ADMINISTERING ORAL MEDICATIONS |
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口服給藥 |
Assessment |
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評估 |
1. Identify the drug(s) ordered: action, purpose, normal dosage and route, common side effects, time of onset and peak action, and nursing implications. |
1、確認藥物:作用、目的、正常劑量及給藥途徑、常見副作用、起效和藥峰時間、和護理含意。 | |
2. Assess for any contraindications to oral medication. |
2、評估是否有口服禁忌。 | |
3. Check allergies and replace any missing or faded identification bracelets. |
3、檢查過敏資料,補充遺失或替換退色的識別腕帶。 | |
4. Assess client's knowledge regarding medications. |
4、評估病人的藥物知識。 | |
5. Assess client's preferences for fluids. Maintain fluid restrictions as prescribed. |
5、評估病人液體喜好。按處方維持液體限制。 | |
Implementation |
實施 | |
1. Use Standard Protocol. |
1、按標準程序開始操作。 | |
Preparing medications |
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準備藥物 |
2. Compare medication administration record with scheduled medication list. If discrepancies exist, check against original physician orders. |
2、對照用藥記錄與藥物單。如有異議,應核對原始醫(yī)囑。 | |
Nurse alert: Review five rights. |
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注意:藥物“五對”。 |
3. Arrange cups in medication preparation area or move medication cart to position outside client's room. |
3、在藥物準備區(qū)備好杯子,或將藥車推到病房外。 | |
4. Unlock medicine drawer or cart. |
4、打開藥柜或藥車。 | |
5. Prepare medications for one client at a time. |
5、準備藥物,一次準備一個病人。 | |
6. Select correct drug from stock supply or unit dose drawer. Compare label of medication with MAR or computer printout. |
6、從備用藥或單位劑量抽屜中選擇所需藥物。 | |
7. Check drug dose. If label dose differs from ordered dose, calculate correct amount to give. |
7、核對藥物劑量。如標簽劑量不同于醫(yī)囑劑量,應算出正確劑量。 | |
8. To prepare unit dose tablets or capsules, place packaged tablet or capsule directly into medicine cup without removing wrapper. |
8、準備單位劑量藥片或膠囊時,直接將包裝好的藥片或膠囊放入藥杯,無需除去包衣。 | |
9. To prepare tablets or capsules from a floor stock bottle, pour required number into bottle cap and transfer medication to medication cup. Do not touch medication with fingers; return extra tablets or capsules to bottle. |
9、從原料瓶準備藥片或膠囊時,將所需藥物倒入瓶蓋,再轉到藥杯,勿使手指觸碰藥品。將剩余藥片或膠囊倒回藥瓶。 | |
10. Check the expiration date of each drug. Return all outdated drugs to pharmacy. |
10、核對每種藥物的有效期。將過期藥品退還藥房。 | |
11. Place all tablets or capsules requiring preadministration assessments (e.g., pulse rate, blood pressure) in a separate cup. |
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11、單獨放置需要進行藥前評估的藥品(如脈率、血壓)。 |
12. Medications that need to be broken in order to administer half the dose can be broken using a gloved hand or cut with a cutting device. |
12、需切半服用的藥物可帶手套用手掰開或用刀具切開。 | |
13. When preparing liquids, thoroughly mix before administering. Check and discard medications that are cloudy or have changed color: |
13、藥液:用前需搖勻。檢查并棄用混濁或變色藥品。 | |
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14. If giving less than 5 ml of liquids, prepare medication in a sterile syringe without a needle. |
14、如所給藥液少于5毫升,備藥時可使用無針頭注射器。 | |
Nurse Alert: EC or SR tablets may be available in liquid or suppository form. Crushing alters absorption rate. |
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注意:腸衣片或緩釋制劑有液劑和栓劑兩種,研碎后可改變吸收率。 |
15. Narcotic preparation. Check narcotic record for previous drug count and compare with supply available. |
15、麻醉藥品。核對用藥記錄,檢查以前 用藥數(shù)量及可用藥品。 | |
16. Sign out narcotics according to agency policy. |
16、根據(jù)醫(yī)院規(guī)定登記麻醉藥品使用情況。 | |
Administering medications |
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發(fā)藥 |
17. Take medications to client within 30 minutes before or after scheduled time. 醫(yī)學 全在.線提供gydjdsj.org.cn |
17、在預定給藥時間30min內(nèi)攜藥品至病人床前。 | |
18. Identify client. |
18、確認病人。 | |
19. Perform necessary preadministration assessment for specific medications. |
19、實施特定藥品的用前評估。 | |
20. Discuss the purpose of each medication and its action with client. Allow client to ask any questions about drugs. |
20、與病人討論每種藥品的用藥目的及其作用。允許病人詢問藥品相關問題。 | |
21. Assist client to sitting or side-lying position. |
21、協(xié)助病人取坐位或側臥位。 | |
Nurse Alert: Check ability to swallow if appropriate. |
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注意:檢查吞藥能力。 |
22. Administer drugs properly: |
22、正確給藥: | |
Nurse Alert: Decide on sequence of administration.
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注意:確定給藥順序。
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23. Stay until client has completely swallowed each medication. If concerned about ability or willingness to swallow, ask client to open mouth and inspect for presence of medication. |
23、確認病人服下全部藥物后方可離開。如擔心病人吞咽能力或不愿意吞咽藥物,應要求病人張嘴檢查口腔內(nèi)是否存有藥物。 | |
24. For certain medications that should not be given on an empty stomach, offer client nonfat snack. |
24、有些藥物不能空腹服用,服用時應向病人提供非脂肪食物。 | |
25. Replenish stock such as cups and straws, return cart to medicine room, and clean work area. |
25、補充備用品,如藥杯和吸管。推車返回藥房,清潔工作區(qū)。 | |
26. Use Completion Protocol. |
26、按標準程序完成操作。 | |
Evaluation |
評價 | |
1. Return within appropriate time to determine client's response to medications. |
1、及時返回病房確定病人對藥物的反應。 | |
2. Evaluate client's learning needs. |
2、評價病人學習需要。 | |
3. Identify Unexpected Outcomes and Nursing Interventions |
3、確認意外結果和護理措施。 | |
Record and Report |
記錄和報告 | |
1. Actual time given and signature according to agency policy. |
1、按醫(yī)院規(guī)定登記實際給藥時間及簽名。 | |
2. Drugs withheld and reason. |
2、停用藥物及理由。 | |
3. Adverse effects/client response. |
3、不利效應及病人反應。 |