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