cognitive domain
involves learning and storing knowledge
affective domain
involves feelings, needs,values and opinion
psychomotor domain
involves learning new skills
kardex
large index-type card usually kept in a flip file or a separate holder that contains pertinent information
unit
dose systems not listed on kardex
single
unit package of drugs dispensed into labeled drawers assigned to paitents
advantages
- less prep time by nurses
- pharmacy review
- less wastage
disadvantage
pharmacy, not nurse, prepares some medications
long term care unit-dose system
each residents medication containers is filed for 1 week
disposal of unused medicine
do not flush prescription drugs into toilet (unless instructed by manufacturer)
if no instructions are given, throw in trash
medication orders
- start order: emergency use
- single order: one-time use
- standing order: given for specific number of doses
- prn order: administer as needed
- verbal orders: avoid whenever possible
- electronic transmission of patient orders
high alert medicatins
- insulin
- heparin
- opioids
- potassium in injectable
- neuromuscular blocking agents
- chemotherapeutic agents
medication reconciliation
- develop list of current meds being administered
- develop list of meds that were prescribed
- compare medications on the two lists
- make clinical decisions on the basis of comparison
- communicate new list to appropriate caregivers and to the patient
nurse responsibilities
- verification
- transcription
- verifying orders transcribed by others
- reporting variance
the seven rights
- right drug
- right indication
- right time
- right dose
- right patient
- right route
- right documentation