counter medicine that your child may need.

For safety reasons, medicine and medical equipment are generally stored in the school health office. Independent students may carry their rescue medicines with them.

All prescribed controlled substances are stored in the school health office.The nurse literally plays the role of a lifeguard in medication administration. She often provides the last opportunity for the health-care team to identify and correct errors in prescribing and distributing medication. Although the physician prescribes the medication and the pharmacist fills the prescription, the nurse usually administers the medication.

She is the last link in medication administration and a safeguard against error. The medication administration record MAR is based on the physician's order and provides the information the nurse needs to administer medication.

Prior to administering medication, the nurse verifies the patient's identity. The "Journal of Continuing Education in Nursing" reports that "patient misidentification continues to be the root cause of many errors.

She compares the patient's wristband identification with a written document such as a MAR or physician's order. Alternately, the nurse may ask the patient to state his name and birthdate and match the information to the patient's wristband. In safely treating the patient, the nurse observes six patient rights, ensuring that she administers the right medication, in the right dosage, to the right patient, at the right time, via the right route, in accordance with the physician's orders.

She completes the process with the right documentation. In addition, before a nurse administers medication, she references the action and expected effect of the drug. She monitors the patient and reports any adverse reactions to the medication. Health-care providers prescribe and administer medication according to a medication distribution system. The health-care team works together to identify and prevent errors in the system.

The nurse verifies medical calculations with a colleague and consults the prescribing physician or her nursing supervisor if she suspects that a prescribed dosage of medication is unsafe. The nurse also identifies prescribed medications, over-the-counter drugs, and client allergies that can interfere with the physician's recommended drug therapy.

She gathers data pertaining to the patient's medical history and compares it to the MAR to identify incompatible drug combinations or possible allergic reactions to medication. Medical facility guidelines also ensure six rights of the nurse. The nurse has the right to legible, clearly written medication orders that specify the dosage, route, and time for medication administration.

The nurse also has the right to receive the correct form of the drug from the pharmacist and to access information about the drug. She has the right to report problems in the medication system, to halt the administration process if she identifies an unsafe condition, and she has the right to work in a medical facility that provides guidelines and policies for safe administration of medication. Miriam Breeze, a freelance writer sinceis a year Marine Corps veteran and was a merchant mariner for five years.

She specializes in health care topics and has published articles on eHow. She has a Bachelor of Science in nursing from National University and a California registered nursing license. Share It. About the Author. Copyright Leaf Group Ltd.


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