Medicine Management Skills for Nurses. Claire Boyd

Medicine Management Skills for Nurses - Claire  Boyd


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about complementary medication? As well as a nurse/nurse educator, I am also a complementary therapist and I am surprised at the number of individuals taking ‘natural’ remedies and not being aware of their interactions with more mainstream medications: Anticoagulants may react with ginseng, ginkgo Biloba (for improved memory and brain circulation) and should be discontinued 36 hours prior to surgery. Other complementary remedies that need to be considered in the conventional healthcare environment are:

       Homoeopathic remedies – individuals may be advised to avoid coffee, peppermint, or menthol as these substances may counteract the effect of the homoeopathic remedy.

       St. Johns Wort – which is often used to treat depression, may be harmful for individuals with bipolar disease as it may induce mania.

       Liquorice root – should be avoided for those with chronic heart failure and those with hypertension.

      

Complementary medicine

      A broad term used to describe medicines used in conjunction with conventional medicine.

      Alternative medicine

      A broad term used to describe medicines used instead of conventional medicine.

Osteopathy Chiropractic Acupuncture
Herbal medicine Homoeopathy Aromatherapy
Alexander technique Massage Counselling and mindfulness
Iridology Stress therapy Hypnotherapy
Reflexology Shiatsu Meditation
Relaxation therapy Thermal auricular therapy Traditional Chinese and Ayurvedic medicine
Crystal therapy Colour therapy Kinesiology

      Drug Administration Routes

      When administering medications, we also need to be completely conversant with the mode of administration, or route. A very sad case involved a young boy called Wayne Jowett who died as a result of being given his medication intrathecal ‘ITH’ instead of intravenously (which is written as ‘IV’).

      If you saw the route written as ‘ITH’ on a prescription chart, what do you think this would mean? Let's look at this and other abbreviations that you may encounter.

      

Activity 1.3

      Here is a list of abbreviations for routes of drug administration. Can you work out what they mean?

1 ITH 4 IV 7 INH
2 SC 5 IM 8 NEB
3 ID 6 O 9 TOP

      

In many NHS Trusts, very few abbreviations are permitted to be used on a drug chart: subcutaneous (SC), intramuscular (IM), IV, O, nebulisation (NEB), topical (TOP), and inhalation (INH). Everything else has to be written out in full so that mistakes don't get made.

      Keeping Updated

      As well as being conversant with the route abbreviations, if we are administering drugs we need to keep ourselves updated about changes to drug names, as well as contraindications.

      Paracetamol (derived from coal tar; also known as acetaminophen) can now be given by the intravenous route, but is obviously much more expensive than oral paracetamol and has a shorter half‐life. This means that it is less effective over a longer time span and, as pain is considered to be the fifth vital sign, we need to be aware of this when keeping our patients comfortable and pain free.

      Single‐Nurse Administration

      In most adult hospital settings, it is one nurse who administers the medications to the patients. This is considered to be the safest option as it thought that the lone nurse will take extra care due to their sole responsibility. The exception to this is often injected drugs and controlled drugs, whereby two nurses check and sign for the drug and go to the patient's bedside together to administer the drug.

      When there are any calculations or working out to do, two nurses should also check their workings out to agree on the correct answer and dose that the patient requires.

       Neonates (up to one month)

       Infants (up to one year)

       One to six years of age

       6–12 years of age

      

Paediatric patients

      These patients are infants, children, and adolescents.

      One of the special safeguards the paediatric clinical areas often have in place is that two nurses have to check and sign the prescription chart. One of these should be a Registered Paediatric Nurse.

      Question 1.4

       Other than paediatric patients, who may be considered as another


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